El sistema de salud chileno : Organización, funcionamiento y financiamiento

Abstract

The author reviews the reforms in the Chilean public health system over the last 10 years. After a brief characterization of the system, some of the new policies and social and economic indicators are evaluated, and the role of the public and private sectors in guaranteeing medical services is described. Up until 1980 the Chilean public health system was highly centralized and consisted of two parts: the National Health System (SNS), which provided preventive care to the entire population and curative care for workers and the indigent, and the preferred supplier system (SPP), which provided curative care for salaried employees. With the creation in 1979 of the National Health Services (SNSS), the SNS was divided into 27 autonomous regional services capable of providing more specialized primary and tertiary care. The Ministry of Health was responsible for setting standards and health policies, and the National Health Fund (FONASA) was created to collect wage deductions for health, finance the respective regional services, and manage the SPP. In 1981 the SNSS was expanded no include the health insurance institutions (ISAPRES) which sold closed group plans, preferred supplier plans, and mixed plans. The aim of the new policies was to decentralize the provision of medical services, encourage collaboration of the private sector, and ensure free choice by the users: to intensify preventive measures