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The Impact of Law No. 100 in Colombia
15 years after the approval of Law No. 11 in Colombia in 1993, it is time to assess its impact on the lives and health of the people of Colombia. Detractors say that the law gave way to a brutal capitalism in the health field, with large intermediary companies, closing down of many public hospitals, worsened health conditions and weakened public health, and ruining of doctors. Some of these complaints may be warranted, but in general they lack objectivity and scientific evidence. Objective analysis shows positive results, although some failures exist. Law No. 100 is the product of two somewhat contradictory political and legal phenomena, just like the Constitution of 1991 and the opening of the market, with clear tendencies against privatization.
Statistics show that over the past 15 years, the population's health has been improving, owing not exclusively to insurance but to several factors. It would not be fair to ignore that today 35 million people have health insurance and over 40 million have access to health services through affiliation with one of the two schemes, being linked to or protected by a special scheme. There is no doubt that equality has increased, as illustrated by Colombia's first place in the World Health Report in this aspect. Today, there are more than 40 competing insurance companies, all under regulations and control and more than 15 000 healthcare providers, including approximately 1000 registered and certified hospitals and clinics, and employing around 500 000 people, of which 40 000 are general doctors and specialists.
Economically, the health sector is one of Colombia's most important ones, with a 20 trillion pesos annual budget. The international academic world and international experts consider Colombia's health system as one of the world's most advanced and efficient, although it is acknowledged that it contains weaknesses and is not perfect.
Shutting down the General System for Social Health Insurance (SGSSS), as some have suggested, would be foolish and impardonable, as this would mean a return to all the failures that existed at the time Law No. 100 came into effect. It is necessary to improve and evolve continually, correct failures and anomalies, finding the ultimate productivity and efficiency, guarantee quality, attain coverage for the entire population regardless of the financial situation of the users, speeding up payments, avoid crime against social security and control the entire operation. All of this is possible without introducing new laws and with a minimum of regulation.
Article from La República