The Government is part of the reminder that the 2008 T-760 judgment highlighted that the National Public Health Plan, which was carried out by the National Government and provided for in Article 33 of Law 1122 of 2007, was shown as a useful tool for unifying public health guidelines. In this regard, the Court's decision emphasized that the plan expressed the contents and priorities of the State regarding health care. This recognition by the Constitutional Court, "allows to see how the bill invades the orbit of objectives and content of such a public health plan."

4.6. Objection to ignorance of organic budget rules

The executive branch points out that the bill pretermized the requirement provided for in article 7o of the Law 819 of 2003, Organic of the Budget, which requires that the fiscal impact of any bill that orders expenditure be made explicit or that it grants tax benefits, an impact that must also be compatible with the Fiscal Framework of the Medium Term. In order to comply with this purpose, the aforementioned provision states that the tax costs of the initiative and the source of additional income generated for the financing of this cost must be included in the explanatory statement and in the respective processing papers.

The executive branch emphasizes that the bill has several expressions that involve the use of new technologies and benefits excluded from the POS, so that they have to study aspects related to the lack of payment capacity of the users, the existence of other therapeutic alternatives of higher cost effectiveness, etc.; omission that subtracts rationality and efficiency to the legislative initiative, while incorporating a fiscal impact, without establishing the sources for their financing. He argues that, "this legislative initiative does not present consistency not only with what is foreseen in the Fiscal Framework of the Medium Term, because it is not properly financed with the available resources, it did not comply with the provisions of Article 151 (sic), but it also generates an imbalance in the General System of Social Security in Health considering that the same does not have a source of financing that allows to attend to the benefits that are granted here."

Finally, in order to support this objection, the National Government puts forward a group of considerations raised by the constitutional case-law, especially those embodied in the T-760 judgment of 2008, which deal with the budgetary requirements that precede the financial sustainability of the SGSSS. He insists, in the same sense, that it is extremely "inconvenient" that through laws the content of the POS and the plan of benefits of the affiliates and beneficiaries be modified to the different regimes, without these alterations having been subjected to the prior technical scrutiny by the bodies such as the CRES, which advance analysis on the appropriateness and financial sustainability of the corresponding measures.

5. Insistence of the Congress of the Republic

Congress of the Republic insisted on the approval of the bill, as it considers the presidential objections to be unfounded. To this effect, the report on the presidential objections given by Senators Dilian Francisca Toro Torres and Alfonso Núñez Lapeira, as well as by the representatives, Zaida Marina Yanet Lindarte and Jorge Ignacio Morales Gil, expose the reasons behind the insistence on the constitutionality of the article objected.

5.1. Regarding the objection for violation of the principles of the SGSSS, the Congress pointed out that in concrete relation to the principle of integrality, this one finds sustenance in the provisions of Law 1122 of 2007, which are aimed at " progressively eliminating the barriers to access to health services from the universality of the assurance with which a greater dispersion of the risk in health and financial will be obtained, the problem of adverse selection would be reduced; and it is determined that the insurers are responsible The health of the population is based on the goals of health outcomes that have been defined. " Consequently, in view of the incidence of cancer in the country, which places it within one of the latent public health problems, the intention of the bill is, " to correct in a certain way the errors that have been committed in the application of the law, giving priority to the attention in this pathology that is currently one of the greatest causes of morbidity-mortality in the country, contributing to improve the quality of life of those suffering from this disease and above all to improve the focus of the resources that in the intervention are destined to avoid the increase of the burden of the disease. "

El Nacional] For the Legislative Assembly, the National Government and the National Government are going to consider that the draft law prevents compliance with the constitutional principles that the SGSSS will prefigure. On the contrary, the initiative provides effective tools to strengthen care in a disease that, by its characteristics, seriously interferes with the rights to life and human dignity. In this regard, it is emphasized that the draft law aims to remedy the governmental omission in the provision of health care, in an efficient way, to cancer patients, who do not obtain sufficient coverage within the general parameters of the SGSSS. In this sense, what the bill seeks is nothing different than protecting the rights to life, health, and human dignity-as defined conceptually by the constitutional jurisprudence-of those affected by cancer, who are, without a doubt, in conditions of manifest weakness, so they require priority attention on the part of the State.

5.2. In view of the alleged lack of knowledge of the competencies assigned to the CRES and recognized by the constitutional jurisprudence, the report argues that the " powers granted to the Congress of the Republic for the passage of laws on the various matters does not exclude those aspects that have been assigned by a ruling to other bodies. For this reason, although it is true what the government has expressed in its office of objections, such statements do not take away any competition, even more so when the object of the bill is precisely to correct the inequities that in the face of the pathology of cancer exist and to take effective actions for the attention of the patients who have serious pathologies that decimate their quality of life, since these actions have not been taken in a timely manner by the governmental agencies to whom it corresponds. "

5.3. With regard to the objection to the lack of knowledge of the right to the participation of users, the Congress maintains that the process of the initiative had the active debate of different associations, who expressed their opinions on the content of the bill. Therefore, there was no support whatsoever to accuse the initiative of violating the aforementioned fundamental right.

Additionally, the report shows that the existence of a national health plan does not imply, as the Executive has erroneously stated, that this is the only space for the participation of public policies on the subject and that it is not compatible with the development of specific laws, which seek to respond to the requirements of pathologies with high impact on the health of the Colombian population.

5.4. With regard to the objection due to the lack of knowledge of the statutory reserve of law, the Congress is part of the warning that, as the Court has established, not all legislative initiatives that regulate matters related to fundamental rights are subject to the aforementioned reserve, but only those that deal with the essential and structural issues of the reserve. The bill does not regulate the essential core of the right to health, but what it seeks is "to allow recognition and prioritization in the care of a pathology that because of its incidence and prevalence in morbidity and mortality rates greatly affect the Colombian population." Thus, the requirements laid down in the constitutional case-law for the retention of the statutory law are not fulfilled in the specific case.

5.5. Finally, with regard to the objection based on the lack of knowledge of the organic rules of the budget, the report points out that several of the provisions of the draft law lack fiscal impact, as they are part of the coverage and resources currently provided for in the SGSSS, a condition that is evidenced in articles 5, 11, 12 and 22. In addition, the measures that demand new resources raise the transition and implementation formulas that make them viable. He insists that "[e]n a thorough look, it was possible to identify that the actions that require or commit new resources to give viability to this project, are of public origin and others of private investment. From the latter, demands are made that do not cosartan the right to free enterprise, rather, what the law tries to do, is to raise the standards of efficiency, effectiveness and quality in cancer care in Colombia ".

The report adds that, as constitutional case law has provided, the enjoyment of fundamental rights cannot be subject to fiscal conditions. Under this premise, considering the incompatibility with the Political Charter of the initiative from economic arguments, would not know the competence of the Congress to configure the institutionality of the SGSSS, conclusion supported in different decisions of the Court, as is the case of the C-1032/06.

Finally, the Congress maintains that the bill does establish the source of financing for the possible cost of some aspects of the initiative, which is attached to the contributions of the members of the SGSSS, along with the fiscal resources of the national and territorial order. Consequently, it is not right to consider that the project involves having additional public resources available to the existing ones for health care.

6. Citizen Intervention

For the purpose of making the citizen intervention effective, by Auto on May 29, 2009, the Judge substantiator ordered to list the present process by the end of three (3) days, in accordance with the provisions of Article 32 of Decree 2067 of 1991. In compliance with the above, the General Secretariat fixed it on the first day of June of the same year.

Within the term of the establishment, the Colombian Association of Integral Medicine Companies, Acemi, through its Executive President, intervened in the present process, in order to defend the inexilibility of the accused norms. To this end, it reiterates the arguments expressed by the government's objections and puts forward the following new cases.

6.1 In the opinion of the intervener, the bill affects the financial sustainability of the SGSSS, while it requires that the contributory and subsidized regimes should offer all medical care benefits for cancer care, without considering the scarce resources that finance the System, the cost criteria, effectiveness for the inclusion of care benefits in the POS, the most relevant risks of the population, nor the average quality and technology available in the country. This is because it will pretermite the CRES as a competent authority to define the contents of the POS. It highlights that, among other measures, the initiative directs the Health Services Institutions, IPS the implementation of Functional Units for Cancer Care, with demanding conditions and standards, a circumstance that would result in discrimination against patients with other high cost diseases, who would not be beneficiaries of similar loan contents.

6.2. In a similar way to the presidential objections, the intervener states that the T-760 judgment of 2008 established concrete orders to the CRES, related to the updating and definition of the contents of the POS, as well as the unification of the benefits between the different regimes, for which it has established certain medical-scientific, budgetary-balance and user-participation requirements. These conditions are unknown by the bill, which defined the contents of the POS regarding cancer treatment, without complying with these requirements.

6.3. Acemi argues that the objecting project violates Articles 48 and 49 of the Constitution, while the inclusion of the comprehensive and definitive treatment for cancer is incompatible with the principle of efficiency of the general system of social security in health, provided for in those higher precepts and defined by Article 2or Law 100 of 1993 as the best social and economic utilization of the resources available for the the benefits to which social security is entitled, be provided in an appropriate, timely and sufficient manner.

To support this statement, the intervener reiterates that the inclusion of the POS that the bill is making were not preceded by technical studies on its financial sustainability and the priority of the patients ' attention to cancer in the face of the universe of pathologies. This omission ignores (i) the constitutional principle of efficiency of the SGSSS, (ii) the technical competencies conferred on the CRES and the CNSSS; and (iii) the orders provided for in the 2008 T-760 judgment, which point to the adequacy of the contents of the POS, under criteria of financial sustainability and user participation.

Likewise, it indicates that the constitutional norms cited are unknown, as soon as they affect the principle of universality of the SGSSS. He considers the intervener that the costs involved in the implementation of the bill would necessarily have an impact on the expansion of the subsidized health system, thus restricting the health care of the poor population.

