Vigilar y castigar: consideraciones sobre el papel de la Superintendencia Nacional de Salud colombiana

With the National Superintendency of Health as the unit of analysis, this article explores the role of regulatory supervision and control in the Colombian health system. What is deemed to be the main body of legislation on the subject is examined, starting with de Constitution of 1991. More than as a supervisor, the Superintendency emerges as a main actor in the making of health care policies. It is argued that this government entity faces a crossroads in attempting to reconcile the right to health care with the socially divided delivery of health services, resulting from financing methods that discriminate between patients according to their ability to pay. Additionally, the historical evolution of the Superintendency is analyzed from the point of view of its functional organization, highlighting potential conflicts of competence with other government entities of supervision and control, as well as the gradual increase of its punitive powers. The article concludes with a brief discussion of the need to understand the operation of the health system and to set criteria of intervention if regulatory supervision and control is to contribute more effectively to achieve the universalization of health services in the country.