It will come as no surprise to learn that health care in Colombia is perhaps not what it should be even though the country has undergone a major transformation over the last decade. Despite the fact that the reputation of Colombia is still dominated by violence, murder and crime there have been major advances in these particular areas which have assisted with the mortality rate – even if an improvement in the health care system in Colombia is still required. However, when you compare the health care in Colombia today to that of the 1980s the difference is enormous although it has to be said it was from a relatively low base.
Many people believe that the major change in the structure of health care in Colombia came about in the 1993 reforms which effectively saw employees forced to pay into healthcare plans which were previously funded by their employers. The net result seems to be more finance for the healthcare system although it has to some extent expanded the difference between the rich and poor in Colombia and the level of healthcare which these particular parties have come to expect. We will now cover the specific changes in the Colombian healthcare system, issues which have arisen and also look towards the future.
General healthcare system in Colombia
In order to appreciate the improvements made over the last decade we need to look back at the 1980s which were a particularly difficult time for Colombia. As with so many South American and Central American countries it was the private healthcare sector which effectively led the way to an increase in the difference between the “haves and the have-nots”. Putting the private sector aside for one moment the National Health Service in Colombia is effectively split into two separate institutions, those who pay for their treatment and those who receive subsidised healthcare from the government.
Despite the fact that the authorities have made a major play in increasing the individual contribution system, as of 2009 there were still over 24 million people on the subsidised plan and just over 17 million people on the contributory scheme. So what can you expect from the various schemes available in the Colombian healthcare sector?
Social security health care in Colombia
There is no doubt that poverty is still a major issue in Colombia which is one of the reasons why Social Security healthcare is still a major part of the underlying system and indeed continues to eat more and more taxpayers money. Even though there is no way that the system can move ahead and take everybody with it at the same time there are many who believe that the current structure is more targeted towards a financial/private sector mindset which has left many people deprived of quality healthcare in the short to medium term.
Public sector healthcare in Colombia
As we suggested above, the public sector health care system in Colombia is very much split into two, those who can contribute to their own treatment and those who are unable to. The additional burden of contributing to the system has also hit the retail arena fairly hard as the authorities look to squeeze as much money as possible to reduce the burden on Colombian taxpayers. However, those who pay and those who are subsidised have for many years allegedly received a substandard level of service and the number of people taking legal action against their local health authorities continues to rise.
Private sector healthcare in Colombia
As is becoming more and more prevalent in South America and Central America, the explosion of private sector healthcare services continues as does the enormous income this continues to create. For many people this is the only real way forward and the only opportunity to ensure you have the highest level of treatment available as and when required. If you are an expats looking to move overseas, and Colombia is potentially one of your considerations, then you need to do your own homework with regards to the cost of health care in Colombia and the various insurance plans available. If you choose carefully it is likely that you will receive the best treatment available in Colombia via your private healthcare service provider.
National health policies and plans
Despite the fact that great progress has been made since the 1980s, when many believe the health care system in Colombia hit rock bottom, there are serious concerns that the Colombian government is beginning to run out of money. Indeed a recent report suggested that some Colombians have taken out loans which now total around $3 billion to ensure they receive private healthcare insurance despite the fact that many cannot afford it. This reflects a growing disillusionment with the healthcare system in Colombia and the fact that rumours that the authorities are struggling to fund subsidised healthcare going forward may well be true.
The problem for many people is the fact that as the public sector health care system continues to struggle this will see more and more people move towards the private healthcare sector potentially starving the public sector of skilled workers. When you take into account the fact that there are around 1.1 physicians per 1000 people in Colombia, against a Latin American average of 1.5, Colombia compares badly even against struggling neighbours. Total healthcare spending in Colombia equates to around 6% of GDP and around 20% of total government expenditure with the balance made up from the private sector.
Expats in Colombia
Those looking to live in Colombia need to address the problem of healthcare in the country as soon as possible. The growth in the private sector, and problems with the public sector, have pushed more and more people out of the system and as the government struggles to continue to fund public sector, subsidised, treatment there are major concerns going forward. So if you are thinking of moving to Colombia you should have your own healthcare in place, whether paid for by yourself, in conjunction with your employer or perhaps a corporate scheme.
