The Ministry of Finance states in the document that “the estimated fiscal impact of the bill can be incorporated in a manner compatible with the Medium-Term Fiscal Framework, maintaining the sustainability of the General Social Security System in Health.”

The Ministry of Health submitted a new health reform today. One of the most criticized aspects of its previous project, which was defeated in the Seventh Commission, was the absence of a fiscal concept.

On this occasion, the Ministry of Health seems to want to get ahead of this criticism. The project is made public together with an economic concept from the Ministry of Finance. In a response sent to the Minister of Health, Guillermo Alfonso Jaramillo and dated September 11, the Ministry of Finance concludes that “the estimated fiscal impact of the bill can be incorporated in a manner compatible with the Medium-Term Fiscal Framework, maintaining the sustainability of the General Health Social Security System and public finances to the extent that the current obligations of the health sector accumulated at the end of 2024 are covered according to the prioritization and definitions made in this regard by the Ministry of Health.”

The concept consists of just over 12 pages and includes some of the key points of the reform. The first of these is the strengthening of primary health care. The Ministry of Finance summarizes some key points of the project, such as the fact that the primary level will be made up of territorial health teams and Primary Health Care Centers –CAPS, which will be the population's first contact with the system. And that the complementary level will be made up of medium and high complexity institutions.

The Ministry of Finance highlights that the Ministry of Health project “incorporates criteria of progressivity and gradualness, which, in favor of fiscal sustainability and budgetary restrictions, seek to allow the implementation of the project in a fiscally challenging scenario.” Elements such as the strengthening of the Public Hospital Network or health incentives are subject to this progressivity.

Primary health care

Direct expenditure on Primary Health Care is detailed in a document from the Ministry of Health and Social Protection. These expenses cover the resources needed for the operation of Primary Health Care Centres (CAPS) and Territorial Health Teams, which are part of the strategy.

As for the cost components, the Ministry of Finance explains that the first is direct labour, which includes the salaries and benefits of staff who work directly in the provision of services, such as doctors and nurses. It also covers the costs of the Territorial Health Teams. Indirect labour refers to administrative staff, such as those in charge of user care or managing referrals and counter-referrals between health services.

Another key component is operating and service delivery costs, which include the costs of purchasing medicines, medical and surgical materials, as well as diagnostic support services. General expenses such as security, cleaning and transportation, which are essential for the proper functioning of health institutions, are also taken into account.

At the medium and high complexity level, funds are allocated based on the proposals of the Ministry of Health, to cover the most advanced health care services. Finally, the strengthening of the public network includes investments to improve the infrastructure and services of the public institutions that are part of the health system, all justified in the technical studies presented by the Ministry.

Next, he presents the projected uses of the system for the next 10 years.

The table shows a breakdown of projected expenditures on the health system, divided by different key areas, from 2025 to 2034. The values are in billions. For primary health care, the estimate starts with a budget of $18,563 million in 2025 and increases each year until reaching $36,636 in 2034, showing a progressive increase.

In medium and high complexity, which represents the expenses destined for the most specialized or complex care (such as surgeries, intensive care, Minhacienda indicates that it starts with an expense of $71,980 in 2025 and increases to $94,075 in 2034, indicating that the costs of these services will also grow considerably. Later, the strengthening of the public network is specified. This component refers to investments to improve public health institutions, such as hospitals and clinics. The values start at $1,000 million in the first years and rise to $4,862 million in 2034.

Other expenses are also estimated, including scholarships, maternity benefits, institutional strengthening and a disaster fund, among others. Scholarships, for example, remain constant at $120 for a few years and then rise to $200. The maternity benefit rises from $450 million in 2025 to more than $1,000 in the following years. The concept is signed by Marta Juanita Villaveces Niño, Technical Vice Minister.