Luz María Múnera (Medellín, 59 years old) has been a loyal supporter of President Gustavo Petro’s cause to reform the health system. She met the president decades ago in leftist activism and they have both criticized the predominant role of the Health Promoting Entities (EPS), the public or private insurers to whom the State allocates resources to contract services with clinics and hospitals. For this reason, Petro entrusted her in December with a key mission for his health policy. In addition to being a presidential advisor for the Regions, she took on the role of ad hoc superintendent for Nueva EPS. She supervised the insurer that concentrates 20% of the affiliates and a large number of complaints for a system on the brink of collapse for five months.
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“This experience has brought me to tears,” she says during an interview in her office at the Casa de Nariño, just meters from the presidential office. She acknowledges countless problems in the EPS that the Government intervened in April 2024, but emphasizes that they are not due to state underfunding, as the unions denounce and the Constitutional Court points out. She believes, like the president, that the failures come from a long list of officials who have not been able to stop the mismanagement of public resources. For this reason, she says, she dismissed the third interventor of Nueva EPS in two years a few days ago, and Petro did the same with his fourth superintendent so far in this Government. “Some do not follow the president’s instructions,” she states.
The official distances herself from them. She claims to be “a woman of the left,” who listens to what the president asks, and who has never had a corruption complaint. Perhaps that is why the president considered her on Tuesday to assume the role of superintendent of the entire system. “We stayed up late looking at the possibilities, but I do not meet the legal requirements,” she says. Hours after this interview, it became known that the chosen one is Daniel Quintero, the former mayor of Medellín who is on trial for corruption, is resisted within progressivism, and whom Múnera questioned as a councilor of that city.
Question. Why do you think the president appointed you in December as ad-hoc superintendent for Nueva EPS?
Answer. It’s speculative. I have never asked him: “Hey, why do you think of me for these things?” But I think it has to do with the fact that my public life has been impeccable. I don’t have a single lawsuit, and I think that counts for him. In these years, you don’t see the media attacking me harshly, not even the right-wing ones. They treat me with respect, I have earned it. And, finally, I am very clear that he is the president and I obey because I share his program.
Q. Your role as ad hoc superintendent becomes obsolete because the superintendent of the entire system, who was barred from Nueva EPS, resigned on Tuesday…
A. Yes, it ended because of that. It’s not that the president told me: “You are no longer useful, you’re leaving.”
Q. Bernardo Camacho was the fourth superintendent of this Government and lasted only six months. Doesn’t it contribute to instability that you both leave when there are only four months left of the Government?
A. The president needs to finish stabilizing the system and Bernardo showed that he doesn’t want to do it. He did not follow the guidelines. The president hasn’t told me, but that’s my reading.
Q. What guidelines did he fail to comply with?
A. First of all, that the health business must end. For that, it is necessary to tighten the EPS from the Superintendency, as I was tightening in Nueva EPS. You have to tighten hard, review the applications [of health providers] month by month and ask in writing: “Why did you pay Pedro 100% and only 10% to María and 0% to José? Give me a valid reason.” I always asked that of Nueva EPS.
Q. Caracol Radio said that Camacho disagreed with liquidating several EPS and transferring affiliates to Nueva…
A. It’s not true that they want to bring all affiliates to Nueva EPS, it’s part of the misinformation. There are EPS that must be liquidated, but their affiliates can go to different EPS, depending on the presence of each in each region.
Q. The justice system overturned a decree that changed the operating rules of the EPS and would have implied that around three million people be transferred to Nueva EPS…
A. Yes, but that’s because Nueva EPS is nationwide. It doesn’t mean it would absorb all affiliates nor that it would happen suddenly.
Q. In any case, was Camacho in disagreement?
A. I don’t know, he never told me. But no one wanted to remove the main officials of the Superintendency. We continue wanting to apply a policy of Gustavo Petro’s Government with men and women who come from Radical Change and the Democratic Center [opposition parties].
Q. The Government usually distances itself from its responsibilities with the argument that the fault lies with second-line officials who are corrupt and betray the president…
A. I have not said they are corrupt. Moreover, I do not accuse anyone.
Q. But they do fail to follow Petro’s instructions?
A. Ah, that yes. When I arrived at this position, the first thing the president asked me was to work so that the State would be the majority [in the shareholding composition of Nueva EPS]. The order was eight months old and had not been fulfilled. I achieved it in 15 days, so it’s not true that it couldn’t be done. The day I am not willing to follow the president’s guidelines, I will leave. I will not stay as a stone in the shoe, it’s not ethical.
Q. You displaced Luis Óscar Gálvez a few days ago, the third interventor that Nueva EPS had since the intervention began in April 2024. In what way did he fail you?
