Los pecados capitales del sistema de salud
Para nadie es un secreto que en Colombia tenemos uno de los peores sistemas de salud del mundo entero. Si no es de los más malos, como mínimo es de los más macabros y vergonzosos. O si no pregúntense por qué en Colombia tanta gente se muere esperando una cita médica o reclamando sus derechos en la entrada de los hospitales. O explíquenme por qué anualmente en este país pierden la vida más niños indígenas que en Somalia, por culpa de la desnutrición y la desidia del Estado como ocurre en regiones como Nariño, Cauca, Meta, Guajira, Putumayo o Casanare. Pero aquí nadie asume responsabilidades. Mucho menos si se trata de un ministro o del propio presidente, que en cualquier país civilizado ya estarían fuera de sus cargos. Porque no hay excusa para tanta negligencia, porque no hay derecho a estar pagando los precios de los medicamentos más caros del mundo, lo cual ha convertido al sistema de salud colombiano en una verdadera máquina de muerte, que se ensaña especialmente contra las y los colombianos más pobres y excluidos.
El diagnóstico es tan aterrador que casi no hay pecado capital que se resista a la comparación con lo que ocurre cotidianamente en el sistema de salud. Tenemos un sistema plagado de avaricia, de pereza, de gula, de ira y de soberbia, como si se tratara de una auténtica clasificación de «vicios» o pecados que definen el pasado, el presente y el futuro. Nunca antes el sistema de salud había contado con tantos billones, cerca de 40 billones, pero tampoco nunca antes su situación financiera había sido más crítica.
Fíjense, por ejemplo, en la avaricia, que no es otra cosa que el deseo desmesurado por la riqueza, propio de algunos políticos y farmacéuticas. Para ello basta recordar el famoso pacto conocido como el «consenso de Acemi», con el cual varias empresas promotoras de salud (EPS) se pusieron de acuerdo para negar arbitrariamente servicios de salud y aumentar los recobros al Fosyga, enriqueciéndose ilegalmente. La avaricia de las EPS les ha alcanzado hasta para adeudarle hoy en día a las clínicas y hospitales más de 4,9 billones de pesos, una deuda que perjudica especialmente a los pacientes, cuyas vidas han querido convertir en negocio y mercancía.
¿Y qué me dicen de la pereza? En el sistema de salud, la pereza se traduce en negligencia. Sí, en negligencia del Estado para regular los precios de los medicamentos, en la flojera del gobierno de turno para proponer una reforma a la salud que elimine las EPS como intermediarias financieras, que conciba la salud como un derecho fundamental, que desaparezca la integración vertical y dignifique la vida de las y los colombianos.
Mientras tanto, no deja de sorprenderme un pecado capital como la gula, ese apetito desmedido de las EPS por los recursos públicos, como ha podido investigar la Contraloría, al confirmar que las «EPS agremiadas en Acemi serían responsables de presunto detrimento por 1,8 billones de pesos». ¿Será por eso que ahora se quieren llamar «gestoras»? ¿Gestoras de qué, de corrupción y clientelismo?
No podemos olvidar la soberbia del ministro de Salud, que no va más allá de su defensa a ultranza del reencauche de las EPS, como advertí hace algunos meses en esta misma columna. La soberbia de Gaviria le alcanzó hasta para descalificar las recomendaciones de la sociedad civil, que se volcó a las calles para protestar contra quienes pretenden desaparecer el derecho a la tutela.
Por eso no es gratuito que por momentos se haya desatado la ira de la ciudadanía, ese sentimiento de enojo y molestia por una realidad que a todas luces es intolerable. Es la ira serena de la indignación por tanto sufrimiento, por tanta complicidad por parte de las autoridades para investigar y condenar a los responsables del desfalco a la salud.
Que no vengan a decir que las y los indignados no tenemos propuestas: ya propusimos una ley alternativa que nunca fue discutida. Ahora exigiremos -una y otra vez- tumbar la Reforma a la Salud de este Gobierno. Esperamos que los demás integrantes de la Comisión VII de Cámara, quienes actualmente son tentados por el gobierno nacional, no cometan el grave pecado de aprobarla.
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