Petro and the health reform

The government of Gustavo Petro has faced its first major political crisis with the dismissal of three ministers.

The underlying trigger has been an issue that threatens to become the great battle of the first left-wing Executive in recent Colombian history: its health reform.

The bill, presented two weeks ago to Congress, has tightened the political strings of the South American country both due to the defense strategy put forward by Petro himself, who called marches in support of the reform and established himself as the absolute center of the public square , as well as the counter-demonstrations of an opposition without visible leadership —former President Álvaro Uribe Vélez has even asked his followers not to insult one of his fiercest critics— but, after months without a clear opportunity to attack Petro ,

In the current system, citizens join a Health Promotion Entity (EPS), which can be public or private.

Citizens contribute according to their income to the health system and the State transfers resources to the EPS based on their number of affiliates, so that they can serve as insurers.

The reform proposes to eliminate the EPS and that the State pay directly to the clinics for the provision of services.

This proposal would put an end to the intermediation of the EPS and the margin they charge, freeing up resources for health, but it runs the risk of creating a state bureaucracy that founders on corruption and mismanagement, as happened with the extinct Social Security Institute. before the emergence of the current system.

The problem for Petro is that health is not among the main citizen concerns, and permanent insecurity, inflation that does not subside or unemployment that is around 12% are among them.

In addition, some fear a return to the situation prior to the current health system, which managed to increase coverage from 24% of protected Colombians in 1993 to 99.6% in 2022.

Petro's proposal is based on well-known programs of the Colombian left, but it has not managed, according to polls, to take root strongly in public opinion, where between 50% and 65% of citizens show their detachment.

Even within the Government, it has had strong detractors, such as the relieved Minister of Education, Alejandro Gaviria, who managed the Health portfolio between 2012 and 2018. Gaviria criticized the project in several internal meetings with the consequence of a dismissal that seeks to discipline the Cabinet around of its president.

A reform of this magnitude, which deals with the health of the more than 50 million inhabitants of Colombia, requires the greatest possible consensus.

From the Government as well as from its adversaries, less tension and more practical solutions can be expected.

Any bill can be improved, and this one certainly too, but only negotiation between the different sectors will be able to move forward with a bill that is widely accepted.