A. I recommended 20,000 times that he implement direct payment so that Adres [the state entity that manages health resources] pays the same percentage, month by month, to all health providers. The interventor would stop applying to whom to pay: he would no longer say pay 20 to one, 100 to another, and 0 to a third. It is the first tool to break some corruption issues. The business of applying for friends ends.
Q. And the interventor did not follow your recommendation?
A. He always told me yes, but he never did it. He didn’t even open the debate nor made complaints that some were given more than others. Also, we had a constant fight because the ones who are paid the least are public providers. We changed that, it’s part of my achievements.
Q. Did he comply with that?
A. He had to, but not willingly.
Q. What self-criticism do you make about having already appointed three interventors who did not work?
A. That question is not with me, but with him [Petro]. When I arrived, there was already an interventor. I gave him all the possibilities, but the results were low. I only had a mockery.
Q. Beyond the lack of compliance with these instructions, what role does the underfunding of the Capitation Payment Unit (UPC) that unions denounce and the Constitutional Court recognizes play?
A. The story that the money is not enough is to be reviewed. I want to know where it is. For example, we should ask why most providers work per event and not by contract. That allows them to charge each procedure at whatever price they want. We see that an appendicitis costs two million for one patient, four for another, and seven for another. How can that be? That must end. And that’s what I have worked on: in some things I made progress, in others not.
Q. The new interventor of Nueva EPS, Jorge Iván Ospina, said this week that the UPC is insufficient…
A. That question is for him.
Q. You appointed him…
A. Yes, but that doesn’t mean I know exactly everything he thinks.
Q. Why did you appoint him?
A. It was the president’s recommendation and the Superintendency constitutionally depends on him.
Q. And why did the president appoint someone with ongoing corruption cases?
A. Ongoing. In a Social State of Law, a person is innocent until the Prosecutor’s Office proves otherwise. And I’m not saying he is innocent or guilty, but in a country like Colombia everyone sues you for political reasons.
Q. But this particular position requires a lot of transparency if corruption is to be fought…
A. Well yes, but it was the president’s recommendation. And Ospina is not the man with the most charges here, there will be others worse that surely I would not have appointed. I will leave the Government before appointing them. But I cannot say who is guilty and who is innocent. The day I have evidence, I will report immediately.
Q. The problems you point out already existed, but during this Government complaints about lack of medicines, difficulties in scheduling specialist appointments, or surgery cancellations have increased. How do you explain this deterioration if it is not due to UPC underfunding?
A. That is the debate. I insist, after everything I have seen inside, that the problem is not the UPC. The Government pays the EPS month by month, but they do not transfer to the providers. They want more money to steal more money.
Q. How do you explain that Nueva EPS has also deteriorated under this Government?
A. It’s not that the situation is worse, but that it is more reported. There is a political intention to air the problems more, to harm the public. When you review the PQRs [petitions, complaints, claims] per capita, Nueva is not first, but third, after Sura and Sanitas [private]. But it is at the center of an electoral debate because attacking it is attacking Gustavo Petro. No one has wanted to say that in the last four months we have reduced PQRs by 40%.
Q. The extension of the intervention, signed a few days ago, states among the arguments that complaints have an annual increase of 14.3%…
A. In the last year. But in the last four months we reduced 40%.
Q. How do you explain that, despite the intervention, Nueva EPS is the only EPS that has not presented its financial statements for 2023 and 2024?
A. We have a lot of invoices and we don’t know which ones have support nor why they were charged. We would need a battalion of people to review them. And a great investment in technological development must also be made, something the interventors have not done and that I have recommended since I arrived.
Q. Does the Government have responsibility in the inaction of the interventors?
A. The Superintendency is a control body. I cannot answer for the Government.
Q. But the Superintendency chose the interventors…
A. Yes, but not me. And now that I leave, I leave my recommendations: direct payment, contracting [instead of events], technological updating.
Q. While the efficiency problems you mention are resolved, shouldn’t funding be strengthened so as not to affect patients?
A. We cannot keep giving money to be lost. When I arrived, I sat down with the pharmaceutical managers. The interventor didn’t want to go, but we made agreements and complied. Agreements can be made and that proves it. What bothers with my presence is that there is no interlocutor for the business, but to solve problems. I will leave my recommendations, which I hope will be a roadmap to think of health as a right. I would have liked to do more, but I didn’t have time.
Q. As a woman of the left, do you think there was self-sabotage in the Superintendency and Nueva EPS?
A. This experience has brought me to tears, but I don’t know if there was self-sabotage. It must be taken into account that we did not arrive alone at the Government, but with agreements with sectors different from the left. Although there are also people on the left who forgot that these were four years to work for the Colombian people. I don’t forget.
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