Domingo, 11 de diciembre de 2016

| 2010/02/05 00:00

Shock treatment

Feb 5--President Uribe tries to push through some much-needed changes.

Shock treatment

As allies of Barack Obama seek procedural tricks to slip his health reforms through a truculent Congress, his Colombian counterpart, Álvaro Uribe, is not bothering with such niceties. He has simply issued a set of decrees ordering a much-needed but equally controversial shake-up of his country’s health service. The Constitutional Court, whose earlier rulings have added greatly to the health system’s financial stresses, is examining the decrees. Mr Uribe has begun negotiating with doctors and other opponents over how they are implemented—but he remains determined to see them through.

There is little argument over the need to close the big deficit in the health service’s budget. Mr Uribe’s decrees include an increase in taxes on alcohol, cigarettes and gambling, and measures to cut losses from corruption and bureaucracy. But his critics accuse him of taking advantage of this financial emergency to make more profound changes to the way health care is provided, and with little public debate.

Doctors are especially angry at a decree limiting their autonomy to prescribe the best treatment for patients. Along similar lines to reforms introduced in Britain in the 1990s, it seeks to introduce a list of approved drugs and treatments. However, Mr Uribe at first sought to go further and impose fines of up to $13,000 for doctors who prescribe beyond what the list allows. Their strong objections prompted him to backtrack and promise that the new treatment standards will be only advisory, except in certain cases.
 
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