Access to health services has been a major factor in reducing poverty

A week ago, the National Administrative Statistics Service (Dane) published the results of the Multidimensional Poverty Index (MPI) in the country, the figure rising from 16% in 2021 to 12.9% in 2022.

In other words, its curve continues to decline, correcting the dynamics seen in 2020when it was due to the epidemic, the index registered an increase.

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Among the amazing data is the role of health in this decline, because the health insurance shortage variable moved from 10.1% in 2021 to 8.4% in 2022, which is one of the variables that provided the largest decline. In addition, the number of barriers to accessing health services increased from 2.2% to 2%.

Accordingly, Acemi, the contribution system EPS consortium, emphasized that “Of all the dimensions, the component that contributes the most to poverty reduction is health. 2% of households reported barriers to accessing health services and 8.4% on insurance coverage..

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But it must be said, as Carlos Alberto Garzón, an economist and researcher on development issues, asserts that this is true, but not directly.

That is, because this index, which was created in 2011, “The MPI includes five dimensions that make up 20% of the index, that is, health weighs like any other dimensions”.

These dimensions are: education, youth, childhood, work, health and housing. For this reason, he points out, it is not true that health had the greatest influence, because every dimension has the same weight.

What applies to the economist is that “Coverage, which is one of the indicators of the health dimension and health care access, when transition is making a strong impact within the MPI.”

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The account will be that “If health coverage moves, it moves 10% or more than it can move in MPI.”Garzon explains.

Furthermore, for multidimensional poverty exceeding the indicator, “Health is one of the most powerful tools for reducing this multidimensional poverty”. This is because when the user has poor health, other abilities are affected. This leads to a situation of multidimensional poverty.

He also confirms that the coverage in Colombia is very high and very good.
“Counting subscription-based, sponsored and private systems, there are approximately 51 million people, and that’s almost complete coverage”explains economist Garzon.
On the other hand, the largest increase in health insurance occurs in the subsidized system.

(See: In Colombia, 2.35 million families don’t eat three times a day.)

Thus, the expert confirms that, according to the data of the Ministry of Health, In the system of contributions in December 2021 there were 24.6 million people, in December 2022 they had 23.5 million and in March 2023 there were 23.3 million. Instead, the supported system had 23 million in December 2021; 25.6 million in December 2022 and 26 million in 2023..

In fact, Paul Rodriguez, a professor at Universidad del Rosario, asserts that the difference in the MPI number occurs because “The vast majority of the population has access to health care, although often without health insurance, which demonstrates one of the great advantages of decisions made by the state regarding health as a fundamental right.”.

And for him, the main component that allows reduction is just that People can access health services. This is for emergencies and brigades, regardless of whether they have a subsidized system or contributions or if they are uninsured people..

The message in this matter, Rodríguez asserts, is that The country should be very careful when talking about changes in the health systemBecause there are two things at stake. “One is insurance, which may be somewhat irrelevant, but what is important is household spending on health, which today is very low for countries in the region and for OECD countries.”.

This last for the teacher, “A big major asset that the state should avoid is such catastrophic spending on health”.

This means that families end up spending a significant portion of their income on medicine and care.

So, “If a new system is created with the health reform, there are difficulties in implementation and it is not possible to guarantee this and users end up moving more into the private insurance sector, this will lead to higher personal expenses and this will create barriers.”says the expert.

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A statement that Carlos Alberto Garzón agrees with, because although there is no direct impact of the reform on coverage, “What is not known is how to improve the quality of care, particularly in the subsidized system and that the working population does not trust their health system and continue to pay their supplemental or prepaid plan.”

Therefore, the best way to reach the 8.4% of those who reported being uninsured in IPM is “Reaching poor families and sharing with them the benefits of the health system, as well as promoting the use of the health system”Garzon asserts.

It is also important to solve knowledge barriers to accessing these services and barriers in terms of distance.

Claudia Milena Quintero Rueda
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