Colombia's health reform: false debates, real imperatives

Another substantial part of the Constitutional Court's jurisprudence has clarified grey zones in the ill-defined POS. Furthermore, actors on all sides of the political arena in Colombia concur that the POS was not based on either sound epidemiological evidence or a thorough actuarial analysis; nor did it set out prioritisation of treatments on the basis of cost-effectiveness criteria.

There is no doubt that Colombia's health system now faces a profound crisis. Pursuant to its declaration of a state of emergency in December, 2009, the government has adopted some important stop-gap measures, including injecting more resources into the system. However, the structural reforms called for by the Constitutional Court in judgment T-760/08 still need to be implemented.

T-760/08 called for universal coverage and the unification of the unequal benefits schemes under the POS, both of which had been envisioned in Law 100. Far from ordering equalisation upward, T-760/08 urged a comprehensive, evidence-based, and participatory process to review the contents of the POS. It is imperative for the stability of the system that the government adopt such a process, including ensuring meaningful participation of a broad range of civil society actors.

I declare that I have no conflicts of interest.