(CNN Spanish) — More than 5.3 million members of the insurance company Sura, which is part of the health promoting entities (EPS) of Colombia, were surprised this Tuesday with the company’s announcement to request authorization from the Government of Gustavo Petro to stop providing services. services arguing defunding and depletion of their assets.
“To all Colombians we want to communicate the most difficult decision we have had to make as a company,” said Juana Francisca Llano, president of Sura, in a press conference.
As Llano explained, Sura, which has served the Colombian market for more than 30 years, evaluated the announced decision for several months and warned the Government since February of 2023.
After Sura’s press conference, the Colombian Government acknowledged in a statement that since 2023 it has held meetings with the EPS “to explore solutions that allow us to address the health system crisis.”
“The health system faces historic underfunding that compromises its sustainability. In Sura we have lost between the year 2022-2023, 360 billion pesos (US$ 93,378,168), which depleted our assets,” Llano indicated.
Likewise, he added that the financial crisis that Sura faces today is a reflection of a critical situation facing the entire health system in Colombia.
At the press conference, the insurer reported that until the Colombian government, through the Superintendence of Health, approves this retirement plan request, the attention to its clients will not be affected.
What would progressive clearing be like?
The request for voluntary and progressive clearing is a legal mechanism provided for in Colombian laws and has certain terms. Once the request for withdrawal authorization has been filed with the Health Superintendency, the entity has 65 business days to respond. If approved, the clearing would begin in an orderly and staggered manner, according to the plan that the company presented this Tuesday along with its application.
On the subject, the Superintendent of Health, Luis Carlos Leal, said that the entity he directs is verifying that the documents presented by Sura are in order to begin the study process.
What else has the Government said
After learning of Sura’s decision, the Presidency of Colombia issued a statement in which, in addition to guaranteeing the provision of the insurer’s services during the duration of the withdrawal process, it denied its responsibility in the current crisis and deterioration of the system. Colombian health center denounced by Sura.
The Colombian Government assures that the decision of Sura and other health promoting entities to cease operations only demonstrates the urgency of establishing a new health model.
The Petro administration proposed a health reform that has not been able to advance in Congress, which shelved it last April.
This Petro proposal proposes a health system with greater state control, less participation from the private sector and a scheme with emphasis on preventive health supported by primary care centers in the most remote regions of the country.
“It is not true that the National Government is destroying the health system. The EPS crisis is the result of structural and systemic problems that have accumulated over the years and is not due to recent cyclical situations. The health system requires an immediate transformation that ensures dignified and quality care for all Colombians, without any distinction. It is not true that the Government has not guaranteed the transfer of resources to the EPS Sura, or any other EPS. The National Government has insured each financial obligation to the EPS,” says the statement from the Presidency issued this Tuesday.
What will happen to affiliates
According to Pablo Otero, general manager of Sura, if the request for voluntary clearing is approved, the Ministry of Health has defined mechanisms and it will be up to the Superintendency of Health to evaluate the capabilities of the existing EPS, their presence in the territory and the needs of the patients in order to determine which EPS each user should go to.
“We offer that this assignment and that support be in an orderly manner and we can accompany our members in the continuities of care in the EPS that they receive,” said Otero.
However, among some members there is already a feeling of uncertainty regarding what may happen if Sura’s withdrawal from the health system is finalized.
This is what Rafael Cabrera, 82, a Sura customer in Bogotá for more than 15 years, told CNN. “This is hard for me, in all these years I have not had any complaints about Sura’s care and I am very worried about what could happen now. I hope the Government itself comes to an agreement with Sura, because one thinks, how are they going to throw more than 5 million patients on their shoulders without being clear about where they are going to receive them? It is serious.”
A concern that Jackeline Ruiz, also a user of this EPS, shares: “This situation is truly sad, and not only for us patients. By chance I was in Sura when the news broke and the internist apologized to me because she treated me 20 minutes later. She started crying in my presence, she told me that she had been in Sura for 17 years, that there were a lot of good staff working and without really knowing what was going to happen.”
Other reactions
Sura’s departure adds to the recent forced interventions by the Government to Sanitas, at the beginning of April, the second largest in the country, as well as that of the Nueva EPS, the largest entity in the sector and of a mixed nature.
Patients Colombia, a movement that brings together more than 198 patient organizations throughout the country, said in a statement that “the collapse of the health system as a consequence of the improvisation and negligence of the national government” is imminent, while making a called for the Executive to convene a working group with all the actors in the sector.
“We demand that the fundamental right to health, which is already being violated, be protected and guaranteed,” the organization stated.
Former Minister of Education and Health, Alejandro Gaviria, told CNN that Sura’s decision is serious and has profound consequences.
“It means that Colombia’s health system, as we know it, is coming to an end. The EPS Sura was for a long time not only the best in the country, but also an example, a symbol we could say, of the benefits of the public-private alliance on which the health system was based. Sadly it also means that health care problems will continue to grow. “We are facing the worst crisis of the system in 30 years.”
“There is no plan B, a reasonable alternative to replace the EPS,” he pointed out.
According to Gaviria, all health systems face sustainability and financial problems, for which measures must be implemented to allow them to function, something that, in his opinion, the current government has not done.
“This government ignored the problem. He bet everything on a failed reform. He underestimated the severity of the crisis and appears to remain in denial. Health crises, which are supply crises (services that close, medications that are not delivered, appointments that are canceled, surgeries that are postponed, etc.) do not occur suddenly. They are getting deeper day by day. But that is what we will have, a gradual and progressive worsening of health care in Colombia,” Gaviria added.
For his part, Gustavo Petro’s former Minister of Finance and professor at the School of International and Public Affairs at Columbia University, José Antonio Ocampo, stated in his X account that EPS Sura’s decision shows that there is an urgent need for a dialogue with the EPS and other actors to seek solutions to the problems of the Colombian health system.
As indicated by the president of EPS Sura, in her press conference this Tuesday, although the request for voluntary withdrawal from the health system is a decision already made, they remain willing to continue dialogue with the Government.
“This is a company that is always willing to talk with all the actors, we will always be willing to talk, the important thing is that we really focus on creating, maintaining, creating and maintaining a sustainable public health system,” he declared. Juana Francisca Llano.