[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Medical ethics](https://durgical.com/en/medical-ethics/) › [The health system and the right to health](https://durgical.com/en/medical-ethics/areas/health-system/) › Ley 100 de 1993: the general social security health system # Ley 100 de 1993: the general social security health system - Law Law 100 of 1993 created Colombia's health system with insurers (EPS), providers (IPS) and two schemes: contributory and subsidised. Updated Nov 5, 2026 ## Key points - SGSSS: insurers (EPS) insure and manage, providers (IPS) deliver. - Two schemes: contributory (pays a contribution) and subsidised (unable to pay). - Art. 157: types of members; art. 162: mandatory health plan. - Reforms: Law 1122 of 2007 and Law 1438 of 2011. - Law 1751 of 2015 ranks above: health is a fundamental right. ## What it is Law 100 of 1993 (23 December) created the Comprehensive Social Security System. Its Book II organises the General Social Security Health System (SGSSS): people enrol with a health insurer (EPS), which organises and guarantees a benefits plan, and receive services from health care providers (IPS). Those able to pay contribute through the contributory scheme; the poor and vulnerable population receives a subsidy through the subsidised scheme. It was reformed by, among others, Laws 1122 of 2007 and 1438 of 2011. ## Key articles - Art. 152: purpose of Book II: to establish the SGSSS, its direction, organisation and operation. - Art. 153 (amended by Law 1438 of 2011, art. 3): principles of the system, such as universality, solidarity, equality, compulsory membership, equity, quality and efficiency. - Art. 157: there are two kinds of members: the contributory scheme (employees, public servants, pensioners and self-employed people able to pay) and the subsidised scheme (people unable to pay). - Art. 162: creates the Mandatory Health Plan and provides for gradually unifying the plans of both schemes. - Art. 177: insurers (EPS) enrol and register members, collect contributions, and organise and guarantee the plan for their members. - Art. 185: providers (IPS) deliver services to members at their level of care. - Arts. 202 and 211: define the contributory scheme (a contribution) and the subsidised scheme (a contribution fully or partly subsidised with public or solidarity funds). ## In clinical practice - Doctors almost always work in a provider (IPS), but many coverage and authorisation decisions go through the patient's insurer (EPS). - The scheme does not change the duty to treat emergencies or the ethical content of the medical act. - The insurer's administrative barriers are not passed on to the patient (Law 1751, art. 10, letter p). ## Status and official text - Official text checked on 2026-11-05 on funcionpublica.gov.co (Law 100 of 1993, Law 1122 of 2007, Law 1438 of 2011) and secretariasenado.gov.co. - Main reforms of the health system: Law 1122 of 2007 (changes to direction, financing and provision) and Law 1438 of 2011 (reform centred on primary health care). Statutory Law 1751 of 2015 ranks higher. - Art. 202 was amended by Law 1607 of 2012 (art. 30); art. 162A was declared unconstitutional; art. 157 has text corrected by Ruling C-458 of 2015. - Ruling T-760 of 2008 ordered the benefits plan of the contributory and subsidised schemes to be unified. The system changes often: check the text in force. ## Test yourself Think of the answer, then tap the question to see it. ## What is the difference between an EPS and an IPS? The EPS enrols members, collects contributions and organises and guarantees the benefits plan (Law 100, art. 177); the IPS provides the health services directly (art. 185). ## Who joins the contributory scheme under art. 157 of Law 100? People with an employment contract, public servants, pensioners and retirees, and self-employed workers able to pay. ## Which laws reformed the Law 100 health system before Statutory Law 1751? Among others, Law 1122 of 2007 and Law 1438 of 2011. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/medical-ethics/ley-100-de-1993-the-general-social-security-health-system/) ## Connections ## Related 3 - [Ley Estatutaria 1751 de 2015: health as a fundamental right](https://durgical.com/en/medical-ethics/ley-estatutaria-1751-de-2015-health-as-a-fundamental-right/) - [Tutela in health](https://durgical.com/en/medical-ethics/tutela-in-health/) - [Allocating scarce resources and triage](https://durgical.com/en/medical-ethics/allocating-scarce-resources-and-triage/) [← All of medical ethics](https://durgical.com/en/medical-ethics/) Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal. Sources: [Ley 100 de 1993, por la cual se crea el sistema de seguridad social integral](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=5248) (Función Pública, Gestor Normativo, 1993); [Ley 1122 de 2007, changes to the General Social Security Health System](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=22600) (Función Pública, Gestor Normativo, 2007); [Ley 1438 de 2011, por medio de la cual se reforma el Sistema General de Seguridad Social en Salud](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=41355) (Función Pública, Gestor Normativo, 2011). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/medical-ethics/ley-100-de-1993-the-general-social-security-health-system/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). 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