6.4. The intervener estimates that the bill affects the right to freedom of enterprise, provided for in the article 333 Superior. This is due to the fact that it forces the health care institutions to implement the units of Functional Care Integral to Cancer, regardless of the economic capacity to establish this infrastructure or its intention to offer this kind of health service. This legal duty, in the opinion of Acemi, is incompatible with the essential core of that right, since intervention on the economic market on adequate and sufficient grounds, or a criterion of proportionality in the strict sense.

6.5. Finally, the intervener warns that the objecting project violates the right to equality, to the extent that it disproportionately favors cancer patients, without irrogue the same treatment for other patients of other high-cost pathologies. This is without the proposed measure meeting the criteria of purpose, necessity and proportionality.

7. Concept of the Attorney General of the Nation

The Attorney General of the Nation, in exercise of the powers provided for in article 278-5 of the Constitution and in article 32 of Decree 2067 of 1991, intervened in this process in order to request the Court to declare the proposed presidential objections unfounded. To this end, he reiterated to a large extent the reasons for the concept presented on the basis of the presidential objections raised against the government on the purpose of the bill 336 of 2008 House, 094 of 2007 Senate "For the right to life of children with cancer in Colombia", subject that is currently under the study of the Court, identified with the radication OP-116.

7.1. With regard to the objection to the violation of the statutory reserve of law, the Public Ministry considers that the draft law submitted to the study does not fully regulate the right to health and therefore does not affect the essential core of the law. Nor is it inferred from a structural change in the provision of the health care service or the existing plans, limiting itself to the treatment of a particular disease.

7.2. With regard to the lack of knowledge on the part of the Congress, of the competencies of the CRES and of the CNSSS, as technical instances for the formulation of the contents of the POS, the concept reiterated what it had indicated in the concept corresponding to the Expedient OP-116, in the sense that although the function of these organs is important to provide cohesion to health care and offer guidelines for the extension of the health plans and the medications to include in each of the regimes; this is not to obtain that the legislator, in exercise of its wide freedom of configuration The law on the subject, proposes, discusses, studies and approves the laws that it considers relevant to deal with the treatment of certain diseases that, as in this case, are of the utmost importance.

The following projects are announced for the plenary session on April 28, or for the next plenary session in which bills or legislative acts are debated, according to the Legislative Act No. 1 of July 3, 2003.

(...)

Reports on Objections

Bill number 090 of 2007 House, 312 of 2008 Senate, accumulated with Bill No. 142 of 2007 House "Law Sandra Ceballos", for which the actions for the comprehensive care of cancer in Colombia are established_[25]".

With regard to the discussion and approval of the objections report, this procedure has been verified at the plenary session of April 28, 2009, contained in Act No. 171 of the same date, published in the Congress Gazette 541 of 2 July 2009. The Court's reading concludes that the bill was duly approved, through ordinary voting and according to the majorities required by the Charter. _[26]

Finally, in the case of the previous announcement and its relation to the publication of the report of presidential objections before the plenary of the Chamber, the considerations made in the previous legal basis, regarding the analogous procedure in the Senate of the Republic, are entirely applicable, reasons that justify the constitutionality of that publication in the light of the precept of the article 157-1 C.P.

According to the foregoing, the Chamber warns that in the case of the House of Representatives, the requirements imposed by the Political Charter for the processing of the analysis are also met. Thus, (i) the advertising requirement was met, to the extent that the report was published in the Congress Gazette prior to the initiation of the debate (article 157, Law 5/92); (ii) the announcement that it deals with the final paragraph of article 160 C.P. was made in the immediately preceding session in which the discussion and vote of the report took place, the vote being verified on the given date of the announcement; and (iii) the approval of the report of objections counted with the majorities (b) the constitutional requirements of the Treaty on European Union, the Council of the European Union, the Council of the European Union, the Council of the European Union, the European Parliament and the Council of the European Union.

this way, it is shown that the Congress of the Republic has spoken about the presidential objections within the maximum term of two legislatures and, in addition, has complied with the constitutional requirements for the discussion and approval of the report of presidential objections. Therefore, after the analysis by its formal aspect, the Court passes to analyze the substance of substance.

3. Material examination of objections

3.1. The content of the objected bill

Bill 3 1 2/08 Senado-90/07 House, "Sandra Ceballos Law, for which actions are established for comprehensive cancer care in Colombia." The overall objective of the initiative, as outlined in Article 1o, is to establish a public policy for comprehensive cancer control, in order to (i) reduce adult cancer mortality and morbidity; and (ii) improve the quality of life of cancer patients.

To fulfill these purposes, the project includes several instruments, among which the declaration of cancer is distinguished as a priority disease in public health in the country, with a view to its comprehensive control based on the provision of all the necessary services for the treatment of the disease (article 5); the obligation of the health-promoting entities, EPS, to advance actions aimed at the promotion and prevention of cancer control (article 6o); the duty to determine the interior of the SGSSS clinical practice guidelines and management protocols that ensure the comprehensive, timely and relevant care of cancer patients (article 7o); the establishment of criteria for care, by the IPS, of cancer patients located in parts of the country (article 9o); the establishment of duties for the EPS of both regimes and the territorial entities of the poor, uninsured population, related to the integral rehabilitation of cancer patients (Article 11); the consecration of the benefit of the nursing homes, payment of displacement costs, and psychosocial support for cancer patients (article 14); the establishment of instruments for the evaluation and implementation of new technologies and medicines, organisational equipment and models and support systems in cancer (Article 18); inclusion in the National Plan of Science and Technology for Cancer as a priority research topic (Article 16); inclusion in academic programmes for the training of health personnel, courses related to cancer control, emphasised in their prevention and early detection (Article 19); the establishment of a system of penalties for non-compliance with the provisions foreseen in the draft law (Article 21); and the determination of the financing of the various measures contained in the initiative, from the sub-account of high cost, specific cancer component (article 22); and the establishment of the day 4 of February as the National Day of the Fight Against Cancer in Colombia.

Similarly, the bill establishes a set of institutional modifications to the SGSSS, aimed at ensuring the adequate and timely provision of the medical-care benefits required by cancer patients. Among these reforms are the creation and establishment of the criteria for the functioning of the Functional Units for Comprehensive Cancer Care, in charge of the IPS (article 8o); the guarantee of access to Paliative Care Programs, whose operating criteria are also foreseen by the initiative (article 10), the establishment of information systems based on the National Records of Adult Cancer, which will be part of the System of Surveillance and Public Health (article 15); the creation of the Epidemiological Observatory of Cancer, belonging to the aforementioned System of Surveillance; and the establishment of a system, consisting of the National Superintendence of Health, the Territorial Directorates of Health and the Ombudsman's Office, aimed at the inspection, surveillance and control of the guarantee of the rights of the users.

3.2. Decision methodology

Given that several of the issues raised by the presidential objections require a common theoretical framework, the Chamber warns that it is necessary to adopt the following methodology in order to resolve the legal problems which they have exposed. First, it will hold a general exposition on the constitutional case law on the broad freedom of legislative configuration with regard to the regulation of the SGSSS. Then, it will assume each of the objections raised, in the order set in the background of this sentence.

In addition, it is pertinent to establish that the examination of constitutionality assumed by the Court on this occasion, in accordance with the provisions of article 167 C. P., it is limited exclusively to the objections raised by the National Government, so that the effects of this decision are of res judicata relative. For this reason, the Court will exclude other matters, exposed by the citizen's intervention, that do not identify with the topics that are the subject of government censorship of the bill.

3.3. General System and Social Security Legislative Configuration Freedom in Health

3.3.1. Previous decisions of the Court have held, based on the interpretation of the express constitutional norms, that the legislator has a wide margin of legislative configuration in regard to the configuration of the SGSSS, as a public service subject to the inspection, control and surveillance of the State. Thus, as the case law has held,_[27] provided for in article 48 C. P. assumes that social security has the double connotation of being an inalienable right and at the same time a public service provided under the direction, coordination and control of the State, subject to the principles of efficiency, universality and solidarity, "in the terms established by law". In accordance with this, Article 49 of the Charter enshrines the right to health care and the obligation of the State to order, direct and regulate the provision of services under the same guiding principles, "in the terms and conditions outlined in the law".

As observed, there is a concrete constitutional provision, which subjects the decision of the legislator, an instance par excellence of the democratic representation, the determination of the design of the SGSSS. However, as with any exercise of political power in the Social and Democratic State of Law, that attribution of Congress is not omnimoda, but is subject to limits. The constitutional jurisprudence has distinguished two levels of limitations that the legislator has at the moment of defining the institutional regime of the SGSSS. _[28]. There are formallimits, which refer to the fact that it is not constitutionally valid for Congress to approve a regulation in which it ignores the rules of competition or legislative procedure for normative production. On the other hand, the substantive or material limits are related to the subjection of the regulation on the SGSSS, to the principles imposed by Articles 48 and 49 of the Constitution, that is, those of universality, efficiency and solidarity; as well as the other rights, principles and values provided for in the Charter. In particular, a social security system according to the constitutional provisions must be adjusted to "the values and principles underlying the Social State of Law (dignity of the human person) and in the clauses of the economic model of the Constitution (State intervention and economic planning, private property and freedom of enterprise and private initiative)." _[29]

3.3.2. The Court, within this framework of analysis, has insisted that the competition of the legislator for the definition of the SGSSS should be understood under a flexible model, in which the Congress can adopt various alternatives of institutional formation, and is only subject to the formal and material limits previously noted. This implies, in terms of the case law, that " [l]as clauses of the Constitution that establish the duty of the State to provide citizens with an efficient health service, are open rules that allow different developments by the legislator, due to the political pluralism and the free democratic game that characterizes the constitutional state of law. The State may opt for different systems or models of social security in health, which corresponds to the own orbit of the political assessment of the legislator, and while respecting the essential core of public liberties and fundamental rights and are based on a principle of sufficient reason, these options are legitimate and are not capable of being removed from the legal order by the way of unconstitutionality. " _[30]. In that order of ideas, the same precedent has stipulated that " This Corporation has recognized the broad margin of configuration of the legislator to regulate the rights to health and social security. The flexible formula adopted by the Constitution (article 48 CP) prevents one from talking about a single structure of social security and a limited action of the legislator in this field. In fact, the Political Charter establishes general, basic and precise principles and rules to which the legislator must abide, but which do not prevent his broad intervention in the matter". _[31] (Non-Original Subrays).

