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Between reforms and extremisms

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Between reforms and extremisms

Since we lived through the electoral contest, Gustavo Petro announced publicly and in his government plan his intention to advance reforms in several sensitive aspects for the national future: health, pensions, labor and politics.

Two of these four issues (health and political system), without a doubt, deserve an urgent transformation, since, little by little, they have been blurring with a common issue: business.

The health system, although it has a high “coverage”, is having increasing problems to provide quality care with opportunity, especially with regard to the subsidized regime, where the problems of medical intervention with patients and the authorization process of Procedures are tortuous for the population served in this segment, which in turn are Colombians with fewer economic possibilities.

During the last few years and with the latent possibility of the current president coming to power, many EPS closed ranks hand in hand with some political actors around creating the fallacy that in Colombia we enjoyed one of the best health systems in the world, however, the annual publication of “World Population Review” where it analyzes the infrastructure, the quality of medical care, the availability of medicines, among other factors, placed our health system, by 2022, in 35th place, behind Argentina , Ecuador and Mexico in the Latin American case.

In conclusion, being in position 35 and reviewing the scores obtained in this study, we are far from being one of the best in the world, as we had been told, so much so that we do not even have the best system in Latin America but the room.

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The need for an urgent transformation of the system is clear, which in itself is economically difficult to sustain, however, radical determinations should not be made to end everything that exists and with some progress that has been achieved, such as the issue of infrastructure, something that has led to the fact that in recent years seven of the twenty best service centers in Latin America are Colombian.

However, this infrastructure has been studied in the main populated centers of the country, as clarified by the authors of said “ranking”, which by the way has caused controversy due to President Petro’s indication of being in position 74 and not in the 35 as it really happened.

If we take, for example, the situation in Valle del Cauca in this sense, which by the way is not the most precarious in the country, we can see very different realities in the possibilities and capacities of the hospital centers located in the department to provide services.

In the Valley, the hyper-concentration of health centers with the capacity to care for highly complex cases in the capital is indisputable, since in the other main cities of the department (Cartago, Tuluá, Buga, B/ventura), with the exception of Palmira, already Despite being development nodes that radiate to other municipalities in their subregions, the possibility of caring for cases that require a more demanding level of intervention at the medical level is practically nil, leading to difficulties for patients, for medical personnel and additional pressure on the hospital network of the city of Cali, in many cases saturating its care capacities.

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The people of Valle del Cauca, for example, should put pressure on our representatives and political actors in the regional order (deputies, governors and congressmen), who urgently advocate to improve this situation.

There is no doubt that the health system requires an urgent transformation, but this must be beyond political interests or ideologies, this is a discussion that must take place at a technical level and must not be approached as a political struggle, and that is where Minister Corcho and the representatives of the political parties are making a mistake.

This is not a matter where ideology has to be measured against the economic and bureaucratic hunger of some actors who are present in congress.

Health is a sensitive issue where we cannot go wrong because the lives of Colombians are “at stake”, it is an issue that must be addressed in a technical and politically pragmatic way outside of political interests, interests that have prevailed thanks to the degradation of the Colombian electoral system, another aspect that must also be addressed and where, in my opinion, closed lists are not the solution, the electoral system begins to improve when real field controls are carried out on the costs of the candidates’ campaigns, but That will be a reflection for later.

For now, the government, represented by its ministers and political actors, must understand that in order to advance the reforms, they must put aside doctrinal and extremist thoughts or, failing that, the backward thinking of maintaining the “status quo.”

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