By OLGA PATRICIA RENDÓN M.
Health reform could deal a death blow to these voluntary plans,
that do not subsist without the EPS. Unions warn that informality would be encouraged.
The companies and unions in the sector are concerned, not only because as a result of the health reform there is a latent possibility that the Health Promotion Companies, EPS, will disappear, but also that other services that are tied to them will do so.
These are prepaid medicine and complementary health plans, which allow their affiliates to have additional services to the traditional Benefit Plan.
According to calculations by the unions of the EPS and Fasecolda (the insurers), in Colombia 4.7 million people take out some type of voluntary health plan, but many will not be able to pay for them if the EPS run out, as they would put a lot of more expensive.
Paula Acosta, executive president of the Colombian Association of Comprehensive Medicine Companies (Acemi), warned that, particularly, the elimination of these figures will not only slow down access to basic health systems for citizens, but also foresees that the expenses for families increase, as well as prepaid medicine rates.
“Due to the lack of coordination of consolidated plans in the current system, they would be left without a basis to function. The complementary plans in which there are more than a million users cease to exist, and it is foreseeable that prepaid medicine will rise in price, since there will be no coordination between these plans and the public health system”, affirmed Acosta.
This would mean a price increase for the logistics of patient care attached to an official system, but with the needs of an additional plan.
In addition, in the event that the EPS runs out, many families and people would be left unprotected in terms of health, so they would resort to a prepaid system, which would increase demand and increase the prices of these services.
From the Government there is no consideration with the users of the voluntary plans, the reform says: “Private companies whose corporate purpose is the sale of prepaid or voluntary health plans may continue to operate and market their services, under the rules and regulations of operation, financing and provision of services that govern them. Plan and insurance subscribers will not have any priority when using the Health System, to which they are entitled.
Rather, whoever wants to pay should pay for the service that the insurer can offer, but outside of the public system that is going to start operating little by little.
On the other hand, if there is no difference between paying the contribution to the health system and not doing so, because care will be received from the State in the same way, there would be no incentive for formalization.
The reform tries to settle this issue when it speaks of the “mandatory nature of contributions” which indicates that “contributions to the Health System are mandatory for all workers, employers, pensioners and capital rentiers except for what is established in this law ”, but where are the independents? The independents, like the contractors, appear later when he talks about the contributors of the system, but they no longer have the burden of obligation. “Every labor contract will include the costs of the contribution,” reads the text of the reform.
Luis Hernán Sánchez, executive president of Aesa, the union of public hospitals in Antioquia, explained that this reform could become a perverse incentive for informality: “What need would an independent have to join the health system and pay their contributions, if you will finally receive the same service that will be universal? The payment would only be made by employees formally linked to a company, ”he said.
In that same sense, he spoke of the difficulties that insurers would go through to support additional services such as complementary plans, since they would lose that “complementary” quality because the basic services would not be covered by them.