“When the Medical Ethics Law was issued it was used for patients to contract a trusted doctor who would do everything; they were known as family doctors or GPs. That doesn’t happen today because we are all insured through a public EPS scheme, a pre-paid insurance, or a complementary medical plan. This is why I believe it is necessary to adjust the model implemented in 1981,” the professor explains.
Since the publication of his article, the panorama has undergone few changes, the reform project for the Medical Ethics Law never having evolved. The expert points out, however, that there have been some advances in legislation on the application of euthanasia for minors, as well as in awareness of the issue of safe surgery, work driven principally by Lorena Beltrán, a person who suffered the consequences of badly executed plastic surgery.
Bernate considers that this is one specific aspect that should be sorted out with the greatest urgency, since rules are required for carrying out certain specialties, cosmetic surgery being a case in point.
Similarly, he believes it is necessary to make changes in other areas, such as administrative practice, finance, limitations in coverage and those related to abusive treatment of citizens. “Colombians are very drawn to exploiting something when it works, and to eventually working it to death. The amount of medical visits in Colombia is among the highest in Latin America. And then there is the excess in expensive cosmetic treatments, unnecessary operations, charged to the system.” Bernate’s understanding of such abuses runs to a long list, including “nurses obtained through health protection but who end up as household workers, cases involving exotic demands, such as requesting equine therapy, and these have to be paid for by all we Colombians. The immense number of fraud cases that come up through the social security health system involving high-cost drugs, for example, which are then sold on the black market; this kind of fraud is scandalous and widespread,” points out Bernate.
Nevertheless, this criminal lawyer is convinced that the glass is half full in terms of the health commitment, and that it can be topped up by including other elements in the health service and by reforming the Medical Ethics Law. “I think we are on the right track, but we have to provide a few more guarantees that professionals are the right ones, that the EPS public system offers cover, that institutions update, and that resources coming in are reinvested in health and not in personal things; I think this is where we have to make progress.”