After a proposed overarching healthcare reform was shelved in May 2021, Health Minister Fernando Ruiz had to refocus his attention on other factors to help sustain Colombia’s social security–based healthcare system. The Ivan Duque government entered office in 2018 amid many healthcare challenges, such as the need to address financial liquidity challenges, incentives for insurance companies and hospitals, the installation of electronic healthcare records, and growing demand and costs for therapies not listed on the basic formulary. Our view is that this government has merely provided short-term support to ensure that the system continues to function. While the pandemic presented a major disruption to the execution of any plan to improve Colombia’s healthcare system, it is now clear that many of the challenges will be left for the next government to resolve after Colombia’s election.
Overview for 2021–2022
Following a 15% increase in the direct contributions to the SGSSS system in 2020, the 2021 budget proposal calls for another 6% increase in 2022. Interestingly, following a boom in the number of subsided regime beneficiaries in mid-2021, the numbers in this regime have stabilized, while the number of beneficiaries in the contributive regime have largely rebounded to their pre-pandemic levels. Meanwhile, an overarching reform for the healthcare system was shelved in early May 2021. We anticipate continued support to the system but a struggle to execute major changes during the remainder of the administration.
Risks to Forecast
The major risks to the current outlook include a potential significant shift of beneficiaries to the subsidized regime once the health emergency ends. Additionally, further social disruptions that might impact government revenue could lead to a weaker-than-expected 2022 budget. Finally, early data suggests that the maximum budgets for 2021 might be under financed, but another allocation from the Ministry of Finance is expected in Q4 2021 like we saw in 2020.
Healthcare firms should anticipate continued prioritization of healthcare financing from the government, but at the same time, rule out finalization of the Acuerdo de Punto Final during the remainder of the Duque government. Major opportunities will come from the general expansion of coverage and the coming rebound in elective procedures. That said, firms will need to closely manage the challenges patients face in getting diagnoses given the high movement of beneficiaries between EPSs and the impact this has on gaining access to an adequate care pathway.
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