Reforming health without dismantling it: the path would be with more resources and incentive adjustments to the Colombian system
The system's coverage reaches about 99% of the insured population in Colombia. Photo: iStock
TL;DR
- The Colombian health system, while achieving almost universal coverage (99%), faces increasing financial pressure.
- Academic analysis from Universidad de los Andes suggests focusing on correcting design and operational flaws rather than dismantling the system's institutional architecture.
- Key issues include chronic underfunding of the Capitation Payment Unit (UPC), territorial disparities in healthcare access, and regulatory rigidities.
- While the system has achieved high coverage and low out-of-pocket expenses, structural failures compromise its sustainability, quality, and legitimacy.
- The proposed government reform to reduce the role of EPS and centralize spending is questioned for potentially diluting incentives to control costs.