Service at the EPS – The wait of a lifetime

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Deplorable conditions in an EPS in Medellin. Photo: hsbnoticias.com

Being sick in Colombia can become a ‘headache’ for an entire family, even if you’re affiliated with a health care provider company. Jaime Sanjuan, an ombudsman of the district of Barranquilla, says that the situation with EPS (Health Provider Entities) is overwhelming. According to Sanjuan, in 2015, more than 3.500 complaints were filed against various EPS companies.  “Patients are not treated; they don’t receive medication on time and procedures are regularly suspended,” he says.

Take for example the case of Salim Barreto, a 4-year-old boy who suffers from cerebral palsy and is affiliated with the EPS, Saludvida. His mother, Astrid López, says that after a lawsuit against the EPS in 2012, the court ordered the healthcare company to provide Salim neurodevelopmental physical and occupational therapy. However, according to Mrs. Lopez, the EPS stopped the treatments without explanation five months ago.

Day in and day out, many people are forced to fight with their EPS to get the medicine and the treatment they need. For those without access to privileged, prepaid medical care, the health system has become a game of chance, not knowing whether you’ll be treated or if they’ll just let you die, sitting in a wheelchair, waiting to be seen.

Such was the case just last month with David Ballén, an elderly grandfather, who, following kidney disease and a four month period of convalescence, went to EPS CafeSalud in Cali. According to his daughter, Marta Ballén, the wait was several hours and he died without having been seen by anyone.

You might think, well, that’s just a one-off case. Not so; the internet is full of examples of poor care, long waits, and negligence by various EPS’ around the country. Here is an example of how more than fifty people died from negligence across just one year at an EPS in the south end of the country.

Just last year, in an effort to turn the situation around and improve the healthcare situation across the nation, president Juan Manuel Santos signed the health statutes which set into place a number of regulations around healthcare including quality of care and access. The statutes grant all Colombians the right to quality medical services.

Meanwhile, there has been an increase of lawsuits against health insurance companies in Barranquilla and around the country due to poor service. Mr. Sanjuan noted there have been many reports that some EPS providers are scheduling “urgent appointments” with terms of up to 20 days. “It’s inhuman,” he said. “A person asking for an urgent appointment isn’t playing; they need immediate medical attention, as opposed to what it is occurring now.”

Last year, 409 complaints were received by the Barranquilla District Office of Consumer Rights, of which 178 requests were due to delays in the delivery of medication and 127 for denial of service. Gloria Lamus, Regional Ombudsperson, says that the situation is overwhelming. “The right to health is a commitment to life. If you don’t receive the attention you require, it puts the integrity of the system at risk,” she notes.

The Colombian National Constitution (Article 49) says, “Health care and sanitation are public services offered by the State. Everyone is guaranteed access to health promotion, protection, and recovery services. The State organizes, manages and regulates the provision of health services to residents and environmental sanitation in accordance with the principles of efficiency, universality, and solidarity. Also, the State establishes policies for the provision of health services by private entities and to exercise supervision and control.”

Unfortunately, this is nothing but words because the reality is totally different. Hopefully, one day everyone will have an access to an adequate medical service in which doctors don’t prescribe simple acetaminophen or loratadine regardless of the ailment or God forbid, let them die, waiting in the emergency room.

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