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Colombia-based insurance provider Sura is set to depart from the country’s public health system, citing financial unsustainability under the current government-controlled payment structure.
The insurer, part of Grupo de Inversiones Suramericana, serves more than five million Colombians but logged a net loss of $94m (364.66bn pesos) in 2023, with projections of a potential increase to $130m this year, reported Bloomberg.
“Although health is a fundamental right and what has been done constitutes a great social achievement for the country, unlimited coverage and services contrast with an insufficient budget,” Sura was quoted as saying.
Colombia’s government sets health insurance rates based on individual income, with funds distributed to insurers responsible for managing patient care and payments to healthcare providers.
However, the system has been criticised for delays and denials in approving medical procedures, and hospitals are reporting debts from insurers, which escalated during the pandemic to $1.5bn, according to AP.
President Gustavo Petro’s administration proposes to replace private insurers with a state-run agency to manage patient care and hospital payments directly.
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By GlobalDataHowever, Colombia’s Congress has rejected the necessary legislation to restructure the country’s healthcare system due to worries that Petro’s proposed changes would give bureaucrats too much control over healthcare spending and could result in resource mismanagement on the part of the state, which lacks the staff and knowledge necessary to oversee millions of health insurance accounts.
Sura’s move follows the government’s recent takeover of EPS Sanitas, a unit of Keralty SAS, due to financial non-compliance, raising concerns about the precedent of increased state control in the health sector.
Suramericana CEO Juana Francisca Llano expressed concerns at a press conference that Sura could face a similar situation as EPS Sanitas due to its financial state.
The business will carry on providing services to customers in the private system.
Despite the withdrawal from the public health system, Suramericana assured that its solvency and liquidity remain intact, as Sura does not contribute to the company’s dividends or cash flow.
In response to Sura’s announcement, the presidency’s office refuted claims of damaging the health system, attributing the issues to “structural and systemic problems” accumulated over time and denying any government responsibility for the sector’s challenges.