:quality(85)//cloudfront-us-east-1.images.arcpublishing.com/infobae/GIJ5AO4ITNEIDDTWOXMZ2BN3DI.jpeg "Health reform: New EPS has over 100,000 complaints and owes over billion")
The project of health reform presented on Monday 13 February by the President Gustavo Petro establishes that the PES which are currently in liquidation will be eliminated and those whose financial statements are optimal will welcome patients in a progressive and orderly fashion so that they do not find themselves without coverage.
Health reform: what will happen to the New EPS in the new system?
The entity must receive affiliates from all EPSs with medium or high risk of liquidation and territories where they are not authorized to operate
Likewise, it will strengthen the new pes to cover the territories which, due to the liquidation of certain entities, are left without said insurance, which means that this EPS should receive 11,490,000 people.
“The New EPS will contribute to the organization of the supply of health services within the framework of social health insurance, facilitate its infrastructure in each territory to organize and make the transition to the organization of the territorial registration of the population and the structuring of the referral and counter-referral system, the formation of Integral and Resolute Primary Health Care Centers (Capirs), as well as the organization of integrated and global networks in the territories that the Ministry of Health and Social Protection and the level authorities determined by territory”, specifies the health reform bill.
Once the idea became known, complaints about it started coming out. One of them is that of the president of the Stock Exchange Autoregulator (AMV), Michael Janawho via social networks assured that it is not reasonable to watch the New EPS, because it is one of those which has the most debts with hospitals and which receives the most complaints from users.
President Petro will lead the presentation ceremony of the health reform on February 13 with a protocol act
After a meeting held by the head of government and the health promotion entities of the country, several doubts remain about the future of it, which is why the public is waiting for the presentation of the modifications of the comprehensive care department
“It is not reasonable to think that the health problems in terms of quality and cash flow are solved by giving more importance to the State when the EPS with public capital (like Nueva EPS) are the ones that have the more debt to hospitals and, moreover, are the ones who receive the most complaints from users,” Janna clarified via Twitter.
The trill was accompanied by two images showing that, according to the Superintendency of Health (Supersalud)The new EPS for the period January-March 2022 resulted from the EPS of the contributory scheme with the greatest receipt of complaints from users during registration 42.233, Wed, 7.06 per 1,000 users. In second place was Surah EPS (29,256 complaints and an average rate of 5.75 complaints per 1,000 inhabitants).
The health reform establishes that 11 million users of the entities in liquidation migrate to the New EPS
The health provider entity will facilitate its infrastructure in each territory to organize and transit the territorial registration of the population
As for subsidized schemeindicated that he was third with 10,085 complaints, i.e. 2.96 per 1000 users. In this regime, up to the said period, the one who complained the most was emssanar (13,222 complaints) and in second place Capital Health (10.366).
Likewise, he noted that in June 2022, he had a total wallet amount of $964,379 millionwhich placed it as the most indebted PES, above Asmet Health ($406,816 million).
GlobeLiveMedia colombia viewed the latest report requests, complaints, claims and suggestions of Superhealth. In this one, which corresponds to 2022, it is detailed that that year among the EPS of the contributory scheme the New EPS registered 173,176 complaints and ranked first. It is followed by EPS Sura (124,810), Sanitas (122,939) and Salud Total (121,766).
Regarding the subsidized scheme, Nueva EPS ranked second when registering 47,876 complaints. It was surpassed only by Emssanar (50,222). Another with a notable number of complaints is Coosalud (40,406).
On the other hand, on January 6, 2023, the Superhealthy presented the figures of the debts carried by the 27 EPS that exist in Colombia.
According to this, the most indebted EPS is the new pescon $3.4 billion. They are followed by Total Health ($2.3 billion), sanitas ($2.1 billion), SURA ($1.6 billion) and emssanar (1.1 trillion pesos), which means that only these five EPS are concentrating 10.5 trillion dollars of the total debt of 16.6 trillion dollars that they had until this moment, or 63% of the total . The other active EPS held 37% of the remaining debt, which corresponded to 6.1 trillion pesos.
Indeed, the former Minister of Health Fernando Ruiz claimed Week that he is very concerned about what will happen to the new pes. He admitted that it will be a new Social Security Institutewhich went into liquidation due to corruption cases, but bigger and inefficient.
“In what I had the opportunity to experience with the New EPS, in what I could see was that they could no longer receive more patients. It became a sort of monopoly power over insurance, especially in the subsidized scheme, and definitely it was already an institution that had problems serving people,” he noted.
He told the media that there will be a transition that we do not know how long this will last because, in addition, very dramatically, the reform does not say so. At the same time, he warned that if there is talk of building any new infrastructure in the service, it is a process that will probably last for eight or ten years.
“At the same time, a system will be built by maintaining EPS which will deteriorate over time and all the conditions of this transience are not written, but on the contrary, they leave the President of the Republic extraordinary powers guarantee the process of transition from a social security system to a health system,” the former minister stressed.