El Gobierno Nacional radicó el pasado 19 de mayo de 2025 una nueva solicitud de consulta popular ante el Congreso de la República, compuesta por 16 preguntas, de las cuales 12 abordan derechos laborales y 4 se centran en el sistema de salud. Esta iniciativa surge luego de que el Senado hundiera la primera propuesta de consulta con una votación ajustada de 49 votos en contra y 47 a favor.
“La consulta anterior sigue vivita y coleando en el Congreso de la República”, afirmó el Ministro del Interior, en referencia a lo que el Gobierno considera un procedimiento irregular durante la votación en plenaria del Senado. Según la administración Petro, el Legislativo ha impuesto una “mordaza” que impide avanzar en reformas estructurales para el país.
El pueblo como constituyente primario – consulta popular
La nueva consulta se basa en el artículo 3° de la Constitución, que consagra la soberanía del pueblo como constituyente primario. Para el Gobierno, recurrir a este mecanismo es una respuesta directa a la obstrucción política del Congreso, especialmente en el trámite de la reforma laboral y la reforma a la salud, iniciativas centrales de su agenda social.
“Sabemos que los colombianos y colombianas respaldan mayoritariamente esta consulta”, señaló uno de los voceros gubernamentales durante la transmisión oficial. “Quieren decidir la suerte de los derechos laborales y de los derechos a la salud en las urnas”, agregó, citando una encuesta de Datexco que reveló que casi el 48% de la ciudadanía desaprueba la decisión del Senado de bloquear el trámite anterior.
Las 16 preguntas: dos reformas, una consulta
Las 12 preguntas iniciales de la consulta mantienen el enfoque en condiciones laborales, abordando temas como horarios, recargos dominicales, formalización, derechos colectivos, trabajo de plataformas digitales e inclusión de personas con discapacidad en el empleo formal.
Pero el mayor cambio de esta nueva versión radica en la inclusión de 4 preguntas sobre el sistema de salud, centradas en el acceso a medicamentos, el rol de las EPS, el modelo de atención primaria y los derechos laborales del personal sanitario.
1. Medicamentos esenciales: hacia la soberanía farmacéutica
Una de las preguntas plantea si el pueblo está de acuerdo en que el gobierno compre o produzca medicamentos necesarios para garantizar su entrega completa y oportuna. El presidente Petro ha defendido esta propuesta señalando que “necesitamos tener la soberanía y que sea el Estado el que asuma la responsabilidad de los medicamentos y pueda verdaderamente lograr que los precios se reduzcan”.
La propuesta busca romper con lo que el Gobierno considera monopolios especulativos del mercado farmacéutico y fortalecer la capacidad pública en producción y compra de fármacos.
¿Está de acuerdo con que el gobierno nacional compre o produzca los medicamentos necesarios para garantizar la entrega completa y oportuna a los pacientes? (Pregunta 13)
2. Transformación de las EPS y giro directo
La segunda pregunta en materia de salud cuestiona si las EPS deben dejar de ser intermediarias financieras y convertirse en gestoras de salud, permitiendo que el ADRES realice pagos directos a hospitales y clínicas. El Gobierno ha reiterado que no se trata de desaparecer las EPS, sino de cambiar su función. “No van a ser aseguradoras financieras porque ni tienen capital, ni patrimonio, ni reservas y siempre se quiebran”, argumentó un vocero oficial.
Como respaldo, el Gobierno menciona que ya se han realizado pagos directos por más de 4 billones de pesos en el régimen subsidiado, y se han anticipado pagos del contributivo, demostrando la viabilidad técnica del giro directo.
¿Está de acuerdo con que las EPS dejen de ser intermediarias financieras, se transformen en gestoras de salud y ADRES pague directamente a Hospitales y Clínicas? (Pregunta 14)
3. Modelo de atención primaria: resolutivo y territorial
La tercera pregunta apunta a establecer un modelo de atención preventivo, resolutivo y con enfoque territorial, combinando servicios públicos, privados y mixtos. “Lo fundamental en el modelo de salud está en la prevención de la enfermedad, la promoción de la salud y la atención primaria”, enfatizó el presidente Petro, haciendo referencia a los déficits actuales en cobertura rural y cierre de puestos de salud.
¿Está de acuerdo en que se garantice a los colombianos un modelo de atención primaria en salud, preventivo y resolutivo, con ampliación de los servicios especializados necesarios, de carácter público, privado y mixto? (Pregunta 15)
4. Dignificación del talento humano en salud
Finalmente, la cuarta pregunta propone crear un régimen laboral especial para garantizar vinculación formal, salario justo y derechos plenos para los trabajadores de la salud, muchos de los cuales prestan servicios bajo órdenes de prestación. “Las heroínas y los héroes de la pandemia se olvidaron. Hoy están por órdenes de prestación de servicios, sin prestaciones sociales. Queremos dignificar el trabajo”, expresó el mandatario.
¿Está de acuerdo con establecer un régimen laboral especial que garantice a los empleados y trabajadores de la salud la vinculación formal, los derechos laborales y el salario justo? (Pregunta 16)
Viabilidad financiera y argumentos técnicos
El Gobierno ha defendido la viabilidad económica de las reformas incluidas en la consulta. Según lo expuesto, la Cámara de Representantes aprobó un paquete financiero que incluye más de 6 billones de pesos: 3 billones por impuestos saludables y 2,6 billones por el llamado “IVA social”. Además, se proyecta un aumento progresivo del gasto en salud que elevaría el presupuesto hasta en un 1% del PIB para 2034.
“Las objeciones financieras han sido superadas”, aseguró el Ministro de Salud, reiterando que los recursos están identificados y aprobados dentro del Marco Fiscal de Mediano Plazo.
Calendario legislativo: tiempos clave
La nueva solicitud de consulta popular fue radicada formalmente por los ministros del Interior, Trabajo y Salud. Según los plazos establecidos por la ley, el Congreso tiene hasta el 17 de junio para pronunciarse sobre la convocatoria. En caso de aprobación, el proceso podría culminar con una jornada electoral a más tardar el 19 de septiembre de 2025.
Cabe mencionar que sectores de la oposición han cuestionado la motivación detrás de esta iniciativa, señalando que podría tratarse de una estrategia anticipada de campaña. Sin embargo, el Gobierno insiste en que se trata de una herramienta democrática legítima para resolver conflictos institucionales.
“Nosotros creemos que el Congreso a día de hoy no se ha pronunciado sobre la consulta. Esta es una nueva consulta, y las dos están vivitas y coleando en el Congreso de la República”, afirmó uno de los promotores durante el acto de radicación.
La decisión ahora recae en el Congreso, que deberá resolver si autoriza o no este segundo intento de consulta popular. Mientras tanto, el país se prepara para un nuevo capítulo de debate nacional que podría transformar profundamente el modelo social, laboral y sanitario de Colombia.
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