Colombia: what has happened with its health reform?

• Main Authors: Rubén Darío Gómez-Arias, Emmanuel Nieto
• Format: Article
• Language: Spanish
• Published: Instituto Nacional de Salud 2014-12-01
• Series: Revista Peruana de Medicina Experimental y Salud Pública
• Subjects: reforma de la atención de salud, colombia; modernización del sector público; financiación de la atención de la salud
• Online Access: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/127

The health reform adopted in Colombia in 1993 was promoted by different agencies as the model to follow in matters of health policy. Following the guidelines of the Washington Consensus and the World Bank, the Government of Colombia, with the support of national political and economic elites, reorganized the management of health services based on market principles, dismantled the state system, increased finances of the sector, assigned the management of the system to the private sector, segmented the provision of services, and promoted interaction of actors in a competitive scheme of low regulation. After 20 years of implementation, the Colombian model shows serious flaws and is an object of controversy. The Government has weakened as the governing entity for health; private groups that manage the resources were established as strong centers of economic and political power; and violations of the right to health increased. Additionally, corruption and service cost overruns have put a strain on the sustainability of the system, and the state network is in danger of closing. Despite its loss of prestige at the internal level, various actors within and outside the country tend to keep the model based on contextual reforms.