4239.0: Tuesday, October 23, 2001 - 3:00 PM

Abstract #27976

Chilean health care as a lesson against the market

Steven P. Wallace, PhD, School of Public Health, University of California-Los Angeles, UCLA Box 951772, Los Angeles, CA 90095-1772, 310-794-0910, swallace@ucla.edu

Favorable long-term economic growth in Chile has made it a popular example for international financial institutions to use when recommending policies to other Latin American nations. In addition to embracing free-trade, open-investment, and export-driven policies, Chile was one of the first to move significant segments of its social provision from the state to the private market. In health care this has been accomplished through the development of private insurance and private providers that compete with the public sector. The initial intent may have been for the private sector to eventually replace the public sector, but over the past ten years a dual-sector model developed that reflects the dualism of the economy. This two-tiered system of health care provides those with significant financial resources, primarily in the "international" sector, with unsubsidized private insurance and providers with ready access to both primary and specialist care as well as modern technology. Those in traditional and low-wage sectors are limited to state-sponsored and subsidized health insurance and providers which is characterized by long waits, limited availability of specialists, and scarce resources. None the less, the most important public health advances in the country, in terms of child survival and improved nutrition of older persons, has come as a result of public sector initiatives. This article analyzes the Chilean health care system in terms of its political and economic roles, arguing that improving solidarity and health outcomes depends on reducing the dependence of the system on market forces.

Learning Objectives: 1. Describe the market principles used to support Chile's health care changes in the 1980s 2. Analyze the causes of the development of a dual health care system in Chile 3. Develop policy proposals to rectify current inequalities in access to care and health outcomes

Keywords: International, Health Care Access

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA