One hundred and twenty days, that is the time that Savia Salud has to define its future after the extension granted by Supersalud. And although the manager of the entity, Lina Bustamante, acknowledges that they received the decision like a shot of oxygen, she accepts, without embellishment, that saving the EPS in four months is a complex task. The manager spoke with EL COLOMBIANO about the plan they will carry out and sent a message of calm to users and providers.
Were they satisfied with the Super’s decision?
“Our expectation was always an extension, and it may be an opportunity to deepen compliance with health indicators. But, on the other hand, it can be short for the financial issue, because in four months financial trends do not change”.
Why did the Super not want to approve the capitalization proposal that Savia submitted?
“Officially he has not denied us the reorganization plan or the capitalization. He made us some requirements that we are answering. What we do not see as easy are the times to reach capitalization and that we have continuity in the plan we had because we depend on people who want to bet on Savia not committing their money in these months”.
But the capitalization proposal that they delivered in July seemed solid, so what does the Super want from you?
“La Super obviously wants us to comply with a positive heritage. What we have considered as EPS is that in order to achieve this equity, at least 50% must be via capitalization. We would believe that the Super would expect capitalization from us. Let’s remember that we did a capitalization of $120 billion, but we needed a second capitalization of between $130 billion and $150 billion. That we can achieve this second in four months, without having approved the first, we do not see it viable”.
The Super ordered a shock plan in which it requires them to strengthen the service, clean up the accounts, review contracts, how are they going to materialize all these demands?
“We are going to make some payments to the network with some reserves that we had. We will make some payment agreements and advance some flow. Today the EPS does not have major portfolio problems. In the last four years we have reduced our debts by 47%. We are going to have the accompaniment of the Ministry and the Super; there we will show what has been paid and the lenders will also show what is owed to them. In addition, I would like to check with the providers, again, the rates. This is an issue where we need to co-manage risk and costs to guarantee health services.”
Beyond the financial, the Super made findings that crack several aspects of health management, such as low coverage in promotion and prevention programs and the 44% increase in tutela actions; why do these faults persist?
“The eight years of special surveillance have been, mainly, due to the patrimonial defect that we have dropped from a negative $900 billion to $560 billion today. However, there are some indicators, for example, in screening and cytology for the detection of cervical cancer and breast cancer in which we must improve, and in which we hope to have the commitment of the department’s public network”.
As the liquidation is still pending, is there a plan B that can reduce the risk of a system collapse?
“We expect the accompaniment of the Ministry of Health and the Superintendency to shield all the capacity that we have strengthened in defense of the most vulnerable users. Today 80% of the service route that Savia has is with the public network. We have an office in each of the 125 municipalities; We have worked with community organizations to manage risk and achieve patient adherence to treatment, for example, for HIV. More than 5,000 patients access treatment against the virus. We arrive at hostels; and we take chemotherapies to the municipalities”.
While the Government and Comfama try to save the EPS, the other partner, the Medellín Mayor’s Office, headed by Mayor Daniel Quintero, is generating noise and misinformation about the origin and nature of Savia, what do you think?
“Savia has been characterized by having a strong corporate governance, with the equal participation of Comfama, the Mayor’s Office and the Governor’s Office on its board of directors. So, although the Mayor’s Office stated that it did not want to capitalize Savia, the board of directors has firmly supported the decisions that have been made. I couldn’t say what context the mayor has about the creation of Savia. But as a manager, I can say that the board of directors of Savia, its corporate body, has some rules that it has respected”.
How many of the 1.66 million users that Savia has reside in Medellín and how much would the city be affected if they liquidate the EPS?
“Medellín has 520 thousand users. In addition, it has the highest health service cost, because it concentrates most of the high complexity. Medellín has historically been one of the most expensive cities for health services.”
In that order of ideas, shouldn’t the Mayor’s Office have a more important role in this plan to save the EPS from the most vulnerable?
“We would like that just as the governor of Antioquia pronounces, the mayor’s office pronounces. In terms of actions, deepen the work with the Ministry of Health to attack specific public health problems.
That the minister, Carolina Corcho, and the deputy minister of Social Protection, Luis Alberto Martínez, are from Antioquia, could have a positive influence to move Savia forward?
“One understands that the position of a public servant must be prudence, fairness. However, we do have our faith in Vice Minister Martínez; first because he knows very well the strengths and weaknesses of the department’s public hospitals and knows the Savia process in detail. We believe in his criteria, his honesty, and that gives us a guarantee that the work table (which he started yesterday) will be handled with total transparency”.
How to guarantee that in these four months there will be no chaos in care?
“There is a very telling fact: despite the uncertainty of recent weeks, the network has not abandoned us. I was afraid that their services might be closed to us, but that was not the case and we were able to continue scheduling chemotherapies and all kinds of procedures. Of 331 providers that we have, only two told us ‘no’. That says a lot about the confidence in Savia. We, in turn, trust in the work that we will carry out with the Ministry and the Superintendence these months”.