Contrast the Health System in Colombia: Social Insurance, Social Health, and Proposed Reform Models

OBJECTIVES: Comparing the Health System characteristics between the previous Social Insurance, Social Security Systems in Colombia, and the Proposed Health System Reform.

METHODS: The research was framed in the comparative, observational, and retrospective descriptive approach, conducted an exhaustive search of different bibliographic sources, related to the health system under social insurance, health social security, and the Proposed Health System Reform’s models.

RESULTS: Law 100 of 1993 made it possible to unify regulations and establish fundamental pillars such as universality, efficiency, solidarity, and comprehensiveness, thus strengthening well-being and equity in society. This led to the conclusion that a reform that guarantees equitable and efficient access to health strengthens primary health care, increases investment in primary healthcare centers and the network of professionals, and improves access to preventive services, diagnoses, and basic treatments.

CONCLUSIONS: When comparing the social security system in Colombia before and during Law 100 of 1993 with the proposed health reform of 2023, a significant evolution in the country's approach to social security becomes evident. There has been a noticeable shift towards a more comprehensive, inclusive, and people-centric approach, focused on the well-being of the population. The reform proposal reflects an earnest attempt to address the identified shortcomings in the previous system, such as the lack of universal access, unequal resource distribution, and fragmented service delivery. This comparison highlights the importance of considering not only the technical and structural aspects of the health system but also the social, economic, and political factors that influence its functioning. It underscores the necessity of adopting a holistic, evidence-based approach to design and implement effective and sustainable health policies.