Análisis del flujo de recursos del régimen subsidiado en salud para Colombia, 2008-2012
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Los recursos que financian el sistema de salud colombiano especialmente el régimen subsidiado, no se usan adecuadamente. La principal causa es que el modelo aplicado (pluralismo estructurado) le permite a las EPS manejar los recursos a su favor, en detrimento de prestadores y usuarios de los servicios. A partir del análisis realizado en este trabajo, se identifican obstáculos en el flujo de recursos del régimen subsidiado que restringen el financiamiento de las IPS. Básicamente el problema radica en altos niveles de deuda de las EPS mayoritariamente vencida y el uso de mecanismos como glosas para el no-pago de facturas. Además la situación se agrava porque los gobiernos plantean soluciones no efectivas, pues la esencia del sistema en cuanto al papel de las EPS, se mantiene.
Abstract. The resources that finance the Colombian health system, specially the subsidized scheme are not used adequately. The principal reason is that the applied model (structured pluralism) allows to the EPS to handle the resources in its favor, to the detriment of users and services providers. From the analysis done in this work, obstacles are identified in the flow of the resources of the subsidized system that restrict the financing of the IPS. Basically the problem lies in high levels of debt of the EPS mainly overdue and the use of mechanisms as glosses for not paying the bills. In addition the situation worsens because the governments raise not effective solutions, since the essence of the system in respect to the role of the EPS, remains.
Abstract. The resources that finance the Colombian health system, specially the subsidized scheme are not used adequately. The principal reason is that the applied model (structured pluralism) allows to the EPS to handle the resources in its favor, to the detriment of users and services providers. From the analysis done in this work, obstacles are identified in the flow of the resources of the subsidized system that restrict the financing of the IPS. Basically the problem lies in high levels of debt of the EPS mainly overdue and the use of mechanisms as glosses for not paying the bills. In addition the situation worsens because the governments raise not effective solutions, since the essence of the system in respect to the role of the EPS, remains.