The counterproposal of the parties Conservative, Liberal and ‘la U’ to the health reform of the government of President Gustavo Petro has at least 40 articles -on Monday night its construction continued- and will be presented this Tuesday to the Executive, which has before it a clear political and governability dilemma.
This is the crossroads for the President: either he does not accept changes in the most critical points of Minister Carolina Corcho’s project and is exposed to running out of the support of three forces whose votes it needs in Congressor give in to some of the most radical changes -such as the virtual end of the EPS- and in any case adjust a first blow to the axis of their proposals for social change.
(You may be interested in: ‘Without modifications, the text of the reform does not pass’: Miguel Uribe)
ELTIEMPO learned of the articles that have been discussed by the heads of the three parties, which are part of the pro-government coalition and have warned that if the Government does not take into account its articles they would leave with an independent proposal that would be added to those already presented by Cambio Radical and the Democratic Center.
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The Government has to define whether to go with the radical proposal of Minister Carolina Corcho -which would imply that would be left without 38 votes in the Senate and more than 70 in the Chamber– and it does not reach the necessary majorities to approve the reform or if it gives in and agrees to build a consensual proposal that, as the three parties have said, does not destroy what was achieved by Law 100 of 1993 and corrects various flaws that persist in the System.
The axis of the project that will be handed over to the President once the benches endorse it keeps the EPS alive, which the parties now propose to call ‘Health and Life Management Entities’ and which might be of an official, private or mixed nature, as in the present. But unlike the Government’s project, which minimizes the current functions of the EPS, that of The three parties maintain the function of “intelligently managing the health risks of people and communities where they operate and who select them.
(Also read: “President Petro threatened Congress and the division of powers”: David Luna)
That is, the EPS -now ‘Health and Life Managers’- they would continue to retain affiliates, albeit prioritizing, as the Government proposes for the entire System, a “highly responsive care at the primary or basic level, close, focused on the user and the place where they live and work, above market considerations”. In this primary care, the CAPs (Primary Care Centers) proposed by the Government would play a basic role.
However, there is a key difference with Cork’s proposal: people would not have to register and agree to be cared for in the place provided by the Governmentbut users “shall have the right to freely choose the Health and Life Management Entity of your choice, within the offer available in the respective region”. And also, as is the case today, the user “can move at any time”. You can also “choose the treating doctor of your choice” within the Network of the Management Entity.
The Government’s proposal has been criticized because it limits that choice.
(Also: The uncomfortable position in which ministers critical of the reforms are left)
Another key change, in a similar vein to what the Government is proposing, is the elimination of the subsidized and contributory regimes and the creation of a single health regime highly focused on user care.
A key adjustment is that the EPS would not handle, as is the case today, the payment to Service Provider Institutions (such as hospitals), but that function would pass to ADRES.
But once more they depart from the official proposal by denying the possibility that the regional authorities have almost total control of health in their areas. They do not want “bureaucratization” or increase the risks of corruption and that is why in their amending proposal they eliminate the regional control figures posed by the Executive.
It may interest you:
– How is the confidence in the Cabinet following the leak of the health document?
– Fiscal impact of this reform is very low: Minister Corcho responds to document
– Ministry of Health classifies the financial situation of the EPS: what is yours?
MATTHEW GARCIA
POLITICAL WRITING
