http://colombiareports.com/colombia-news/news/8074-thousands-march-against-health-reforms.html
Critics of the reforms have argued that they complete the process of making healthcare into a business, and will lead to the impoverishment of hundreds of thousands of Colombians. The government argues that the measures are necessary in order to make the healthcare system economically viable.
Amongst the reforms, which were introduced in government issued decrees at the end of January, there are two points which have caused huge controversy. The health system is based on insurance: there is a basic health insurance plan which states the illnesses and conditions which health insurance companies cover, and a list of illnesses and conditions which are not included in the plan (generally more expensive illnesses).
Until now, the government has had the responsibility of funding treatment for such cases. However, the decrees take this responsibility away from the government and give it to the patient. The patient or their family will be offered a loan (usually from the health insurance company) and will be forced to take on the debt for a treatment which was formerly paid by the government. In a country with up to 15% unemployment, and up to 50% of the population working in the informal sector (selling sweets on buses, cleaning cars at traffic lights etc), the impact could be catastrophic.
In the second controversial measure introduced by the decrees, doctors are given a list of approved medicines and treatments which they are obliged to prescribe for specific illnesses and conditions (the most cost-efficient cheapest option). If doctors prescribe a non-recommended treatment or medicine, they must justify their decision to a special regulatory board, which may fine the doctor up to $13,000 dollars for the economic damage caused to the health insurance company. Doctors have been extremely critical of this measure, arguing that it takes away their autonomy, and reduces the health of the Colombian public to a simple economic issue.
The decrees have been even more controversial because of the way the government has gone about introducing them. At the end of December, the government declared a state of social emergency due to the economic crisis facing the health system. This gave it special powers to issue decrees which seek to address the financial crisis without the normal process of debate and submission for approval by the Congress. Doctors and patients’ associations were not consulted, whilst it was revealed last week that the government paid huge sums of money to important figures from health insurance companies to act as consultants in the formation of the decrees.
The public anger caused by the improvised health sector reform has taken the government by surprise, with marches held all over the country last week and more marches protests planned in the coming weeks. President Uribe has seen his popularity impacted heavily as May’s presidential election approaches (he hopes to stand for a second re-election if the Constitutional Court approves a referendum in which the electorate would decide over a proposed constitutional amendment which would allow Presidents to serve three consecutive terms). Faced with this public anger and his dip in popularity the government has begun to backtrack on some of the measures introduced in the reforms, but the fundamental changes remain the same. The Constitutional Court last week announced that it is going to study the constitutionality of the decrees.
Health service group activists from UNISON Northern will be visiting Colombia on a delegation in April as part of UNISON Northern’s solidarity ties with Sintrahospiclinicas, a health trade union based in Valle del Cauca department, Southwest Colombia.
