The health system prepares for the post covid-19

Bogotá, October 16, 2020.The Minister of Health and Social Protection, Fernando Ruiz Gómez, explained the situation that the country is going through at this stage of the pandemic in which it is important to take into account prevention measures from home and have, in the future, a system based in that aspect and family medicine.

“This pandemic has revealed weaknesses, but also strengths, of the Colombian health system. If we weigh up the results that we have had so far in the country, we can say that there are more strengths. Colombia has been able to respond from a healthcare perspective and epidemiological, grow in diagnostic capacity, care and surveillance. The response we have given shows us those strengths, “said the head of the Health portfolio, also explaining that in terms of weaknesses it has to do with the limitations that some territories for access to services, control and surveillance.

He affirmed that if Colombia is compared with other Latin American countries, or with Spanish, for example, reference is made to a system that did not collapse, as happened with Spanish and Italian.

“We have the pending task of developing many of the approaches contained in the Statutory Health Law and that has to do especially with access and availability of services. In the pandemic, people stopped going to hospitals, they stopped going to many reasons, mainly for fear, “he said.

Faced with this, he pointed out, what we developed as a country was the possibility of home outpatient consultation and teleconsultation. “In the latter, we advance what was not possible in the last 10 years. This gives us an idea of ​​a system that has significant flexibility, which had to be adapted, but which will come out in a different way from how it came in,” said the minister .

Future of the system

The Minister of Health indicated that the system will have to think about its future development as a much more patient-centered system, “which comes from the Statutory Law, but also from the possibility of primary outpatient services rather than capacity. resolution. That is one of the great lessons of the pandemic. “

Given this, he said, issues have been collected and it is still necessary to take more evidence of what has happened. Based on this, the Government is clear that it is necessary to make adjustments to the health system, adjustments that imply a transformation, not a reform. “There are many of these actors who seek to end the system and build another, but when we go to the approach, that other is a desert, where there are no ideas, simply the antithesis of ending everything.”

Among the fundamental issues is the concentration on the outpatient, patient-centered care, citizen care, that their first entrance door is not the emergency room, so the system must get as close to the residence hall.

The second is transactionality. “We cannot have a system where 10 years later we are resolving debts and we are not clear about who owes what and how much,” he said.

He explained that some areas must be strengthened, especially with what has to do with the management of chronic diseases, which will surely be after the epidemiological transition. “Cardiovascular disease, cancer or mental illness are critical issues and the system must respond by having structured routes to serve the population and precise monitoring of the citizen.”

He also explained that the National Government has supported Bill 010, an initiative under which a process of transformation of the system is being promoted. Within this process there is a very important issue, it is medical care with a family medicine approach.

The latter means that “each person has a respondent with his or her own name, which does not change every time, which is a system in which I have my doctor, he knows me, knows what my pathologies are, I have the ability to speak to him and that he knows my problems. On that basis, a patient-centered approach, consolidate a system in which prevention works. “

“The epidemic has taught us to prevent, to wear masks, to keep our distance. Our Colombian vision was always curative, to get to the hospital for emergencies. We have to think and focus on prevention, home care and family medicine,” he added.

Role of EPS

Minister Fernando Ruiz also spoke about the role of the EPS and what they represent in the modifications proposed to the system. “As we make greater use of health services, what is called the accident rate, that is, the UPC’s spending has been reducing. We are in a system that is highly stressed by various situations and this has led to some EPS to lose their ability to respond financially to risks, “he said.

“What we propose is to make a complete recomposition, trying to make a restructuring and leaving only those insurers that have the capacity to respond. Also territorializing insurance and making it a system of provision, insurance and public health moves through more territorial relations than nationals, “said Ruiz Gómez.

In addition, generating comprehensive care networks where the patient knows from the beginning where and how they are going to be treated. The idea then is for EPS to manage people’s risk, to focus more on health and less on financial resources.

“We have two important opportunities: the first is the electronic invoice and the second is the interoperability of the medical record, where we will have the option of transforming the system so that the patient does not carry the medical record under his arm but has all the information available to access of every hospital in the country. We have to look at a system towards the future, “he said.

Regarding medicines, he indicated that a very important effort has been made for several years in regulating the prices of medicines. “Today the prices of medicines, in what is called the institutional market, are not so expensive, they are international reference prices for the majority. We must be clear about the entry of innovative medicines and how to define if they enter to compete with medicines It is a task for the system to do. “

“Also the drug from the commercial channel, the ones we buy in the drugstore, we have a small percentage of drugs that they don’t give us and we go to the drugstore and when compared with other countries, they are more expensive. At that point there is an important task” added.

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