3.3.4. The precedents noted lead to a single conclusion: the constitutional regime applicable to the definition of SGSSS does not imply, in any way, the requirement of a particular institutional model.   On the other hand, these forecasts give the legislator a wide degree of freedom of configuration on the subject, subject only to the formal and material limits previously noted. Thus, any definition of SGSSS will be legitimate, from the perspective of the Political Charter, when it responds to a criterion of sufficient reason and ensures the effectiveness of constitutional rights, principles and values.

3.3.5. Within this wide margin, in turn, the case-law has provided for the possibility that even the legislator may grant differentiated treatment within the SGSSS, provided that these do not constitute unjustified discrimination. This was the case studied by the Court in Judgment C-671/02 (M. P. Eduardo Montealegre Lynett), a decision that analyzed the constitutional of some norms of the social security system in the health of the Military Forces, which imposed the requirement that the parents of the officers and non-commissioned officers be able to access the condition of beneficiaries, as long as they have the character of assets. On this occasion, the Court pointed out, based on previous decisions of this Corporation,_[32] that " [l]criteria from which the coverage of the service is progressively expanded are multiple, and although they are limited by constitutional normative aspects, there are other factors, economic and demographic, among others, that it is the responsibility of the legislator to weigh in the first place. Within this analysis it is up to the legislator to determine which social groups most urgently require coverage so that the distribution of benefits is done according to the social needs checked. "

From this consideration, the same ruling stated that " [e]the preceding analysis is sufficient to conclude that, without prejudice to the State's duty to establish a system of social security and universal health, that is, that it covers all Colombians, the law has a wide freedom to determine what the group of beneficiaries of a special social security and health system is, such as that enjoyed by members of the Public Force. This obviously does not mean that any delimitation of the group of beneficiaries is constitutional, because if the Congress excludes certain persons using discriminatory criteria or that affect other fundamental rights, such as the free development of the personality, the regulation must be declared inexequable. "

3.3.6. The above considerations make it possible to identify the jurisprudential rule that will serve as a guideline for the analysis of a good part of the objections raised by the National Government: The Congress enjoys, by express constitutional mandate, wide freedom of legislative configuration in terms of defining the content and institutional design of the SGSSS. Consequently, a legislative regulation on the matter will violate the postulates of the Charter when (i) it does not know the material or substantial limits previously recorded; (ii) it incurs in a discriminatory practice that it is not covered by a criterion of sufficient reason. These limits, by virtue of their generality, imply that the judgment of constitutionality that the Court has to proceed must be flexible in order to preserve the wide margin to which it was referred. The opposite, that is, to apply a strict analysis on the topic, would lead to the fact that there is a single model of definition of the SGSSS, a conclusion that contradicts the provisions of the articles 48 and 49 of the Constitution, which defended this function, in a prevalent way, to the legislator.

3.4. Objection based on ignorance of the principle of integrality

3.4.1. The National Government maintains that the bill is unconstitutional, as it configures a partial legislation, occupied with the comprehensive care of cancer patients, which (i) fragments the SGSSS, creating difficulties in the interpretation of its rules, which contradicts the principle of integrality, recognized by the Court in Case T-760 of 2008; and (ii) establishes specific regulations regarding medical-care benefits that the SGSSS must provide to adult patients with cancer, which does not know the competences that the legislator has provided to the CRES and, while this institution enters into office, the CNSSS.

3.4.2. In the judgment of the Court, the objection raised by the Executive Branch does not provide the necessary parameters for the Court to issue a substantive statement, while it does not present a contradiction between the parliamentary initiative and the Political Charter, but rather restricts itself to contrasting the bill with previous rules of a strictly legal nature. In this sense, the objection raised offers a false problem of constitutionality, founded on (i) the lack of knowledge of the control parameter for the case of presidential objections; and (ii) the wrong understanding of the principle of integrality, defined by Judgment T-760/08, based on the collection that this decision made of the constitutional jurisprudence on the implications, from the perspective of the Political Charter, of the public service of health care.

3.4.3. As indicated in the legal basis 3.3., of this statement, the contents of the articles 48 and 49 C. P., the Constitution gives the Congress the power to define the content of the SGSSS, which implies that the body of democratic representation has the possibility to set different modalities of the prestational and institutional organization of the health system, subject only to the material and substantial limits previously analyzed.

For the proposed case, the Executive part of a substantial budget, according to which the fact that Judgment T-760/08 has recognized as valid, from the constitutional perspective, the institutional and competence arrangements provided for in Law 100/03 and Law 1122/07, a limitation arises for the legislator regarding the regulation of formulas other than the definition of the content of the SGSSS. Therefore, the draft law objected to, as it departs from that initial legislation and, in particular, the powers that such normativity had conferred on the CRES, violates the Constitution.

This objection does not know that the constitutional rules governing the SGSSS, state that it is up to the legislator, autonomously, to define the content of the SGSSS. This implies that the Congress, once the reasons for political and social expediency that correspond to the parliamentary work, can be modified to the health system. In this sense, the assertion that the previous legal norms set a limit for the exercise of the legislative configuration is not supported.

This freedom of legislative configuration, in the same way, is not limited by the recognition of the constitutional validity that this Corporation makes of a certain model of organization of the SGSSS. In this regard, it should be noted that in Case T-760/08, the Second Chamber of Review of the Constitutional Court reviewed different rulings of guardianship, related to failures in the health care provided by the SGSSS and ordered a series of structural orders to the different instances of the system, aimed at correcting the main shortcomings of the system, which do not know the duties of protection, respect and guarantee of the fundamental right to health.

In this judgment, the Court expressly acknowledged that the taxative nature of its powers prevented it from fixing the content of the SGSSS, task

that the Political Charter had conferred on Congress.   Regarding the particular, the decision in commented established, from the moment of the definition of the general legal problems that assumed the judgment, the following:

" The legal problems of a general nature refer to questions of constitutional order that have to do with the regulation of the system of protection of the right to health, which affect the possibility that this is effectively enjoyed by people in specific and specific situations, as evidenced in the cases accumulated in the present process. All the general problems can be met in one, namely: Are the regulatory failures found in the present judgment from the cumulative cases and the evidence practiced by this Chamber, represent a violation of the constitutional obligations that the competent authorities have of respecting, protecting and guaranteeing the right to health to ensure their effective enjoyment? This question is answered in the affirmative and the necessary orders are given for the detected regulatory failures to be overcome. The orders that will be delivered are framed within the system conceived by the Constitution and developed by the Law 100 of 1993 and subsequent norms, since it would exceed the jurisdiction of the Court to order the design of a different system, since that decision falls to the legislator. The orders will be given to the legally competent bodies to adopt the determinations that could overcome the failures of the regulation that have resulted in a lack of protection of the right to health evident in the actions of guardianship that have been presented more and more frequently for several years, as will be analyzed later (chapter 6)" (Non-original Subrays).

As noted, the Court established that the structural orders it adopted would be directed to the authorities and instances of the SGSSS, which had set the law. Consequently, he directed concrete forecasts to the Ministry of Social Protection, the CRES and the CNSSS, in so many institutions that the Congress had assigned competence in defining the specific content of the health system. This decision is then framed in respect of the democratic principle and the constitutional rules which confer on the legislature, and not the judges, the definition of the content of the SGSSS.

However, this decision does not mean, in any way, the petrification of the legislator's ability to establish various institutional arrangements of the SGSSS. Therefore, if the Congress in exercise of its constitutional powers and under the submission of the formal and material limits referred to above, decides to modify this legal configuration of the health care system, such a forecast, as happens with the proposed bill, is a constitutionally legitimate expression of the normative configuration power.

On the other hand, it has to be taken into account that the alleged disadvantages in the application of the rules of the bill, because of the collision of competences that it generates between the different institutions of the SGSSS, in particular the CRES, is a matter that clearly falls within the questions for the convenience of the legislative initiative. These matters, as derived from the provisions of article 167 C.P., are beyond the control of constitutionality by the Court in this instance.

3.4.4. The Executive, within the objection of study in this section, considers that the bill, to the extent that it establishes a partial regulation of the SGSSS, does not know the principle of integrality. The government's argument to support this conclusion is to consider that this principle implies that the legislator is obliged to regulate the health system based on criteria of generality, in terms of the identification of the population that is subject to care.

The principle of integrality, which is insisted upon, has origin in provisions of legal status, was identified by the constitutional jurisprudence as a conceptual instrument, which is related to the protection of the rights to health, to life and to human dignity. This principle consists of the obligation of the institutions of the health system to provide the health care services continuously, comprehensively and subject to criteria of opportunity, efficiency and quality, so that the user of the SGSSS achieves the restoration of the state of health or of not being this possible, the guarantee of the maintenance of a dignified life.

Judgment T-760/08 describes the principle of integrality from specific case-law rules, which describe the obligations mentioned above, by the different bodies of the SGSSS. In particular, this decision established the following arguments that, because of its importance in resolving the proposed objection, is transcribed in extensive:

" The principle of integrality has been postulated by the Constitutional Court in situations in which the required health services are divided or separated, so that the person concerned only authorizes a part of what he should receive in order to recover his health and forces him to pay for himself the other part of the required medical service. This situation of fractionation of the service has various manifestations in reason of the interest that the entity has in charge in avoiding a cost that in his judgment it is not up to him to assume.

This principle has been developed in the case law of the Constitutional Court based on different legal norms_[33] and refers to the care and treatment that users of the social security system are entitled to in health, as prescribed by the treating physician.