These are issues which you should address before taking on any positions in Colombia because ultimately if you are left high and dry with no healthcare insurance then you could be in grave danger should you require any treatment. Without meaning to be too alarmist, even though there has been significant improvement in the healthcare system in Colombia in the 1980s, the changes brought in by various governments now seem to be running out of steam and the funding pot is empty after the recent economic downturn.
Health care benefits available to expats
Subsidised health care for all in Colombia is written into law although the ability of the authorities to carry out these obligations is literally being stretched to the limit. As we mentioned above, more and more people are now taking legal action against hospitals and doctors than ever before due to delays in treatment and concerns about the standard of treatment available. This legal action is not only taking up a significant amount of time for staff in the medical system in Colombia but any payouts will effectively reduce the budget for health care in Colombia. As the authorities improve the system, as many hope they will in the future, the number of legal actions should start to fall and hopefully funds which have been used to compensate those allegedly mistreated can then be redirected back into the health care system.
So while everybody is eligible for healthcare treatment in Colombia, if you’re looking for something reliable then perhaps you need to look at the private healthcare system and insurance policies.
Medical conditions prevalent in Colombia
There have been and continue to be many medical conditions prevalent in Colombia which take in the likes of strokes, respiratory disease, road accidents, diabetes and AIDS/HIV. Again, while there has been much progress made with regards to the treatment of the above conditions there is also much work to be done in this particular area. Instances of AIDS and hepatitis B continue to rise despite the fact that the authorities have poured significant money into this area of the healthcare system although whether it has been targeted at the correct areas is open to debate.
It is also worthwhile being aware that various waterborne diseases such as malaria are still very common in the lowlands and coastal areas although treatment should be readily available if you fall foul of these particular troubles. Unfortunately in the short-term it is highly likely that desperate funding for treatment of various life-threatening conditions prevalent in Colombia will be in very short supply because of the worldwide economic downturn and the fact that the Colombian government’s budget has been stretched to the limit.
Emergency treatment in Colombia
As we mentioned above, each and every person in Colombia has a legal right to medical treatment whether this is subsidised or free from the state. However, there is no doubt that the difference between medical treatment from the private sector and the public sector is enormous and those who are in a position to cover their own healthcare bills, via various healthcare policies, should seriously consider doing so. Whether or not we will see more changes in the health care system in Colombia, due to the lack of funds available to the authorities, remains to be seen but more and more experts in this particular field have expressed their concerns about the short to medium-term outlook.
The future of healthcare in Colombia
In many ways it seems as though the Colombian authorities have “run out of money” with regards to their continued investment in the Colombian healthcare system. The decision to effectively split the public sector into subsidised and non-subsidised has not been very well received by the population although there is no doubt it has had a positive impact upon cash flow in the short to medium term. However, it has also highlighted the attractions of the private health care system in Colombia which could possibly be to the detriment of the public health care sector in the long-term.
There is now a real danger that progress made in the 1980s and the 1990s could very quickly unravel unless the authorities are able to put in place a significant increase in available funding. However, when you set this against the current economic backdrop in Colombia, South America and around the world, what are the chances of the Colombian government increasing its tax take in the short to medium term?
There are certainly a number of plus points and a number of negative points with regards to the healthcare system in Colombia and there is no doubt that health care in Colombia is very much a hot topic in the region. As we mentioned above, the authorities made great progress in the 1980s and changes in 1993 effectively split up the public sector healthcare system into subsidised and nonsubsidised arenas. This seemed to work in the short-term although the government has recently confirmed budget difficulties could reduce the amount of funding available for the subsidised healthcare system in the short to medium term.
As a consequence, and this is not really any different to any other country in Central and South America, if you’re moving to Colombia you should really be looking towards private healthcare insurance to ensure a swift response and a high standard of treatment when required. If you are moving overseas with your employer then there is every chance there will be some form of corporate health care plan in place, whether or not you have to contribute is a different matter. There are dangers with relying on the public health care sector, both subsidised and nonsubsidised, in the short to medium term which need to be considered against the cost of private healthcare cover.
There is now a real danger that the Colombian authorities could run out of money in the short to medium term and very quickly the changes which were put in place back in the 1980s and the 1990s could unravel. This would be a disaster for the Colombian authorities who have over recent years worked very hard to increase the standard of treatment available at a cost to both the state and the end user. As ever, there are pros and cons with regards to the national healthcare system in Colombia and you need to be fully aware of these before making the move.