In the bill you seek reform health in Colombia there are figures of what some of the changes that the Government wants to make would cost; however, there is still uncertainty about the total cost.
In it Treasury They will ensure that they will release these numbers. At the moment, what is expressed in the project is that it will be financed taking as a starting point the resources allocated to the system in 2023 and that additionally the Government will make an effort aimed at strengthening primary care and strengthening the public hospital network.
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It must be taken into account that today the Directorate manages 95 percent of health resources and that these are about 80 billion pesos. The main source of financing is the General Budget of the Nation, which for this year contemplates 50.2 trillion pesos.
As the director of the Directorate told EL TIEMPO, Felix Leon Martinez, with this reform the weight of public spending on health would increase from 5.4 to 5.7 points of GDP. “Investment expenses in infrastructure and sanitation of public hospitals are not considered here, which will have an additional cost,” he said.
Address as sole payer
The health reform that was filed this Monday by the Government of Gustavo Petro contemplates that the Administrator of the Resources of the General System of Social Security in Health (Address) works as a single payer. This entity would be in charge of receiving all the resources of the sector and turning them directly to the providers, be they hospitals and EPS, among others.
The concentration of the management would be based on the conformation of seven regions that would contract the network and would have the budget estimate to order the payment of services and 32 departmental offices, which would receive and audit in the first instance both medical bills and disabilities and licenses, in addition to the Soat, which is currently centrally audited.
The central expense of the Directorate and its reorganization have a cost, which according to the project it could reach 1.01 trillion pesos, as a more viable option, if the validation of the accounts is done with intelligence systems and not manually, as has been done traditionally.
These resources include a payroll of 819 people, which would cost 95,180 million a year, in addition to the costs that the installation and operation of the offices could have. Likewise, the investment in software and platform development is taken into account, which would support the greater technological development and analysis capacity.
However, if the audit is manual, the cost could reach 3 billion pesos, according to the specification in the bill.
To estimate the costs, the calculations that contemplate the reform are based on the need to review and recognize an average of 3 specialized and hospital care per citizen per year, which in turn include a group of services as an integral part of care.
The estimate of the reform supposes 156 million medical accounts that must be audited and recognized annually in the 32 departmental offices and the Special District; Finally, it will approve and order the payment by the Regional Social Security Funds, which in turn will request the respective transfers to the Directorate.
Radical government in Congress the health reform.
How much does infrastructure investment cost?
In order to develop a preventive, predictive and problem-solving care model, based on primary care that facilitates access in rural areas, the reform proposes an intervention strategy in infrastructure, equipment and technology to strengthen the public network for the provision of services services.
Specifically, he talks about transforming the Health Centers and Posts in Primary Care Centers of the State Health Institutions. The idea is to have one center for every 20,000 inhabitants.
In addition to this, it is contemplated to intervene in the hospital infrastructure to expand the installed capacity, improve the offer of services, innovation in the endowment and strengthen the strategies of telehealth and telemedicine, among others.
In total, infrastructure costs are projected to be 1.67 trillion pesos by 2023. For Primary Care Centers 663,638 million pesos would go, for level 1 intramural hospital infrastructure around 200,000 million pesos, for level 2 and 3 another 510,000 million pesos and for the national 300,000 million pesos.
This cost would amount to 4.04 trillion pesos in 2024, would rise to 4.2 trillion pesos in 2025, and would be 1.4 trillion pesos in 2026. Four years from now, it adds up to 11.3 trillion pesos. pesos
Investment for the information system
The reform also proposes creating a unique, public, transparent information system, available online, which, using the latest Big Data technology resources and digital image processing, allows the recovery of the maximum amount of economic, clinical, scientific, technological, technical, and administrative information. . The main element should be the single clinical history.
For this, the bill contemplates resources for 73,000 million pesos.
Primary benefit costs
The bill says that the total value of the cost of providing primary services for the Colombian population for 2023 was estimated at 24.86 trillion pesos, based on the per capita value paid for the provision of primary health services in Public hospitals.
This cost will be prolonged taking as a reference the per capita value in public hospitals for 2023 of the provision of primary health services, for a target population of 17.3 million people, whose total cost is 8.79 trillion pesos and the per capita value per year is 508,232 pesos.
Cost of health workers
The project also says that health workers must be formalized, abandon labor intermediation and the violation of rights and that for this 9 billion pesos are required.
Capitalization of the New EPS
The articles propose a capitalization of the new EPS. However, the document states that this will not be a cost attributable to the reform, since it was included in the Development Plan and is due to the need, in any case, to strengthen this institution in any scenario.
The New EPS, which currently has 5 million affiliates in the contributory regime and 5.3 million in the subsidized regime, could have 11.5 million people in the short term.