In this regard, the Court has said that " (...) the care and treatment of those belonging to the social security system in health whose condition of illness is affecting their personal integrity or their lives in dignified conditions, are integral; that is, they must contain all care, supply of medications, surgical interventions, rehabilitation practices, tests for diagnosis and monitoring, as well as any other component that the treating physician valorates as necessary for the full restoration of the patient's health_[34] or to mitigate the ailments that prevent them from leading their lives in better conditions; and in such a dimension, it must be provided to their affiliates by the entities charged with providing the public health social security service" _[35]

To the extent that people have the right to be guaranteed the treatment of health that they require, integrally, especially if it is a 'catastrophic' disease or if they are committed to life or personal integrity, territorial entities cannot divide and fracate the health services required by people. Thus, for example, a department, which is responsible for paying attention to people with cancer, cannot fail to guarantee the supply of permanent home oxygen to a cancer patient who requires it as an integral part of its treatment, on the grounds that the oxygen service, individually considered, corresponds to the municipal entities_[36].In terms of guaranteeing effective access to the health service required of a person, it can be said that the health institutions and institutions are in solidarity with each other, without prejudice to the rules that indicate who should assume the cost and the recognition of the additional costs incurred by an entity that guaranteed the provision of the health service, even if it does not correspond to it.

It is important to stress that the principle of integrality does not mean that the person concerned can ask to be supplied with all the health services he wishes or considers advisable. It is the treating physician assigned to the corresponding EPS that determines what the patient requires. Otherwise the principle of integrality would become a kind of blank cheque, instead of being a criterion to ensure that the user provides the health service ordered by the treating physician in a complete manner without having to go to another action of protection to request a part of the same health service already authorized. " (Non-original Subrays).

3.4.5. The reading of the aforementioned precedent shows that the references made by the constitutional jurisprudence to the principle of integrality are related to the identification of a parameter of a legal nature, which serves as a computer criterion of the SGSSS.   In this way, it is not feasible that from that principle and based on the lack of knowledge of the constitutional competence of the legislator to define the content and the institutionality of the health system, an objection of unconstitutionality can be built.

El Nacional] Before, in the Chamber's opinion, the problems raised in this section by the National Government point to the alleged budgetary difficulties and the implementation of the measures contained in the bill. These matters are limited to the exercise of powers that in matters of tax appropriation and execution that the Constitution recognizes to the same Executive Branch. In this way things cannot be considered as a presidential objection, which correspond not to the contradiction of the draft law with the Political Charter, but to the proper exercise of the powers that it gives to the various organs of public power.

On the basis of the above criteria, the Court concludes that (i) the recognition in a judicial decision of a certain institutional design of the SGSSS, is not incompatible with the possibility that the legislator establishes new modalities of regulation, competence that is subject only to the formal and substantial limits described above; (ii) of the principle of integrality, which has foundation in norms dictated by the Congress in exercise of the competition of legislative production, does not derive a the constitutional duty to restrict the legislative formulas on the content to the SGSSS to only those that stipulate rules for the generality of the population subject to health care; and (iii) the objection raised establishes a false problem of constitutionality that, in contrast, points to the proper exercise of the powers of appropriation and budgetary execution, and implementation of public policies, all of which are the responsibility of the National Government. On the basis of these considerations and in the absence of sufficient arguments to rule on the case raised, the Chamber will make an inhibitory decision in respect of the objection based on the alleged affectation of the principle of integrality.

3.5. Objections to the lack of knowledge of the competencies of the Health Regulation Commission and the National Public Health Plan

The National Government maintains that the provisions of the bill generate a fragmented and complex conception of the regulation of the institutions and benefits of the SGSSS. He points out that the rules provided for in Law 100and in Law 1122/07 had granted to the CRES, a technical instance trained and guided by scientific criteria, competition for the definition of the contents of the POS and the other benefits of the health system. Thus, the Congress had unknown such parameters of rationality and had adopted a partial and contrary legislation to the principle of integrality-in the particular interpretation given to it by the Executive-and the financial sustainability of the system.

Likewise, in the subsequent section, the Government makes similar reasoning, in the sense that Judgment T-760/08 had recognized the importance of the National Plan of Public Health, provided by article 33 of Law 1122/07, as a valuable tool in the search for a coordinated and efficient health system. Therefore, the partial and fragmented nature of the bill, contradicted the purposes of the aforementioned plan.

3.5.1. These objections are, in the judgment of the Court, in the absence of such objections, which, as in the previous case, make it impossible for the Chamber to take a substantive decision on the matter.     As has been pointed out repeatedly in this ruling, the Constitution confers the power to the Legislative Assembly to fix, within a wide margin of normative configuration, the institutional arrangement that it considers appropriate for the SGSSS. The ordinary rules of repeal and reform of the legal precepts determine that this power of regulation entails the possibility of modifying, eliminating or reconsidering the competences of each of these institutions. Therefore, the Congress is fully empowered to separate itself, if it deems it appropriate, from a certain institutional model that it has designed, in order to meet the needs of a particular social group, to whom it considers deserving of a differentiated treatment. This exercise, as has also been pointed out on several occasions, is limited only to the formal limits and constitutional materials explained above.   

Consequently, the proposed presidential objections are unaware that the Court's judicial control is limited to comparing the legal standard that is charged with the rules that make up the Political Charter and those that make up the constitutionality block. This control is not preaches to other provisions of an eminently legal ordinary character, since the same ones do not conform a normative parameter suitable for imposing limits or prohibitions on the competence of the legislator. This criterion is maintained, even when such institutional arrangements of legal origin have been found valid by decisions of this jurisdiction, since they also recognize the primeval faculty of the legislative on the matter. Such censures, as demonstrated in the case raised, end up related to reasons of political or economic convenience, aspects that prima facie escape from the Court's jurisdiction.

3.5.2. The provisions of Law 1122/07, which fix both the existence and functioning of the Commission on Health Regulation, CRES, and the objectives of the National Plan of Public Health, do not set a limit for the exercise of the legislator's competence with regard to the definition of the institutions that make up the health system. However, compliance with the functions of these institutions, of legal strain, should be coordinated with the subsequent provisions of the legislator, which, as in this case, are the subject of specialized care for certain groups of patients. It is therefore up to the Congress, in the terms set out above, to define the institutions and bodies that make up the SGSSS, which is limited by the formal and substantial restrictions previously mentioned, as well as the prohibition of unjustified discrimination between users. These restrictions, as stated insistently in this providence, do not involve prior legislative decisions, since they do not conform to the constitutionality of ordinary laws.

Additionally, it cannot be lost of sight that, as provided by article 33 of Law 1122/07, the definition of the contents of the National Public Health Plan corresponds to the National Government. _[37]

Therefore, it is not right to consider, as the presidential objection argues, that the legislator's broad faculty to determine the contents and the functioning of the SGSSS should be subject to the actions of the Executive, since this would mean not knowing the express constitutional mandates provided for in Articles 48 and 49 of the Charter, the content and scope of which was defined in the legal basis 3.3. of this judgment.  

In the past, it is noted that the arguments put forward by the National Government are based on the legality of the bill, which is outside the jurisdiction of the Court, as provided for in Article 167 Superior, a rule that empowers this Court to decide on objections for unconstitutionality. This circumstance prevents the Court from ruling on various matters. Therefore, in the absence of a presidential objection of this nature, the Chamber will be inhibited to adopt a fundamental decision on the censorship founded on the incompatibility of the project with the competences of the CRES in terms of regulation of the content of the SGSSS and with the forecasts of the National Plan of Public Health.

3.6. Objection relating to the infringement of the right to the participation of users

The National Government maintains that the draft law objected to is contrary to the rights of the SGSSS to participate in the decisions that affect them. To this end, after highlighting the importance that in Case T-760/08 was granted to this right, within the framework of the institutional and performance definition of the health system, it is limited to establishing that "the democratic element in the planning process, the legal stature of the national public health plan and the content of the plan exclude the possibility that the priorities of health care are defined by other means, without the technical components and the structure of the planning process being consulted periodically to include health risks, such as cancer, in isolation, fragmented and without consulting the criteria of integrality and financial sustainability of the General System of Social Security in Health. "

For the Court, it is evident that the proposed censorship does not meet the minimum conditions necessary to set up an objection of unconstitutionality. In fact, the argument put forward by the executive branch omits to indicate that normative statements of the bill prevent the effective enjoyment of the rights of participation of the users of the SGSSS and the way in which they achieve this alleged objective. On the contrary, it reiterates the argument about the fragmentation of the institutional health care regime of adult patients suffering from cancer, a matter that has already been elucidated in previous paragraphs of this ruling.

It should be emphasized that the article 166 C. P., does not establish the requirements that must be met by the objections raised by the Executive, this does not imply that they have to comply with minimum standards of argument that allow to sustain an objective and verifiable opposition between the legislative initiative and the Constitution, which allows a statement of substance from the Court. This is due to the fact that the competition to raise the objections, according to the aforementioned standard, corresponds to the government, so that if the objection does not offer these minimum arguments, this Court is barred from assuming the study of reasons that adds to the proposals by the Executive, because this would not know the arrangement of competences that the Political Charter provides for the presidential objections. If, as is the case in the present case, there is no basis for the analysis of constitutionality, the Chamber does not have a different alternative to an option to adopt a decision on the matter, since the argument put forward by the Government lacks the ability to produce an analysis of the constitutionality of the bill, as far as the right to participation is concerned.

3.7. Objection based on violation of the statutory reserve principle

In the Government's view, the bill is contrary to Article 152 of the Constitution, because as long as the constitutional jurisprudence, systematized in the several times cited Judgment T-760/08, granted the right to health condition of fundamentality, then the bill should be dealt with under the rigors of the statutory laws, and not according to the rules of the ordinary laws, as it did indeed. In addition, he maintains that the legislator made a mistake, when he indicated in the initiative that he was regulating the right to life, although in reality he was dealing with the fundamental right to health.

This objection is dismissed by both the Congress and the Attorney General, based on similar reasons. They argue that constitutional jurisprudence has established that not every rule that refers to a fundamental right is subject to the statutory reserve of law, but only those that meet certain criteria, related to the comprehensive regulation of the law or the aspects that make part of its essential core. For the case raised, the proposed law has a specific and specific scope-the care of adult cancer patients-which excludes it from those rules that require statutory processing.

