La crítica situación financiera de los hospitales públicos en Colombia ha llevado a los gobernadores del país a solicitar formalmente la intervención urgente del Ministerio de Salud y Protección Social. La gobernadora del Valle del Cauca, Dilian Francisca Toro, advirtió que la crisis amenaza con deteriorar gravemente la capacidad operativa de las instituciones de salud en todos los departamentos.
“Los gobernadores del país le hemos enviado una carta al señor Ministro de Salud porque hay una crisis grave en los hospitales públicos en todos los departamentos. Necesitamos una intervención urgente”, declaró la mandataria, haciendo eco de la misiva enviada a través de la Federación Nacional de Departamentos (FND) al ministro Guillermo Alfonso Jaramillo.
EPS intervenidas, cartera impagada y colapso inminente
Uno de los principales factores que, según los mandatarios regionales, ha desencadenado la situación actual es el manejo de las Entidades Promotoras de Salud (EPS) intervenidas. De acuerdo con Toro, “esto se debe a que tenemos nueve EPS que están intervenidas y esas EPS tienen el 49% de las personas que están afiliadas al régimen subsidiado o al régimen contributivo. Eso quiere decir que 30 millones de personas están en estas EPS, y eso ha generado que no haya un pago oportuno”.
El bajo nivel de cumplimiento en las obligaciones financieras por parte de estas EPS está agravando la crisis estructural. “Solamente se paga el 65% de las deudas, lo que conlleva a que hoy tengamos una deuda acumulada de 6 billones de pesos y en lo corrido de este año puede llegar a 17 billones de pesos de deuda”, agregó la gobernadora.
Impacto en el Valle del Cauca: una deuda de $1,5 billones
La situación en el Valle del Cauca es especialmente crítica. Según cifras entregadas por la mandataria, solo en este departamento la deuda acumulada con la red pública asciende a 1,5 billones de pesos. El Hospital Universitario del Valle (HUV), centro de referencia para toda la región suroccidental del país, enfrenta una cartera vencida de $525 mil millones, convirtiéndose en la institución más afectada.
Este nivel de endeudamiento está impactando directamente en la prestación del servicio de salud, comprometiendo la continuidad, la calidad y la oportunidad en la atención a los pacientes, advirtieron voceros del sector hospitalario.
Tres medidas urgentes solicitadas por los gobernadores
En respuesta a esta crisis, Dilian Francisca Toro planteó tres acciones concretas que deben adoptarse de inmediato desde el Ministerio de Salud:
- Exigir a las EPS el pago corriente
“El Ministerio de Salud en conjunto con las entidades territoriales debe exigir a las EPS el pago corriente de los servicios y la prestación de los servicios de los hospitales públicos a los pacientes”, afirmó la gobernadora. - Diseñar un cronograma estricto de pago de deudas
Se propuso la construcción de un plan claro y verificable para saldar las deudas acumuladas con los hospitales públicos, con fechas definidas y mecanismos de monitoreo que garanticen su cumplimiento. - Fortalecer la vigilancia por parte de la Superintendencia Nacional de Salud
“La Superintendencia de Salud debe hacer un seguimiento muy estricto para que así de esa manera no se acumulen más deudas y los hospitales públicos puedan prestar ese servicio con calidad y con oportunidad a los pacientes”, puntualizó Toro.
Un sistema en riesgo de colapso
La situación descrita no es exclusiva del Valle del Cauca. En todo el país, múltiples hospitales públicos reportan retrasos severos en los pagos por parte de las EPS, generando dificultades para cumplir con obligaciones básicas como el pago de salarios, adquisición de medicamentos e insumos, mantenimiento de equipos y cubrimiento de servicios públicos esenciales.
La crisis también pone en jaque la estabilidad del talento humano en salud, dado que Profesionales médicos, enfermeros y personal administrativo enfrentan incertidumbre laboral, retrasos en sus honorarios y una creciente sobrecarga operativa debido al colapso financiero de las instituciones.
Contexto nacional y respuesta del Gobierno
La carta firmada por la FND se suma a otros llamados recientes de asociaciones médicas, federaciones hospitalarias y gremios del sector salud que han solicitado al Gobierno Nacional acciones estructurales para enfrentar lo que muchos ya califican como una “emergencia humanitaria en el sistema hospitalario público”.
Hasta el momento, el Ministerio de Salud no ha emitido una respuesta formal al pronunciamiento conjunto de los gobernadores. Sin embargo, la presión política y social sobre el ministro Guillermo Alfonso Jaramillo se intensifica, especialmente frente al riesgo de parálisis en servicios estratégicos como urgencias, hospitalización, cuidados intensivos y atención materno-infantil.
¿Qué está en juego?
De no tomarse medidas inmediatas, advierten los gobernadores, el sistema público de salud podría experimentar un deterioro irreversible. La interrupción en la atención de enfermedades crónicas, cirugías programadas y tratamientos de alto costo podría impactar negativamente indicadores de salud pública y elevar la mortalidad evitable en varias regiones.
Además, el incumplimiento de las EPS y la inacción regulatoria comprometen la confianza del sector en el modelo vigente, abriendo la puerta a un debate más profundo sobre la necesidad de una reforma estructural del sistema de salud colombiano.
El llamado de la gobernadora del Valle y de los demás mandatarios departamentales a través de la FND refleja una preocupación legítima por la sostenibilidad de los hospitales públicos en Colombia. Las cifras son contundentes: una deuda acumulada que podría llegar a 17 billones de pesos en 2025, instituciones con cartera crítica y una red pública al borde de la asfixia financiera.
Ante este panorama, los gobiernos territoriales demandan del Ministerio de Salud acciones urgentes, articuladas y eficaces. La atención oportuna de esta crisis es clave para evitar un colapso mayor del sistema y para garantizar el derecho fundamental a la salud de millones de colombianos.
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