We look at both candidates’ positions on a range of key issues. Find out here what Gustavo Petro and Rodolfo Hernández have to say about healthcare.
Both Gustavo Petro and Rodolfo Hernández have grand and radical plans for healthcare. There’s a few minor differences in what they’ll do, but the gist is similar in both plans. With so much agreement, it’s time to find out what healthcare might look like going forward. The main gist is that it’s likely to be a lot more equitable than it is today. All reforms here apply to mental and physical healthcare.
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Healthcare in Colombia has long been a contentious issue, most notably since the implementation of ley 100 in 1993, which was designed to bring healthcare to all Colombians and establish norms and standards of care and provision. It also removed the state monopoly on healthcare. Prior to that, only around one in five Colombians were in the healthcare system. While 96% of Colombians are now covered, the law also meant that many more people are exposed to rapacious healthcare providers under the EPS system rather than public services.
New healthcare systems
Continued universal care is at the heart of both candidates’ visions. Petro is unambiguous in wanting all healthcare to be universal as well as public. He thinks this can be done by immediately implementing ley 1751, which already provides for much of this. However, that law was passed in 2015 and has been largely ignored since then, meaning there’s significant opposition. Along the same lines, Rodolfo stresses the need to revive and expand the public health system as well as heavily controlling private providers, especially in terms of costs to end users. He will give care to all people in all situations, which means ripping up all the existing plans.
The EPS system will likely be eliminated in its current form if either candidate is elected. A lack of precision in both manifestos and public discourse means that it’s not entirely clear how they’ll carry this out, but the broad aims are clear. For Petro, it’s an essential state monopoly. It’s unlikely he’ll be able to ban all private practice, but he’ll try to take it as far as he can. Management of health will be under a Consejo Nacional, incorporating absolutely every voice you can imagine, from the LGBTQI+ community to academia. The private sector would have some involvement too. Rodolfo is less direct, but his plans to equalise payment, costs, and contracting mean that they will have to make enormous changes. He also plans to recover the public healthcare system anyway, which would also push the EPS providers to the margins.
Into the regions
Rural areas are key focus points for both men. As with other policy areas, such as education, they promote a vision of Colombia that includes and supports the hinterland as well as the major cities. Petro promises hospitals and clinics everywhere, with the express aim of having a healthcare centre within reasonable distance of every Colombian’s home and place of study/work.
Prevention is better than cure, say both men, and so they’ll orientate health measures towards that. Rodolfo sees patient responsibility as important here, so he’ll have family doctors educating and helping people to monitor their own health. On Petro’s side, it’s more about identifying social conditions to seek out the sources of problems. Top-down like Petro or bottom-up like Rodolfo, both hope that these measures will pay for themselves in reduced hospital admissions.
Drug addiction is seen as a healthcare issue in both camps, so addiction will be treated rather than persecuted. This is a major step forward for Colombia and follows similar models in countries such as Portugal. The idea is to get addicts away from the streets through centres providing drugs. This in turn should reduce the problems associated with the ollas where drug users congregate.
In the end, it seems whoever ends up victorious next weekend will try to implement big changes. However, the reality may be more complicated. Cost is a big issue. Petro says that progressive taxation will solve it, Rodolfo thinks that it will come naturally from the efficiency savings and trimming off the profits. Given that corruption is endemic and tax reform has been very contentious, there may be problems for both here.
It’s also unlikely that the proposals in each plan de gobierno will go through Congress without a lot of fighting and modification. With the EPS commanding a fair deal of clout in lobbying terms and political influence, it won’t be easy to bin them off. Smaller measures such as increased rural coverage and addiction treatment are much easier targets to reach, so we are likely to see more changes in these aspects. Just don’t expect a revolution tomorrow. In the meantime, an apple a day keeps the doctor away, so stay safe.