3.7.1. Article 152 of the Political Charter establishes the statutory reserve of statutory law for certain matters, related to (i) the fundamental rights and duties of persons and procedures and resources for their protection; (ii) administration of justice; (iii) organization and regime of political parties and movements, opposition status and electoral functions; (iv) institutions and mechanisms of citizen participation; (v) states of exception; and (vi) electoral equality between the candidates for the Presidency of the Republic.

The consequences of this constitutional provision are of a formal and material nature. First, the statutory reserve of law implies, in the terms of Article 153 C.P., that the legislative procedure prior to its approval must comply with specific requirements and controls. Thus, the absolute majority of members of Congress will have to vote and the procedure must be completed in a single legislature. In turn, the approved bill is subject to the automatic control of constitutionality by this Corporation. In the face of material effects, the Court has recognized that the statutory norms, due to the status they acquire in the legal order, are part of the constitutionality parameter for ordinary legislation. _[38]

However, the fixing of the statutory reserve of law for the subjects mentioned, generates a controversy on the determination of the limits of the action of the statutory legislator and the ordinario.effect, are multiple the issues that can be versed, central or tangentially, on the topics of the statutory reserve of law. Therefore, the maximalist understanding of this reservation, in the sense that all norms of this character must be subject to the rituals of the statutory laws, would have the effect of emptying the competence of the ordinary legislator, a solution that is contrary to the Political Charter, in particular to the powers that the Congress has in accordance with the article 150 C.P.

The need to establish a parameter that defines the limit of the statutory legislator, led to the previous decisions of the Court, which have been repeated in a stable manner up to the present, established the material characteristics of the matters submitted to the statutory reserve of law. A comprehensive synthesis of that doctrine is found in Judgment C-981/05 (M.P. Clara Ines Vargas Hernández), in which it was established that the statutory reserve of law was enforceable, in the case of fundamental rights, in the events in which it is before "i) rules that develop and supplement the rights (ii) that regulate only the essential structural elements, (iii) that directly regulate their exercise and also the development of their scope from the essential core defined in the Constitution, (iv) that refer to the contents closest to the essential core, v) that regulate aspects inherent to the exercise and mainly what it means to enshrine limits, restrictions, exceptions and prohibitions that affect the essential core, vi) when the legislator assumes in a way integral, structural and complete the regulation of the law, vii) that allude to the general structure and regulatory principles but not to the integral and detailed development, thus regulating the fundamental structure and the basic principles, and viii) that refer to laws that deal with important and important situations of the rights. " These rules, in turn, synthesize several judgments about the same particular, which have contemplated unambiguously that the statutory reserve of law is preaches to norms that regulate in a full, structural and complete way the fundamental rights or duties, or refer to areas of its essential core_{. [39]}

3.7.2. For the case raised, the Chamber warns that the budgets are not met to consider that the draft bill under censure is subject to the statutory reserve of law.   In fact, article 1 of the bill, which defines the objective of the initiative, establishes that the purpose of the normativity is to regulate "actions for the comprehensive control of cancer in the Colombian population, in a way that reduces mortality and morbidity for adult cancer, as well as improving the quality of life of cancer patients, through the guarantee by the State and the actors involved in the General System of Social Security in Health in force, the provision of all services that are required for their prevention, early detection, comprehensive treatment, rehabilitation and palliative. " From this definition, it can be co-established that the bill (i) seeks to establish tools for the effective and comprehensive treatment of adult cancer; and (ii) to introduce modifications to the institutional arrangement of the SGSSS, in order to comply with that purpose. Therefore, the legislative initiative, in no way, seeks to regulate in a comprehensive, structural and comprehensive way the right to health, but rather, expressly declares its specific and sectoral character, that is, circumscribed to the treatment of the adult patients of cancer.

The Court warns that presidential objections are an insurmountable contradiction in this section. In fact, several of the censures set out by the Executive Branch are based on the fact that the regulation examined, because of its partial, fragmented and independent nature of the legal forecasts provided for by the current institutional arrangement of the SGSSS, would be inconvenient for the proper functioning of this system. This statement, therefore, shows that for both the legislator and the government it is evident that the bill does not shape a general, structural and comprehensive regulation of the right to health. It is therefore wrong to move from this premise to the requirement for a statutory reserve of law, where one and the other are incompatible, in accordance with the requirements explained above. It should be emphasized that a partial regulation of a fundamental right or duty, by antonomasia, falls within the jurisdiction of the ordinary legislator, which inhibits the possibility of fixing them within the subjects provided for in Article 152 C. Q. I regret to empty those powers.

3.7.3. It is clear to the Chamber that, apart from the argument raised in the constitutional case-law on the condition of the right to health, for the case of the draft law which is the subject of a study, its partial and specific nature as regards the scope of protection of this right, it is an element of sufficient judgment to register it within the legislative configuration margin of the ordinary legislator. In this way, the Court dismisses the objection raised by the Government regarding the violation of Article 152 of the Political Charter.

3.9. Objection based on ignorance of organic budget rules

The executive branch considers that the bill is unconstitutional, since it establishes orders that involve public spending, without having met the legislative procedures provided for in Article 7or Law 819/03, a rule that requires that initiatives that provide for the public budget to be carried out should establish the source of its financing and the compatibility of that expenditure with the Fiscal Framework of the Medium Term. Thus, while the organic norms are part of the parameter for the control of the constitutionality of the ordinary laws, the lack of compliance with the aforementioned requirements affects the exequability of the corresponding bill.

The Congress rejects the proposed objection, arguing that a good part of the measures contained in the bill do not entail additional fiscal impact, but are based on the use of resources currently perceived by the SGSSS. Moreover, in relation to the forecasts that could involve public expenditure, its source of funding has been duly foreseen, assigned to the sub-account of high cost, specific cancer component, as regulated in Article 22 of the initiative.

The Public Ministry shares the position expressed by the Congress, in the sense that more than generating public spending, the bill aims to reorganize existing resources in the SGSSS, so that satisfactory care is achieved for adult cancer patients. Therefore, the requirements of organic regulation were not applicable.

3.9.1. Article 7or Law 819/03-Organic Budget, establishes a group of mechanisms designed to make compatible the fiscal expenditures that can be established in legislative initiatives with the economic policy of the State. For the purpose, defined conditions are set, as the text of the precept states:

" Article 7o. Analysis of the Fiscal Impact of Standards. At all times, the tax impact of any bill, ordinance, or agreement, which mandates spending or grants tax benefits, must be made explicit and must be compatible with the Medium Term Fiscal Framework.

" For these purposes, the tax costs of the initiative and the source of additional income generated for the financing of this cost must be expressly included in the explanatory statement and in the respective processing papers.

" The Ministry of Finance and Public Credit, at any time during the respective procedure in the Congress of the Republic, will have to render its concept in the face of the consistency of the provisions of the previous paragraph. In no case will this concept be in the way of the Medium-Term Fiscal Framework. This report will be published in the Congressional Gazette.

" The bills of government initiative, which will raise additional spending or a reduction in income, will have to contain the corresponding substitute source for decreased spending or income increases, which will have to be analyzed and approved by the Ministry of Finance and Public Credit.

"In the territorial entities, the procedure provided for in the preceding paragraph will be set before the respective Secretariat of Finance or who will do its own times."

Previous Court rulings have elucidated the implications of this organic forecast as to the constitutionality of the legislative process. In particular, it has been considered that the requirement referred to in Article 7or Law 819/03 seeks to satisfy constitutionally valuable purposes, related to (i) the granting of rationality to the legislative procedure; and (ii) the material effectiveness of the laws, which inevitably passes through the determination and achievement of the necessary economic resources, in a framework of compatibility with the country's economic policy. However, the same precedent has provided for the literal tenor of the article 7 or cited, it is noted that the achievement of such compatibility is a task in which the executive and the Congress have concurrent powers. The current constitutional precedent on the subject was set out by the Court in Case C-502/07 (M.P. Manuel José Cepeda Espinosa), failed to study the constitutionality of the statutory bill number 34/05 Senate and 207/05 House "for which the article 227 of the Political Constitution is developed, in relation to the direct election of Andean parliamentarians." Within this process of constitutionality, the topic referred to the alleged unconstitutionality of the initiative was addressed, while it had failed to comply with the requirement to incorporate its fiscal impact and its compatibility with the Medium-Term Fiscal Framework.   This was because the bill set some tasks in charge of the Electoral Organization, which, in the opinion of the Attorney General and some of the speakers, involved the execution of public spending.

On the particular, the sentence expresses the following reasons, which because of its nodal importance to resolve the subject matter of analysis, it is appropriate to transcribe in extensive:

" Article 7or Law 819 of 2003 requires that in any bill, ordinance or agreement that orders expenditures or grants tax benefits, it is made explicit what its fiscal impact is and establishes its compatibility with the Fiscal Framework of the Medium Term that the National Government gives annually. For this purpose, it has to be stated that in the project's explanatory statements and in each of the papers for debate, the tax costs of the projects and the source of additional income to cover the aforementioned costs must be expressly included. In the same way, it states that during the process of the projects the Ministry of Finance must provide a concept about the tax costs that have been estimated for each of the projects, as well as the source of income to cover them and the compatibility of the project with the Medium Term Fiscal Framework.

Evidently, the rules contained in Article 7or Law 819 of 2003 constitute an important instrument for streamlining legislative activity, in order for it to be carried out with knowledge of the fiscal costs generated by each of the laws approved by the Congress of the Republic. They also allow the laws to be enacted to be in harmony with the economic situation of the country and with the economic policy outlined by the authorities concerned. This certainly contributes to generating order in public finances, which has a positive impact on the country's macroeconomic stability.

In the same way, compliance with the requirements set out in the aforementioned article 7or must have a favorable impact on the effective application of the laws, since the approval of the laws will only occur after knowing its foreseeable fiscal impact and the possibilities of financing it. This indicates that the approval of the laws will not be accompanied by the permanent uncertainty about the possibility of fulfilling them or of developing the public policy in them. With this, the instruments contained in article 7or analyzed can contribute to the overcoming of that existing tradition in the country-of such deleterious effects in the Social State of Law-that leads to the passing of laws without incorporating in the design of the same the necessary elements-administrative, budgetary and technical-to ensure its effective implementation and to keep track of the obstacles that hinder its full, timely and full compliance.

