Petro's Failed Health Insurance Rescue Exposes Deep Flaws in Colombia's System

Gustavo Petro's government set out to rescue Nueva EPS, Colombia's largest health insurer, with the kind of determination that comes from both political necessity and ideological conviction. The company represents something symbolically important to the left: a remnant of the old system where the state played a larger role, a public institution that absorbed millions of workers when the government privatized health insurance back in 1991. When Petro took office, Nueva EPS was drowning. He intervened in April 2024, promising to stop the bleeding. Two years later, the intervention has become a case study in how good intentions collide with structural dysfunction.

The numbers tell the story of accelerating collapse. Nueva EPS's debt has swollen from 18.4 trillion pesos—about 5.1 billion dollars—in December 2024 to 26.1 trillion pesos, roughly 7.2 billion dollars, by November 2025. This is not an abstract accounting problem. It translates directly into the lived experience of 11.5 million Colombians who depend on this insurer. Surgeries disappear from the schedule. Appointments with specialists evaporate. Medications that once took two or three weeks to arrive now vanish for months. Néstor Álvarez, who speaks for the Nueva EPS users' association, remembers when the crisis meant waiting a month for a drug. Now patients wait four, six months. The shortages have spread beyond expensive treatments to generic medications. He estimates the problem now touches 40 to 60 percent of patients, though he suspects even that figure understates the reality. Many people have stopped filing complaints altogether, having learned that nothing changes.

The government's response has been to shuffle the deck repeatedly. Since January 2024, Nueva EPS has cycled through two presidents and four interventors—administrators appointed to run the company and theoretically fix it. Each arrival brings the same pattern: accusations that the predecessor was corrupt, wholesale staff changes, new strategies that contradict the old ones. This week alone, the government fired Luis Óscar Gálvez and installed Jorge Iván Ospina, a physician and former mayor of Cali who faces multiple corruption investigations. The superintendent overseeing Nueva EPS, Luz María Múnera, is leaving after only six months in the role. Meanwhile, Bernardo Camacho, the superintendent of the entire health system, was replaced this week as well—he had a conflict of interest because he had previously served as an interventor at Nueva EPS. The carousel of leadership reflects deeper chaos: Caracol Radio obtained a letter from Superintendency officials alleging that the decision to extend the intervention was illegal, that proper internal controls were bypassed, and that Ospina does not meet the legal requirements for the position.

The accounting is opaque in ways that deepen the sense of crisis. As of February, only 3 of 15 trillion pesos in overdue accounts had been processed. No one can explain why these charges were made or what they represent. Nueva EPS has not filed financial statements for 2023 or 2024, unlike every other health insurer in the country. Múnera acknowledges the gap but frames it as a management problem, not a funding one. The interventors before her, she argues, mismanaged resources catastrophically. They allowed providers to charge whatever they wanted for each procedure. They paid some providers in full while leaving others unpaid. Fix these practices, she suggests, and the money will stretch far enough. The alternative—simply giving Nueva EPS more money—would only disappear into the same broken system.

But this diagnosis faces serious challenge. Augusto Galán, a former health minister and director of the think tank Así Vamos en Salud, argues that the problem is not individual incompetence but structural. Interventorships, he contends, are designed to fail. They eliminate internal oversight mechanisms—the assembly, the board of directors—and concentrate power in a single administrator managing two billion pesos monthly, about 550 million dollars. That concentration of authority without accountability creates conditions for either catastrophic mismanagement or worse. Diana Cárdenas, a former deputy minister, adds that the government made a critical error by replacing much of the provider network. This broke continuity for patients in the middle of treatment. The criteria for selecting new providers remain murky, and some lack the quality of those they replaced.

Underlying all of this is a more fundamental question: Is Nueva EPS starving because the government refuses to fund it adequately, or is it collapsing because those running it are incompetent or corrupt? The Constitutional Court ruled in January 2025 that the government must increase the per-capita payment it makes to health insurers, including adjustments dating back to 2021. The government has refused. It has kept annual increases below what insurers request. The impact is visible across the entire system: the net equity of all health insurers combined fell from 110 billion pesos in 2021 to negative 16.9 trillion pesos in 2025. For the intervened companies, the picture is worse—from negative 2.1 trillion to negative 13.3 trillion in the same period. Nueva EPS, unable to publish its own numbers, sits at the center of this wreckage, a company too large to fail and too broken to fix, serving millions of people who have nowhere else to go.