February 28, 2024

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Dismantling Lies About Health Reform: The Case of Section 70

Dismantling Lies About Health Reform: The Case of Section 70

In any democratic debate, argumentative transparency and intellectual honesty are of particular importance; These are two features that were unfortunately conspicuous by their absence on the part of many opponents of health system reform, one of the symbolic projects of Gustavo Petro’s government.

The latest chapter of this behavior, in which lies, misinformation and “little tricks” prevail to provoke…

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In any democratic debate, argumentative transparency and intellectual honesty are of particular importance; These are two features that were unfortunately conspicuous by their absence on the part of many opponents of health system reform, one of the symbolic projects of Gustavo Petro’s government.

The latest episode of this behavior, in which lies, misrepresentations and “little tricks” to break a quorum are prevalent, occurred last week, when several members of Congress opposed to the reform – and in practice defenders of the current model of health – and, apparently, the House, pointed out, Led by reform speakers, he intends to approve the “orangutan” with the proposal of Article 70 of the health reform project; They indicated that this would allow 85% to be disbursed without any kind of audit, and only the remaining 15% would be subject to audit.

The above is incorrect and, moreover, is the result of a misleading and falsified interpretation of the meaning and purpose of the article in question. let’s see.

First, the above proposal specifies that the Health Resource Officer (Adres) will pay, within a maximum period of 30 days, at least 85% of the value of accounts for services requested and provided by IPS providers, and that payment of the remaining 15% will be subject to a review process. Audit of accounts, and if no discrepancies are found, payment may not exceed 90 calendar days.

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The above goes in the direction of overcoming one of the problems existing in the current health system, because although the EPS receives 100% of the value of services monthly in advance, it takes up to 360 days to transfer resources by paying the bills submitted to the Prison Service – It is the real provider of services -; The previous situation explains why today many clinics and hospitals are paralyzed in the provision of services or the delivery of medicines is compromised, as happened recently with EPS Sanitas in relation to Cruz Verde, distributor of medicines to its members. That is, Article 70 of the health reform aims to accelerate payment to hospitals, clinics and other providers in the system to prevent them from being exposed to financial problems due to delays in the transfer of resources through the EPS.

Second, the misinterpretation by opponents of the reform suggests that, with the approval of the article in question, 85% of the system’s allocated resources will not be subject to any kind of scrutiny. What critics of the reform do not say is that 100% of the resources from prepaid accounts are currently not subject to any audit, while these revenues belong to the EPS business conglomerate. This is known as vertical integration: an EPS company contracts services to its own IPS company without any kind of oversight by the state. This is the reason behind the more than P23 billion debt EPS currently owes with those clinics and hospitals that do not belong to its business group.

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On the other hand, the article in question specifically seeks that, without stopping payment to service providers, a recurring and permanent audit can be carried out on all accounts and not just 15% of their value, and that the remaining 15% be paid. Subject to satisfaction with the audit conducted. This means that it is not the case that only 15% of the value of the accounts will be audited, but rather the opposite: once the entire account audit is completed, if no discrepancies are found, the remaining 15% will be audited. It is paid. Strictly speaking, this remaining payment of 15% will serve as a kind of guarantee that the system will receive, which will be subject to approval of the accounts after the audit.

In short, the article in question accelerates the repayment of accounts to service providers and ensures that they receive the cash flow that guarantees their operation, favors the transparency of the system, as it leaves 15% of the repayment of the account as a security deposit that depends on not finding discrepancies in the audits, and, finally, strengthens the mechanism for monitoring public resources that The system is used by the private sector.

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