Thus, the aforementioned article 7or Law 819 of 2003 stands as an important tool both to rationalize the legislative process and to promote the implementation and enforcement of the laws, as well as the effective implementation of public policies. But this does not mean that this article can be interpreted as a barrier to the Congress exercising its legislative function or a procedural burden that falls on the legislature exclusively.

35. Certainly, given the current conditions in which the Congress of the Republic is playing, admitting that Article 7or Law 819 of 2003 constitutes a procedural requirement, which creates an additional and exclusive burden on the Congress in the formation of the bills, means, in practice, considerably fencing the power of Congress to legislate and grant the Ministry of Finance a sort of veto power over the bills.

On the one hand, the requirements contained in the article assume that the congressmen-or the banks-have the knowledge and tools sufficient to estimate the tax costs of a legal initiative, to determine the source with which they could be financed and to evaluate their projects against the Fiscal Framework of the Medium Term. In reality, accepting that the conditions set out in Article 7or Law 819 of 2003 constitute a procedural requirement that it is the sole responsibility of the Congress to comply exclusively and exclusively reduces the capacity of legislative initiative that resides in the Congress of the Republic, thereby violating the principle of separation of the Ramas from the Public Power, in so far as the autonomy of the Legislative Branch is seriously injured.

Precisely, the almost insurmountable obstacles that would be generated for the legislative activity of the Congress of the Republic would lead to the granting of a form of veto power to the Finance Minister on the bills in Parliament. The Ministry of Finance has the necessary elements to be able to make estimates of the tax costs, to establish where the necessary resources can arise to assume the costs of a project and to determine the compatibility of the projects with the Fiscal Framework of the Medium Term. He would have to go to the congressmen or the benches who want to present a bill that involves spending. In this way, the Ministry would decide which requests it serves and the order of priority to do so. By doing so, he would acquire the power to determine the legislative agenda, in a way that would mean the autonomy of the Congress.

Cambio] But, in addition, the Ministry could decide not to intervene in the process of a bill that would create fiscal impact or simply disregard the project's process. This could lead to the project being approved without having listened to the position of the Ministry and without knowing in a certain way whether the project is in line with the macroeconomic requirements set out in the Fiscal Framework of the Medium Term. In reality, this situation has already been presented in the case analyzed in Judgment C-874 of 2005-behind reviewed-and the President of the Republic objected to the bill for the Ministry of Finance had not conceptualized about the legal initiative. However, as was recalled, the Court stated that the Ministry of Finance's omission did not affect the validity of the legislative process.

36. For all of the above, the Court considers that the first three points of Article 7or of Law 819 of 2003 should be understood as parameters of rationality of the legislative activity, and as a burden that is initially incumbent upon the Ministry of Finance, once the Congress has valued, with the information and the tools it has at its disposal, the tax incidents of a certain bill. This means that they are instruments to improve legislative work.

That is to say, the aforementioned article must be interpreted as meaning that its purpose is to obtain that the laws that are dictated take into account the macroeconomic realities, but without creating insurmountable barriers in the exercise of the legislative function or creating a legislative veto power in the head of the Finance Minister. And in that process of legislative rationality the main burden rests with the Ministry of Finance, which is the one that has the data, the officials ' teams, and the economic expertise. Therefore, in the event that the congressmen process a bill incorporating erroneous estimates on the fiscal impact, on how to deal with these new expenses or on the compatibility of the project with the Fiscal Framework of the Medium Term, it is up to the Finance Minister to intervene in the legislative process to illustrate to the Congress about the economic consequences of the project. And the Congress will have to receive and value the concept issued by the Ministry. Nevertheless, the burden of demonstrating and convincing the congressmen about the incompatibility of a certain project with the Fiscal Framework of the Medium Term is on the Finance Minister.

On the other hand, it is necessary to reiterate that if the Ministry of Finance does not participate in the course of the project during its formation in the Congress of the Republic, it may well mean that the legislative process is flawed because it has not taken into account the conditions set out in Article 7or Law 819 of 2003. Since the main burden in the presentation of the tax consequences of the projects is the Ministry of Finance, the omission of the Ministry in informing the congressmen about the problems presented by the project does not affect the validity of the legislative process or the corresponding law. "

3.9.2. Based on these considerations and based on the analysis of the other judgments that have been dealt with, most recently the Court, in Case C-315/08 (M.P. Jaime Cordoba Triviño), ruling that he decided on the presidential objections made to Bill 18/06 Senate, 207/07 House, "by which they establish rebates in the sanctions for the remaking of the mandatory military service", fixed the jurisprudential rules related to the implications of article 7or Law 819/03 for the processing of the ordinary laws by the Congress. In this regard, the following criteria were established_[40]

3.9.2.1. The obligations laid down in Article 7or Law 819/03 constitute a parameter of legislative rationality, which is aimed at fulfilling constitutionally valuable purposes, including the order of public finances, macroeconomic stability and the effective implementation of laws.   The latter, as a preliminary study of the compatibility between the content of the bill and the projections of economic policy, decreases the margin of uncertainty with respect to the material execution of the legislative forecasts.

3.9.2.2. The mandate of adequacy between the justification of the bills and the planning of economic policy, however, cannot be understood as a requirement for the approval of the legislative initiatives, the fulfillment of which will be exclusively in the Congress. As such (i), the Congress lacks the technical assessment bodies to determine the fiscal impact of each project, the determination of the additional sources of financing and the compatibility with the medium-term fiscal framework; and (ii) accepting an interpretation of this nature would constitute an unreasonable burden on the Legislator and would grant a correlative power of veto to the Executive, through the Ministry of Finance, in respect of the Congress ' competence to make the laws. A power of this character, which involves a barrier in the constitutional function of normative production, is incompatible with the balance between the public authorities and the democratic principle.

3.9.2.3. If this mandate is considered as a mechanism of legislative rationality, its fulfillment initially corresponds to the Ministry of Finance and Public Credit, once the Congress has valued, through the tools it has at its disposal, the compatibility between the expenditures generated by the legislative initiative and the projections of the economic policy outlined by the government. Thus, if the Executive considers that the chambers have carried out an analysis of the wrong fiscal impact, it is up to the Ministry of Finance to participate in the legislative procedure, in order to illustrate to the Congress the economic consequences of the project.

3.9.2.4. Article 7or Law 819/03 cannot be interpreted in such a way that the lack of concurrence of the Ministry of Finance and Public Credit within the legislative process affects the constitutional validity of the respective procedure.

3.9.3. These rules are applied to the case that we are dealing with. At different times in the legislative process, the Congress expressed the fiscal implications that the bill implied and, therefore, stipulated a model of financing to deal with them. Thus, in the paper for the first debate in the Seventh Committee of the House of Representatives, some considerations were made about the cost of comprehensive care for cancer patients proposed in the initiative:

Cost-benefit analysis

The costs of cancer management, thanks to the constant introduction and uncontrolled use of new technologies and treatments State of the Art, have entered an uncontainable spiral. The approximate cost of medical care for patients with cancer in EE. In the United States, it exceeds $35 trillion per year; in an American Health Maintenance Organization (HMO) 47% of patients with cancer were "high risk enrolled", that is, they cost more than $4,500,00 per year. As the investment in health of developing countries is minimal and the percentage of the uninsured population is majority, these populations are unfortunately receiving care below the standard or not receiving it.

The "pharmacy" represents 70-80% of the cost of cancer treatment, and the prices of oncology drugs are uncontainable with the constant entry of new agents produced by the new and expensive technology. Global cancer medicine spending tops $10 trillion.

The economic impact of these treatments on the economy of the sick with uninsured cancer, and finally on the country's health budget, deserves to be analyzed, especially considering that most are palliative treatments.

The World Health Organization, considering that most of these expensive drugs produce only limited benefits, has reiterated its recommendations on drugs essential for cancer treatment especially in third world countries. " _[41]

As of this verification, the article of the paper in this same instance of the legislative procedure, provided a technical and specific formula for financing the medical assistance provided in the bill. Thus, a precept of the following tenor was established:

" Article 20. Financing.   From the time of this law, this law will be financed with the resources that will be incorporated into the Sub-account of the High Cost-specific component Cancer, and will make part of the system of financing of the SGSSS that integrate the parafiscal resources from the social security contributions in health with the fiscal resources of the national and territorial order, based on a criterion of co-financing and equity, with the purpose of generating full solidarity.

Among other resources, the SGSSS High Cost Sub-Account will be funded with the following sources:

a) The surpluses in the ECAT account;

b) The resources of the General System of Participations for collective actions of public health, as defined in Law 715 of 2001;

(c) Resources from 1% of the profits of oil companies in the oil-producing phase;

d) Resources from 2% of the profits of the financial sector operating in the country;

e) Resources from the tax on arms purchases, corresponding to 10% of a minimum monthly salary, and ammunition and explosives, which will be charged as an ad valorem tax with a rate of 5%, with the exception of arms, ammunition, and explosives from the Armed Forces, Police, and State security entities;

f) The resources coming from the plan of action and recovery of money lost for evasion and avoidance and evaluated according to the joint performance plan with the Fosyga, DIAN and Ministries of Finance and Social Protection that will have to be defined at December 31, 2008 and will be structured with a schedule of execution to 4 years.

PARAGRAFO 1o. Coefficient of UPC. In order to balance the deviations that may exist between the different EPS regarding the observed number of patients with Cancer, an EPS coefficient will be calculated, which will determine the resources to be recognized or discount to each EPS during the compensation process, for having a higher or lower frequency of cases of Cancer. This coefficient results from dividing the total of the value of the adjusted hypothetic compensation according to the number of cases of Cancer of the EPS, among the total of the value of the Compensation Observed of the EPS, not adjusted, in the study period. For this purpose the calculation formula defined for the adjustment of the UPC for the IRC and the modifications it requires for this purpose shall be used. The fiduciary order of the Fosyga will apply in the process of compensation of each EPS the coefficient defined annually by the CNSSS that recognizes the greater or lesser value to discount or to recognize in the process of compensation of each EPS for the occurrence of the greater or lesser number of cases of Cancer, by multiplying the compensation calculated from the UPCs of the age groups approved by the National Council of Social Security in Health, by the Coefficient. For the application of the coefficient shall be made from the compensation corresponding to the two (2) months following the penalty of this law.

