Colombia faces a silent emergency: the healthcare system is collapsing under unpayable debts, unchecked corruption, and thousands of patients left without care.
Denied Rights in Latin America
Colombia’s healthcare system is going through one of its worst crises in decades. Millions of citizens face delays in treatment, medicine shortages, and the potential disappearance of several Health Promotion Entities (EPS), threatening to leave a significant portion of the population without coverage.
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EPS have accumulated losses of 9.6 trillion pesos so far in 2024, 70% of which belong to entities under government intervention, such as Nueva EPS, Sanitas, and Savia Salud. The delay in payments to clinics and providers exceeds 54%, with overdue debts surpassing 18 trillion pesos. The government has warned that at least eight EPS could be liquidated in 2025.
Medicine shortages and growing humanitarian crisis
Adding to this bleak picture is a shortage of medications, especially for patients with chronic and rare diseases, who face delays of up to several months in accessing their treatments. This has led to a 15% increase in legal actions over the past year. In cities like Cali, more than 4,000 people turned to the Mayor’s Office in 2025 to obtain medicines, most of them affiliated with intervened EPS. Although Resolution 542 of 2025 aimed to improve access to high-cost medications, organizations such as Fecoer (Colombian Federation of Rare Diseases) consider it insufficient and far from a structural solution.
Healthcare system on the verge of collapse
The system also suffers from chronic underfunding. The 5.36% increase in the Capitation Payment Unit (UPC) for 2025 is seen as inadequate compared to the 9.54% increase in the minimum wage, leading to an estimated 3 trillion peso deficit for Health Service Provider Institutions (IPS). The Constitutional Court ordered the government to recalculate the UPC and settle pending payments for maximum budgets, but the Ministry of Health has delayed compliance.
Corruption and lack of oversight: a ticking time bomb
Adding to the crisis are corruption scandals. Investigations are underway into billions in diverted contracts during the pandemic, many of them lacking any audits. The Superintendency of Health is being criticized for its lack of effective oversight, allowing both EPS and IPS to accumulate debts without real consequences.
Failed reform and public discontent: Colombia’s healthcare system in crisis
The institutional crisis is also reflected in the failure of the healthcare reform pushed by President Gustavo Petro, which aimed to eliminate EPS. Archived in 2024 due to a lack of consensus, a new proposal that would transform them into “Health Managers” is making its way through Congress, though experts have criticized it for potential excessive centralization without guaranteeing increased efficiency. While the political debate drags on, a recent survey found that 25% of Colombians see healthcare as the country’s most urgent problem, even above insecurity and corruption.
Human toll: preventable deaths and overwhelmed hospitals
The human consequences are already evident: long lines in hospitals in cities like Bogotá and Cali, rising numbers of preventable deaths due to interruptions in cancer, HIV, and rare disease treatments, and a progressive collapse of hospital services. In 2024, more than 1,200 providers shut down operations due to lack of payment.
Possible solutions or insufficient measures?
Among the proposed solutions by sector analysts are adjusting the UPC based on inflation and real costs, creating emergency funds to settle debts with providers, conducting forensic audits to fight corruption, and better integration between public and private hospital networks. But as these proposals remain unrealized, the crisis escalates, pushing the system to the brink of collapse. The lingering question is whether government responses will come in time to prevent a greater humanitarian tragedy.
