Vicente Calvo, who has spent recent years investigating and reporting on the embezzlement of health insurance companies (EPS) from the healthcare system, published an analysis of how the financial crisis that erupted in 2024 unfolded. According to Calvo, the collapse could have been avoided if the regulations issued since 2007 had been followed.
In 2007, Decree 574 required EPSs to maintain technical reserves as a financial protection mechanism to provide healthcare services. However, year after year, this requirement was extended through various resolutions, allowing the entities to operate without the required real support.
Starting in 2014, new regulations granted additional prerogatives to EPSs, making their obligations more flexible. Instead of strengthening controls, recovery and reorganization routes were created that allowed them to continue operating despite their financial problems. This permissiveness, Calvo asserts, ended up institutionalizing noncompliance.
The researcher also noted that the 2019 Final Point Agreement did not resolve the structural problems. Although it partially covered historical debts, the EPSs still lacked sufficient reserves, and the flow of resources to the IPSs remained weak and opaque.
Finally, resolutions issued in 2021 and 2022 allowed solvency indicators to be manipulated by relaxing the reserve calculation criteria. This, according to Calvo, was a time bomb that exploded in 2024, directly affecting millions of healthcare users and workers.
For Calvo, the central lesson is that the system requires clear rules that are effectively enforced, preventing temporary exceptions from becoming permanent rules and preventing financial fraud from taking precedence over the health of Colombians.