A WIDE SELECTION

Colombia 2013 | HEALTH & EDUCATION | REVIEW: HEALTH & EDUCATION

The government, educational institutions, and private healthcare providers are working to develop the best people and products in the sector, as Colombians demand greater access and transparency.

With a population of over 47 million and a growing number of medical tourists, Colombia is looking to provide the right care for those seeking treatment in the country. The government currently spends approximately $618 per capita, or 9% of the national budget, on healthcare, which came to a total of $27.5 billion in 2012. Government expenditure in the sector is expected to grow by 6.6% in 2013, to reach $29.2 billion.

Although the number of people working in the local health workforce is still well below the regional average, with less than 14.7 doctors and 6.2 nurses and midwives per 10,000 people, life expectancy is high in the country. Every Colombian male is expected to enjoy 74 years of life, while women are born with a life expectancy of 81 years.

Since corruption cost the country's healthcare sector up to $5 billion since the turn of the 21st century, the Santos administration has worked diligently to develop new legislation that can prevent losses in the future. In 2013, health reform is expected to play a key role in the sector, with a restructuring set to take place that removes intermediary health businesses.

Meanwhile, the pharmaceuticals industry is experiencing growth that is forecasted to continue well into 2013. Through collaboration between academia and the private sector, segments of the pharmaceutical industry such as biotechnology and generic products are seeing increased attention.

NEW LEGISLATION

In a move to remedy a sector that has suffered from the poor quality of health insurance intermediaries, a variety of proposals have been made to restructure health care in Colombia. In response to mismatched insurance claims for patients seeking medical care, the President has suggested the creation of a centralized system that would be more cost-effective and make better use of taxpayers' funds.

President Santos submitted his healthcare reform bill to Congress in March 2013. Under the new legislation, a number of private insurance companies, or Entities Promoting Healthcare (EPS) that manage public healthcare funds, would be eliminated. According to local media, the President explained that the new healthcare model would be “much more efficient, much more accessible, and much more supportive." The EPS, which manage taxpayer-funded healthcare, would eventually be replaced by a single, government-controlled fund called Salud Mía, or My Health. Once installed, the program is estimated to collect, manage, and sustain approximately $26 billion in healthcare resources. At the same time, operating costs, operation, and the technological development of the new entity are estimated to reach $55 billion by 2016.

In place of the EPS, the government will create a number of health consultancies that will not manage any funds, but instead help to provide an intermediary function between the government and the people by ensuring that health care reaches the population within the new system, defining service networks, auditing accounts, and defining direct payments to healthcare institutions. The reform will also cut current services that do not result in direct diagnoses or cures.

Those who oppose the suggested health plan criticized President Santos for allowing an existing number of EPS to be involved at any level in the new system. In opposition to the government's plan, an alternative health reform proposal was announced in April 2013. This program, submitted to Colombia's Senate Secretary, would nationalize the system completely and was created by the Commission for Monitoring the 2008 Structural Reform of Health and Social Services (CSR) and the National Alliance for a New Health Model (ANSA). In addition, representatives from different political parties, medical fields, patient organizations, and unions offered their input. One of the key aspects of the alternative proposal is the intention to launch a base restructuring of the system. It also includes a request to repeal the controversial Law 100, which was a reform implemented in 1993 and subsequently established the privatization of the sector. With the support of senators and representatives from the various opposition parties, the plan is based upon the principle that health care is a fundamental human right and should be provided by the state rather than a free-market mechanism. Similar to the Santos administration's reform plan, the alternative proposal also aims to remove the privately run EPS network.

In addition to structural reforms expected to take place in 2013, a number of other public health issues have been brought to the table. In particular, solving the issue of obesity has become significant to improving the health of Colombia's citizens overall. According to the Ministry of Health, 50% of Colombians are overweight and 16.5% are classified as obese. In response to these findings, the Constitutional Court of Colombia has ordered the government to campaign against obesity and provide operations for the disorder, local media reported in January 2013.

COSMETIC SURGERY

In addition to medical options for health, Colombia has begun to specialize in beauty procedures in recent years. Although plastic surgery has been widely available since the 1970s, Colombia has been recognized recently for its doctors' level of expertise, affordable prices, and the attractiveness of the country in general.

In total, about 500,000 cosmetic operations are performed in the country on an annual basis—the second-highest number in South America after Brazil. Worldwide, Colombia is the 18th most popular destination for plastic surgery, and the country is ranked fifth in per capita terms.

With liposuction, breast augmentation, and rhinoplasty among the most popular procedures, the National Society of Plastic Surgery (SCCP) has noted a significant growth in the number of patients arriving from abroad. “To meet demand, we are receiving more training in our own country," Carlos Enrique Hoyos Salazar, President of the Society, explained to TBY. “We maintain an actualization of our knowledge with symbiosis courses or by going to other countries, such as Europe, the US, Brazil, Argentina, and even Mexico." To keep up to date with the latest trends, the company works with advanced technology and techniques and attends a variety of conferences to compare Colombia's situation and knowledge with that of other countries.

PHARMACEUTICALS

As an important segment of the healthcare sector overall, the pharmaceuticals industry is estimated to reach a value of $4.45 billion in 2013. This volume marks almost 6% growth compared to 2012, when the volume of the sector was recorded at $4.2. billion.

As one of the most biodiverse countries in the world, Colombia has a wide range of resources to draw upon for the development of the pharmaceuticals industry. In addition, its geostrategic location—with easy access to markets such as Venezuela, Ecuador, and Peru—and the free trade agreement (FTA) with the US make it an attractive investment destination for multinational corporations. In this context, biotechnology and related research could play a starring role in the sector in years to come.

Due to the prevalence of viral infections such as dengue fever and malaria in Colombia, several pharmaceutical companies operating in the country are focused on products that target specific diseases. For Fernando Londoño Benveniste, President of Biogen, R&D has become an increasingly important part of operations in Colombia. “We invested more than $12 million in innovation in 2012," he explained to TBY. “We are currently in the process of developing viral infection related products, a segment in which we have specialized for the last 14 years." Speaking to the potential of the pharmaceuticals sector, Londoño believes that the commercialization segment of the industry holds important investment potential, especially as higher education institutions and the private sector begin to collaborate.