PARAGRAFO 2o. The Fosyga compensation sub-account shall maintain an annual balance (zero sum) between the negative and positive values resulting from the application of the formula established with the parameters described in Article 3 of this Agreement. The annual ceiling of the compensation with the CIRCI Coefficient for each EPS, may not exceed or be less than the result of the difference of the compensation with the Coefficient CIRC in relation to the Observed Compensation, obtained in the period of study, July 1o of the year n-2, to June 30 of the year n-1.

PARAGRAFO 3o. The Coefficient defined in this Agreement shall not apply for the Entities Adapted to the SGSSS, exemption regimes and special schemes.

PARAGRAFO 4o. The Ministry of Social Protection and the National Council of Social Security in Health or those who do their times, will be used as a contingency for the financing and execution of the Plan of Action against Cancer defined in this law, for this purpose, will be allocated 20%, corresponding to the equitable distribution according to the burden of the disease of each one of the pathologies defined as catastrophic or of high cost, of the Sub-account of High Cost defined in Decree 2699. The resources defined in this law will be administered by an independent trust that can be constituted by both contributory and subsidized EPS operating in the country. These resources must ensure that the risk of illiquidity and bankruptcy of Health Promoters is exceeded by not taking decisions in the face of the proven behavior and trend of the high cost in the System. " _[42]

In turn, in the report for the first debate in the Seventh Committee of the Senate of the Republic, it was proposed to reformulate the method of financing approved by the House. Thus, in the corresponding amendments, it was indicated that the financing article "eliminates the disposition in which they distribute taxes and royalties among other forms of financing of the fund for the management of cancer, which is why the Political Constitution in its article 154 provides that they are of the private initiative of the National Government, the projects that propose to order participations in the national income or transfers of the same." _[43] Therefore, he established the text on funding that was eventually welcomed as Article 22 of the contested bill, which states that "From the time of this law, this law will be financed with the resources that will be incorporated into the Sub-account of the High Cost-specific component Cancer, and will make part of the system of financing of the SGSSS that integrate the parafiscal resources from the social security contributions in health with the fiscal resources of the national and territorial order, based on a criterion of co-financing and equity, with the purpose of generating full solidarity. "

3.9.4. On the other hand, in what has to do with the intervention of the Ministry of Finance and Public Credit during the process of the bill, the Court finds that the bill was made through the concept of October 20, 2008, presented to Senator Ricardo Arias Mora, president of the Seventh Senate Committee of the Republic_{Mexico [44}. This concept focused on making some observations to the Congress, in the sense that comprehensive care for cancer patients should be articulated with the competencies of the CRES, according to the functions assigned to it by Law 1122/07, which had been endorsed by the Court in Case T-760/08. Additionally, he insisted on the need to grant rationality and efficiency to the use of resources for health care, as well as to information systems on users, in order to ensure the adequate provision of medical-care benefits.

However, such intervention did not give any consideration to compliance with the organic budget rules, in particular with regard to the satisfaction of the requirements for the establishment of the source of financing and compatibility with the medium-term fiscal framework, which is dealt with in Article 7or in Law 816/03.

3.9.5. In this order of ideas, the Court concludes that, for the case of the proposed law, there is no evidence of an unconstitutionality caused by the violation of the organic regulations of the budget. Note that the Congress, based on the tools it had at its disposal, established a method of financing to address the tax impact of the measure. In this instance, it was up to the Ministry of Finance and Public Credit, in accordance with the duty imposed by the third paragraph of Article 7or Law 819/03, to present a concept in which it would have indicated that the financing formula proposed by the legislature was opposed to the Medium-Term Fiscal Framework or did not contemplate the necessary sources of financing. On the contrary, in his intervention, he kept silent on the matter, omission that, according to the jurisprudential position of this Corporation, cannot give rise to the affectation of the constitutionality of the procedure.

It should be emphasized that if the government considered that the mode of financing provided by the chambers did not conform to the requirements and conditions of its economic policy, it was obliged to indicate, through the instance provided for in Article 7or Law 819/03, the observations of the case. Thus, it is not acceptable to accept that the omission in the use of this instrument could serve as a basis for the configuration of a vice of constitutionality of the initiative. This is under the understanding that the compatibility between the bills and the economic policy is a matter in which Congress and the government are present, without the government having a veto over the legislative capacity to produce the laws.

Based on the above arguments, the Court will dismiss the presidential objection based on the pretermission of the organic budget regulations.

3.10. According to the reasons explained in the preceding legal bases, the Court finds that none of the presidential objections raised against the bill lead to questioning its constitutionality. The Chamber will therefore declare the initiative to be exequable, restricting the effects of this decision to the matters studied in this judgment.

DECISION

In merit to the above considerations, the Constitutional Court, administering justice on behalf of the People and by mandate of the Constitution,

RESOLVES:

First. Declare Unfounded the Presidential Objections to Bill 312/08 Senate, 90/07 Chamber, "Sandra Ceballos Law, establishing the actions for comprehensive cancer care in Colombia."

Second. As a result of the above and exclusively with respect to the objections raised by the National Government, the Draft Law No. 312/08 Senate, 90/07 House, "Law Sandra Ceballos, for which the actions for comprehensive cancer care in Colombia are established."

Third. Inhibit to adopt a substantive decision regarding the presidential objections based on (i) the incompatibility of the project with the principle of integrality, the competences of the CRES in terms of regulation of the content of the SGSSS and with the provisions of the National Plan of Public Health; and (ii) the violation of the right to the participation of the users, because of the absence of sufficient reasons to effect a judgment of constitutionality on the matter, as expressed in the legal bases 3.4., 3.5. and 3.6., of this decision.

Fourth. Please note that the provisions of Article 167 of the Political Constitution are fulfilled.

Copy, notify, contact the President of the Republic and the President of the Congress, insert yourself in the Gazette of the Constitutional Court, comply and file the file.

The President,

Nilson Pinilla Pinilla.

The Magistrate,

Maria Victoria Calle Correa.

The Magistrate,

Mauricio Gonzalez Cuervo.

The Magistrate,

Juan Carlos Henao Perez.

The Magistrate,

Gabriel Eduardo Mendoza Martelo, OP 124.

The Magistrate,

Jorge Ivan Palacio Palacio.

The Magistrate,

Jorge Ignacio Pretelt Chaljub.

Magistrate

Clarification of vote.

Humberto Antonio Sierra Porto, with voting clarification.

Magistrate (P),

Luis Ernesto Vargas Silva.

The General Secretariat,

Martha Victoria Sachica of Moncaleano.

* * *

1 Cfr. Folio 808-812 of the main file 1.

2 Cfr. Folios 696-701 of the main file 1.

3 Cfr. Folios 599B-607 of the main file.

4 Cfr. Folio 628 of the main file 1.

5 Cfr. Folios 577-578 of the main file 1.

6 Cfr. Sheet 539 of the main file 1.

7 Cfr. Folio 538 of the main file 1.

8 Cfr. Folio 380-395 of the main file 1.

9 Cfr. Folios 331-333 main file 1.

10 Cfr. Folios 160-171 of the main file 1.

11 Cfr. Folio 285 of the main file 1.

12 Cfr. Folios 110-123 and 128-142 of the main file 1.

13 Cfr. Folios 178 and 216 of the main file.

14 Cfr. Folio 86 of the main file 1.

15 Cfr. Folios 49-81 of the main file.

16 Cfr. Folios 1 and 20 of the main file 1.

17 Cfr. Constitutional Court. Statements C-510/96, C-063/02 and C-068/04.

18 Cfr. Folios 23-25 (reverse) of Test notebook 1.

19 Cfr. Portfolio 1 of the main file 1.

20 Cfr. Congress Gazette 441/09. Page 34

21 Ibidem. Page 68.

22 In this regard, in the Act cited, on page 14 of Gazette 442/09, which works on the page 35 of the test book 3, reads as follows:

" Secretary General Dr. Jesus Alfonso Rodriguez C. Reports:

Approved President is a report of objections.

According to the designation made in the Sandra Ceballos Bill, for which actions are established for the comprehensive care of cancer in Colombia and as referred to in Article 167 of the Constitution and subsequent ones, we insist on the sanction according to the text approved by the Congress of the Republic and do not accept the objections presented by the National Government.

Firman: Dilian Francisca Toro, Alfonso Nunez, Zaida Marina Janeth, Jorge Ignacio Morales.

The report of objections has been read, Mr President.

of the Presidency Doctor German Varon Cotrino.

[El PaisThe report presented by Dr. Morales, which opens its discussion, announced that it will be closed, is closed, does the Plenary Assembly approve?

General Dr. Jesus Alfonso Rodriguez C. Reports:

Approved the report. "

23 Cfr. Folios 14-20 of the test notebook 2.

24 Cfr. Sheet 20 of the main file 1.

25 Cfr. Folios 43 of the test notebook 4.

26 On the particular, in the Gazette, the relevant section of which is the relevant section of the booklet 7, sheet 7, the following is verified:

Address of the Presidency. Dr German Male Cotrino.

We proceed in that way if there is no objection and no discussion is generated with the project.

Pais you approve of modifying the order to approve this conciliation, your discussion will be opened, you will be closed, you will be closed, will the Plenary Assembly approve it?

General Dr. Jesus Alfonso Rodriguez C. Reports.

Approved President is a report of objections by law Sandra Ceballos, for which actions are established for the comprehensive care of cancer in Colombia and as contemplated in article 167 of the Constitution and subsequent, we insist on the sanction according to the text approved by the Congress of the Republic and we do not accept the objections presented by the National Government.

Firman: Dilian Francisca Toro, Alfonso Nunez, Zaida Marina Janeth, Jorge Ignacio Morales.

