The president-elect Abelardo De la Espriella appointed this week Ana María Vesga as Minister of Health, who will have the task of leading the recovery of a system that is going through a deep crisis of care, financing, and trust.
Her arrival at the Ministry of Health is known after the president-elect’s team presented the first lines of the plan with which they will seek to face the system’s crisis during the first months of Government.
Within the framework of the National Congress of Hospitals and Clinics, Iván Sánchez, spokesperson for De la Espriella’s health team, announced a rescue plan that contemplates the mobilization of up to 10 trillion pesos during the first 90 days of Government to address the humanitarian emergency, stabilize the system’s finances, and recover trust among the different actors.
“The first decision of Abelardo De la Espriella’s Government will be to launch its 90-day rescue plan with the determination to mobilize up to the 10 trillion pesos referenced during the campaign and today are a reality within the corresponding fiscal and budgetary framework. It will not be a blank check, it will be a conditioned, prioritized, audited, and traceable injection,” he stated.
According to him, the initial distribution of these resources plans to allocate up to 4 trillion pesos to cover overdue payrolls and critical debts with public and private hospitals and clinics; 3 trillion to guarantee the delivery of medicines and reactivate interrupted treatments; 2 trillion to address the accumulation of patients with catastrophic and chronic diseases, and one trillion to strengthen the capacity of entities such as Invima.
Sánchez stated that the disbursement will be subject to technical and prioritization criteria. “We will not pay due to media pressure or political closeness. We will pay according to the patient’s risk and the evidence of the obligation. There will be direct transfers, a public disbursement schedule, a monitoring dashboard, and concurrent auditing. Every peso will have a destination, responsible party, date, and expected result. The rescue cannot become a stage of opacity,” he said.
The spokesperson assured that the priority of the new Government will be to address the humanitarian crisis facing the health system. In this regard, he indicated that the transition team has received preliminary reports that must be verified and audited, according to which there are more than 900,000 records and alerts associated with cancer patients with pending, interrupted, or incomplete care; nearly 1.6 million patients with chronic diseases facing delays in treatments or medications, and around 3,000 transplanted patients exposed to interruptions in the delivery of essential medications to preserve the transplanted organs.
Although he clarified that these data must be refined, he insisted that they cannot be ignored. “I will not present these figures as a closed statistical truth until there is verification of this information, but I also cannot ignore them. For the new Government, a clinical alert will be a person who must be located,” he stated.
Sánchez also referred to the financial situation of the system. Citing figures from the Colombian Association of Hospitals and Clinics, he indicated that the portfolio amounts to nearly 25.7 trillion pesos in 232 institutions, with a delinquency rate of 58 percent. He added that the intervened EPS and those under special surveillance concentrate 12.6 trillion pesos of that debt and that the public hospital network reports overdue labor obligations exceeding one trillion pesos.
“When a hospital stops receiving payroll payments, the problem is not only accounting. The team breaks up, talent is lost, services close, and the patient faces a door that still has the sign but has no capacity to respond,” he assured.
As part of the strategy to stabilize the system, the official announced that on August 7 a national concertation table will be established with the participation of the Ministry of Health, the Ministry of Finance, ADRES, the National Health Superintendency, the National Planning Department, territorial entities, EPS, IPS, providers, patients, workers, and scientific societies.
The first objective will be to build a unique methodology to identify and classify accumulated obligations between August 7, 2022, and August 7, 2026, differentiating audited debts, accounts under review, legal processes, and obligations of the State and the different system actors.
“Not all accounting liabilities are enforceable debts, but every certain debt must have a payment route. This will be the rule,” he said. He also explained that the table will seek to establish behavioral agreements during the implementation of the rescue plan. Among them, prioritizing the payment of payrolls, essential medicines, oncological treatments, dialysis, immunosuppressants, maternal and child care, and emergency services.
“Concertation does not mean impunity. Whoever has defrauded the resources will be held accountable. Whoever has provided a service must receive payment. Whoever has a legitimate dispute will have a quick procedure to resolve it,” he stated.
Another announcement was the establishment, also on August 7, of a technical table to define the 2027 Capitation Payment Unit (UPC). According to Sánchez, the methodology will incorporate variables such as the real disease burden, multimorbidity, population aging, rurality, geographic dispersion, effective service delivery costs, and medical inflation.
Likewise, the Government will evaluate the possibility of making an extraordinary adjustment for the 2026 UPC. “The table will also have an urgent call to determine if there is technical and fiscal support for a transitional adjustment of the 2026 UPC. If the data recommend it and the Ministry of Finance finds budget availability, the Government will make that adjustment before the end of this year,” he said.
Sánchez concluded that the rescue plan will only be viable if all system actors assume shared responsibilities. “The State cannot do it alone. The new Government will provide resources, regulatory capacity, budget discipline, coordination, and transparency. In return, it will ask all actors to do their part,” he concluded.
HEALTH EDITORIAL