Tendencia Económica No. 266

Abstract

Editorial: Between 2000 and 2025, the health sector budget grew at an average real annual rate of 6.5%, exceeding the 4.0% growth of the overall budget, which increased its share from 6.1% to 12.8% of the General Budget and from 1.9% to 3.8% of GDP, consolidating it as the third-largest sector. Despite this expansion, important challenges persist in the composition and efficiency of spending, as 87% was concentrated in insurance between 2018 and 2022, limiting investment, and 98.8% of the budget was rigid between 2019 and 2023, above the General Budget average of 92%. At the municipal level, average coverage efficiency stands at 79%, with wide territorial disparities, suggesting that similar outcomes could be achieved with fewer resources if best practices were replicated. At the provider level, average efficiency in generating operating revenues was 41%, with private providers reaching 49% and public providers 33%, highlighting substantial performance gaps. These findings underscore the need to align expenditure growth with fiscal constraints, strengthen institutional capacity, improve the flow and transparency of resources, refine targeting in the subsidized regime, and reinforce cost-effectiveness criteria in the incorporation of new technologies.

Actualidad: In 2025, the Colombian economy grew by 2.6% year-on-year, accelerating from 1.5% in 2024, although remaining below analysts’ forecast (2.8%). From a supply-side perspective, growth was primarily driven by the strong performance of commerce (4.6%), public administration (4.5%), and artistic activities (9.9%). On the demand side, expansion was supported by public consumption (7.1%) and private consumption (3.6%), while investment (1.3%) grew at a slower pace than the overall economy. As a result, the investment rate declined to 16.0% of GDP, its lowest level in the past two decades, reflecting the elevated cost of capital and persistent economic policy uncertainty. In 2026, growth is expected to face downside risks, with weaker household consumption amid higher inflationary pressures and interest rates, alongside continued headwinds for investment related to tighter financing conditions, electoral uncertainty, and fiscal sustainability concerns.