The report of objections has been read, Mr President.

of the Presidency Doctor German Varon Cotrino.

[El PaisThe report presented by Dr. Morales, which opens its discussion, announced that it will be closed, is closed, does the Plenary Assembly approve?

General Dr. Jesus Alfonso Rodriguez C. Reports:

Approved the report. "

27 Cfr. Constitutional Court, Judgment C-1065/08 (M.P. Clara Ines Vargas Hernandez). In this decision, the Court decided on the constitutionality of the rules of Law 100/93 which establishes the requirement of exclusive academic dedication so that under 25 years old are the beneficiaries of the SGSSS.

28 About the material and formal limits on the legislative definition of the SGSSS, Cfr. Constitutional Court, Sentences C-1489/00 (M.P. Alejandro Martínez Caballero), C-1065/08 and C-675/08 (M.P. Jaime Cordoba Trivino). In this last sentence, the Court dealt with the constitutionality control of the Law of Law 1122/07, which imposes on the institutions of health-IPS the obligation to recognize advance payments to the EPS.

29 Cfr. Constitutional Court, Judgment C-616/01 (M.P. Rodrigo Escobar Gil). In this ruling, the plenum of the Court decided on the exequability of different norms of the Law 100/93, which establish the regime of vertical integration between the EPS and their own IPS.

30 Cfr. Constitutional Court, Judgment C-616/01.

31 Cfr. Constitutional Court, Judgment C-516/04 (M.P. Jaime Cordoba Trivino). In this decision, the Court analyzed the exequability of the law of Law 776/02, which establishes the deadlines for the transfer of professional risk management entities, in respect of the members of the Social Insurance Institute.

32 On this particular, the judgment reiterates what was stated by the Court in decision SU-623/01 (M.P. Rodrigo Escobar Gil).

33 In Case T-179 of 2000 (M.P. Alejandro Martínez Caballero) was indicated on the " The mandatory health plan is for all inhabitants of the national territory for the integral protection of families to maternity and general illness, in the phases of promotion and promotion of health and prevention, diagnosis, treatment and rehabilitation for all pathologies (article 162 Law 100 of 1993).  | | In addition, there is a comprehensive care guide, defined by Article 4 of Decree 1938 of 1994: " It is the set of activities and procedures most indicated in the approach to the promotion and promotion of health, prevention, diagnosis, treatment and rehabilitation of the disease; in which the minimum steps to be followed and the sequential order of the disease are defined, the level of complexity and the qualified health personnel that must address them, taking into account the conditions of eligibility of the patient according to variables of gender, age, health conditions, expectations In addition to the results in terms of quality and quantity of life won and with the best use of resources and technologies at a cost that is financed by the social security system and by the members of the social security system. | | By another aspect, the system is designed, according to the Preamble of the Law 100 of 1993, to assure the quality of life for the integral coverage, hence that within the principles that infuse the system of integral social security, this, is worth the redundancy, that of the integrality, defined like this: " It is the coverage of all the contingencies that affect the health, the economic capacity and in general the living conditions of the entire population. To this effect, everyone will contribute according to their capacity and will receive what is necessary to attend to their contingencies covered by the law " (article 2or Law 100 of 1993). | | What's more: article 153 (3): "The General System of Social Security in Health will provide comprehensive health care to the population in its phases of education, information and health promotion and prevention, diagnosis, treatment and rehabilitation, in quantity, opportunity, quality and efficiency, in accordance with the provisions of Article 162 regarding the mandatory health plan." | | In turn, the literal c) of article 156 ibidem expresses that "All the members of the General System of Social Security in Health will receive a comprehensive plan of health protection, with preventive, medical-surgical and essential medications, that will be called the mandatory plan of health" (highlighted out of text). | | There is therefore, in the Law 100 of 1993 and in the decrees that regulate it, it expresses the integral coverage, the basic attention, the integrality, the integral protection, the comprehensive care guide and the comprehensive plan. Comprehensive care, which refers to rehabilitation and treatment, as the rules indicate. "

34 In this regard, the Corporation, among others, has been pronounced in Case T-136 of 2004 M.P. Manuel José Cepeda Espinosa

35 Judgment T-1059 of 2006 (M. P Clara Inés Vargas Hernández). See also: Statement T-062 of 2006 (MP Clara Inés Vargas Hernández). Other judgments: T-730 of 2007 (M. P Marco Gerardo Monroy Cabra), T-536 of 2007 (MP Humberto Antonio Sierra Porto), T-421 of 2007 (M. P Nilson Pinilla Pinilla).

36 In Case T-1091 of 2004 (M. P Humberto Antonio Sierra Porto), the right of a person to be provided by the Departmental entity (Secretariat of Health of Antioquia) will provide him with the permanent home oxygen that he required as part of his cancer treatment, even though such a service, individually considered, is the responsibility of the municipal authorities. The Constitutional Court pointed out that the regulations charge the departments of the comprehensive treatment for cancer, so the competition of the oxygen service cannot be assigned to the Municipalities, with the argument that this service, individually considered, outside the treatment of cancer, is up to them.

37 The cited rule states the following:

Article 33. National Public Health Plan. The National Government will define the National Public Health Plan for each four-year period, which will be expressed in the respective National Development Plan. Its objective will be the attention and prevention of the main health risk factors and the promotion of healthy living conditions and styles, strengthening the capacity of the community and the different territorial levels to act. This plan must include:

a) The epidemiological profile, identification of protective risk factors and determinants, the incidence and prevalence of the main diseases that define priorities in public health. For this purpose, the investigations carried out by the Ministry of Social Protection and any public or private entity will be taken into account. In the field of vaccination, sexual and reproductive health, mental health with emphasis on domestic violence, drug addiction and suicide;

b) Activities that seek to promote the change of healthy lifestyles and the integration of healthy lifestyles at different levels of education;

c) Actions that, according to their competencies, must be performed at the national level, the territorial levels and the insurers;

d) The public health financial and budgetary plan, defined in each of the actors responsible for the General System of Social Security in Health, including the territorial entities, and the EPS;

e) Mandatory minimum coverage in health services and interventions, goals in preventable morbidity and mortality, to be achieved and reported with zero tolerance, to be set for each year and for each four-year period;

(f) The goals and responsibilities in public health surveillance and the actions of inspection, surveillance and control of risk factors for human health;

g) Public health priorities to be covered in the Mandatory Health Plan and the goals to be achieved by the EPS, to promote health and to control or minimize the risks of getting sick or dying;

[h] The collective activities that the Nation and the territorial entities are in charge of with resources to do so must complement the actions provided for in the Mandatory Health Plan. The Public Health Plan for collective interventions will replace the Basic Care Plan;

i) Models of care, such as family and community health, primary care and home care;

j) The national immunizations plan to structure and integrate the specific protection scheme for the Colombian population, in particular the biologics to be included and to be reviewed every four years with the advice of the National Institute of Health and the National Committee on Immunization Practices;

k) The plan should include actions aimed at promoting mental health, and the treatment of disorders of higher prevalence, the prevention of violence, abuse, drug addiction and suicide;

l) The Plan will include actions aimed at promoting sexual and reproductive health, as well as measures aimed at responding to the behavior of maternal mortality indicators.

38 Cfr. Constitutional Court, Sentences C-578/95 (M.P. Eduardo Cifuentes Munoz) and C-993/04 (M.P. Jaime Araujo Renteria).

39 Cfr. Constitutional Court, Sentences C-251/98, C-013/93, C-313/94, C-620/01 and C-646/01, among others. For example, Judgment C-646/01 (M.P. Manuel José Cepeda Espinosa), offers similar rules regarding the rules governing fundamental rights, subject to the statutory reserve of law. In this ruling, the Court stated that: In accordance with that case law and with the constitutional precedents prior to it, it can be concluded that such a situation occurs when (i) the matter is a fundamental right and not a constitutional right of another nature, (ii) when, by means of the rule, a fundamental right is being regulated and supplemented, (iii) when such regulation touches the minimum conceptual and structural elements of fundamental rights, and (iv) when normativity has a pretense of integrally regulating the law fundamental. | | In this order of ideas, it can be observed then that the existence of the statutory laws has a double function, identified especially by means of the criteria (ii) and (iii). On the one hand, to allow the legislator to integrate, perfect, regulate and complement norms on fundamental rights, which point to his proper enjoyment and enjoyment. On the other hand, it is possible to establish a constitutional guarantee in favour of citizens against possible limits which, in accordance with the principle of proportionality, can only be established by the legislator. | | 7. Because of the special importance of the statutory laws in the system, it is necessary that the analysis of a charge that reproaches the lack of knowledge of the statutory reserve, also takes care of at least three fundamental aspects. First, avoid that in determining the material scope of the statutory law, the competence of the ordinary legislator is emptied. Second, it prevents the material content and the own scope of the statutory laws from being removed in search of the maintenance of the previous ordinary constitutional competence of the legislature. And third, prevent a interpretation of the content of the statutory laws from granting them a competence in the field of fundamental rights regulation, which will allow them to affect their basic conceptual contents, without a proper judgment of previous proportionality. | | Based on the above assumptions, in order to determine whether the defendant's rule should have been dealt with by a statutory law, it is not sufficient to determine whether the object of that provision is related to a fundamental right. It will also be necessary to ascertain whether the normative content expressed by the law from the material point of view, regulates elements that are close to and around the essential content of a fundamental right, and in case of restrictions, limits or conditions on these, must be verified if they have a proportional and constitutionally reasonable character. "

40 It should also be noted that the same precedent has been accepted in its entirety by the most recent case law of the Court. Cfr. Constitutional Court, Judgment C-441/09 (M.P. Juan Carlos Henao Perez).

41 Cfr. Congress Gazette 140/08, page 12. Portfolio 604 of the main notebook 1.

42 Ibidem. Page 14, portfolio 606 of the main notebook 1.

43 Cfr. Congress Gazette 710/08, page 384 of the main notebook 1.

44 Cfr. Congress Gazette 748/08, pages 6-8. The original of the concept works to folios 374-378 of the main notebook 1