Criticism of the government's new healthcare model: experts warn of legal and operational risks

In a joint statement, health sector organizations and experts, part of the Todos por la Salud movement, expressed their concerns regarding the Ministry of Health's draft decree proposing a new health care model called the "Preventive, Predictive, and Resolute Health Model."

The document was signed by representatives of scientific associations, academics, patient organizations, and trade union representatives, including Bruce Mac Master, president of Andi; Ana María Vesga, executive president of Acemi; Agamenón Quintero, president of the Colombian Association of Scientific Societies; Alejandro Gaviria, former Minister of Health; and Congresswoman Jennifer Pedraza, among others.

" It does not resolve patient care problems and eliminates users' free choice of insurer and provider. The draft decree creates new bottlenecks for patient care, weakens comprehensive risk management, creates corruption risks, and deepens the health crisis. Furthermore, free choice is one of the pillars of the system and is statutory," the signatories point out.

One of the most critical points of the statement is the warning about a possible overreach of the government's powers. "The draft decree proposes changes that exceed what can be done administratively, by invading powers reserved for the legislator," they state. These changes include structural transformations in the insurance model and in the functions of EPS, IPS, and regional entities.

According to experts, the decree also "generates conceptual confusion about Primary Health Care (PHC)" by wrongly reducing it to low-complexity services and failing to adequately differentiate between prevention, promotion, and curative care, which creates ambiguity in its financing and operation.

Another aspect of the dispute is the transfer of the authorization of health care provider networks to the Ministry, displacing the territorial entities, which violates Law 1438 of 2011. Furthermore, the exclusion of EPSs from key functions such as referral and counter-referral "distorts their role in comprehensive risk management."

In financial terms, the movement warns that the government is attempting to fund new functions with the same resources allocated for healthcare, which they describe as "unconstitutional." "The planned investments in infrastructure and labor formalization lack real budgetary support," the statement reads.

Finally, the document, which includes 10 comments on the Ministry of Health's draft, concludes that if the decree is enacted in its current terms, "the operational and financial problems currently facing the health system would worsen, increasing access barriers for patients and users." It also questions the lack of definition regarding the care pathway and the absence of a responsible figure for patient representation and management within the system.

"This lack of definition regarding coordination channels between the different levels of care could jeopardize comprehensive and continuous access to health services, affecting the quality of care patients receive," they add.

Environment and Health Journalist