En una carta dirigida al presidente, Gustavo Petro, y como antesala al debate en plenaria de la reforma a la salud en la Cámara de representantes, 147 personas, entre exministros, expertos y actores del sistema, hicieron reparos al proyecto de Ley y pidieron que se retire el proyecto, con el fin de hacer mesas técnicas de trabajo.
Como primer punto, señalaron que, hasta el momento, no se ha tenido una participación amplia y transparente por parte de la sociedad en este proyecto de ley, pues, aunque varios expertos, usuarios, pacientes, hospitales, empresarios, médicos y trabajadores del sector de la salud han expresado sus preocupaciones y planteamientos, “estas no han sido debidamente tomadas en cuenta”.
“La discusión ha parecido un monólogo en el que se ha impuesto una única visión, que no considera los riesgos que podríamos enfrentar al realizar cambios tan drásticos en el sistema de salud de los colombianos sin aprovechar la estructura existente para mejorarla y reducir de esa manera el riesgo de implementación de los cambios”, dice en el documento.
Otra de las preocupaciones es que hasta el momento no se ha dado una explicación clara sobre cómo se hará la transición de un sistema en funcionamiento a otro que no existe; y cuya operación no es clara ni para los colombianos ni para los migrantes que hoy tienen un plan de salud a través de las EPS.
Para los firmantes, lo aprobado en la Comisión VII de la Cámara deja más incertidumbres que certezas. “El paso de un modelo de aseguramiento mixto como el que tenemos actualmente, a uno completamente estatal en el aseguramiento, plantea desafíos extremos e innecesarios que sobrepasan las capacidades de nuestro país y su sector público, y que podrían generar consecuencias nefastas en el ámbito social, generando retrocesos en salud pública y en materia de equidad y pobreza, afectando la dignidad y la vida de muchos ciudadanos del común”
También destacan que el articulado planteado hace prever retrocesos en materia de derechos de los usuarios del sistema de salud, pues se perdería el derecho de escoger el asegurador, en la portabilidad del servicio en el territorio, en contar con un plan de beneficios en salud claro y exigible en todos los niveles de atención, tener un agente que representa y en los mecanismos de garantía de derechos, “que, como la tutela, no son claras dada la indefinición y traslape de roles entre las nuevas instituciones que crea la reforma”.
Aunque afirman que se comparte el objetivo de ofrecer mejores servicios de salud en áreas rurales, así como la preocupación del Gobierno en cuanto a la prevención de la enfermedad y la promoción de la salud, consideran que la reforma no es la solución más adecuada para lograr esos objetivos, porque pierde de vista los avances significativos que se han logrado hasta el momento en materia de salud.
“Creemos que se está perdiendo la oportunidad de mejorar la organización, la eficiencia y la calidad de la prestación del servicio y de aprovechar más adecuadamente los recursos disponibles, regulando la manera como se ofrece el servicio y se controla la demanda sin afectar el derecho a la salud”, dice en la carta.
Y se agrega que “es claro que el sistema actual adolece de muchas fallas de diseño, pero el propuesto no contempla la posibilidad de mejorarlo, sino que augura lo contrario”. Se advierten, también, de los riesgos fiscales que conlleva la reforma.
Con esto en mente, los firmantes solicitaron que se retire la reforma y se abra una mesa técnica.
“Muchos de nosotros tenemos planteamientos valiosos y prácticos sobre la reforma a la salud. Por ello, le solicitamos, con amabilidad y confianza en su liderazgo, que haga una pausa en el proceso, retire la propuesta como lo han solicitado otros por distintas razones válidas, y abra una mesa técnica en la que todos los sectores relevantes puedan participar activamente”.
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