Copays and moderating fees generate disagreement

Elizabeth R. Rojas

LA PATRIA I Manizales

2021 arrived and, six days into its course, the country’s Current Monthly Legal Minimum Wage (SMLMV – See box In figures) continues to be debated in different scenarios. Different sectors state that the 3.5% increase is insufficient for expenses corresponding to transport, education, health, etc.

In the latter, contributors and beneficiaries must take charge of the co-payments and / or moderating fees for the services received. The adjustment is for what is included and not the Health Benefit Plan (PBS – See the PBS box).

To whom it May concern

It is worth clarifying that the moderating fees are the contributions that contributors and / or beneficiaries make when they attend their EPS for a medical or dental appointment. They are canceled when the citizen requires drugs, home care and clinical laboratory and imaging tests. Its final purpose is to regulate the use of the service.

The cancellation of copayments only corresponds to the beneficiaries. They refer to a part of the value of the service required. Its purpose is to co-finance the health system. Each user is subject to limited amounts in terms of health events and general price caps per year.

This co-financing does not apply to control of communicable diseases, promotion and prevention, maternal and child control and high-cost diseases (cancer, leukemia, lymphomas, epilepsy, rheumatoid arthritis, HIV / AIDS, chronic kidney disease, etc., in addition to hemodialysis, dialysis and transplants).

Dissatisfied

LA PATRIA asked two characters from the city about the provisions for copayments and moderating fees. This was said by councilor Christian David Pérez (1) and union leader Moisés Gallego (2):

1. The increase in the value of the moderator fees and copayments goes hand in hand with the economic reality of the country. However, it would have been good if, compared to last year, they were maintained. In other words, they will be frozen for those workers who earn up to two minimum wages.

I believe that the increase will not significantly hit the pockets of Colombians. It should be noted that due to the pandemic brought by the coronavirus, many of these charges have not been made. That has made clinics and hospitals bill less.

The pocketbook of Colombian workers must be safeguarded and even those who, being in the subsidized regime, have to assume -in some cases- co-payments of up to 10% of what they practice.

2. The increases are disproportionate, like everything the national government is doing. The increase for those who earn up to two salaries constitutes 3.0% compared to 3.5%. It already begins there to take part of what raised the minimum. In those who earn more, the expense is worse.

One does not understand how in a moment of crisis these charges rise in this way. Add to that the growth in utility bills, transportation, the family basket, etc. There you already get lost.

They should have lowered those charges. The Government should assume a large part of them with international reserves, stopping what they take with corruption, renegotiating the State’s debts and demanding a moratorium on the payment of interest.

I do not agree, because the care in the health system is terrible. We continue with the walks of death, since it takes at least eight days to access an appointment, if you are feeling good. Apart from the delay in complementary examinations and in the delivery of medicines. It also increased the payment of the Integrated Contribution Settlement Return (Pila) by $ 3,800. We need the service to be timely.

In figures

Decrees 1785 and 1786 of 2020 updated the Current Legal Monthly Minimum Wage (SMLMV) of 2021, this with an increase of 3.5%; in addition to transportation assistance.

In the previous term, the SMLMV was $ 877,803, to which a transportation aid of $ 102,854 must have been added. For this 2021, the SMLMV was $ 908,526 and the transportation aid at $ 106,454. Now the Minimum Daily Legal Wage (SMLDV) of $ 30,284 must also be taken into account.

What PBS

The Health Benefits Plan (PBS) aims to make the service more equitable. It determines that all members of the General System of Social Security in Health in Colombia have the right to this. It was born with the Statutory Health Law 1751 of 2015.

The PBS covers at least 200 drugs, treatments and medical items. The cost-effective relationship for the system must be respected; also the list of exclusions: those that are aesthetic, that are experimental, that are not endorsed by Invima, their effectiveness has not been proven or those that occur abroad.

Infographic I THE COUNTRY

.

Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.