Healthcare Systems Across the Border: Implications of Latin American Experiences for US Healthcare Reform

Objectives: To share challenges and lessons learned about Latin American healthcare systems, in terms of quality, organization, financing and services delivery, and to examine implications for US health care reform. Background: Compared to the US, all Latin America countries allocate a lower percentage of their total gross national income to healthcare. However, many of these healthcare systems address the health needs of their populations more humanely and fairly than does the US healthcare system, leading to better healthcare outcomes.

Methods: Ten Latin American countries (Argentina, Brazil, Chile, Costa Rica, Cuba, Guatemala, México, Puerto Rico, Venezuela and Uruguay) were visited to assess: innovations in health promotion and disease prevention; comprehensiveness of and universal access to services; culturally appropriate services; health outcomes; and current challenges. Data collection methods included visits to hospitals and clinics; individual interviews; and group discussions with consumers, professionals and administrators. Results: Many countries have universal healthcare systems (Argentina, Cuba, Brazil, Colombia) and policies for providing healthcare to immigrants (Argentina). Brazilians have made health a right in their constitution. Others have developed multi-sectorial partnerships with public and private organizations. Many policies recognize social, political, and economic determinants of health and create supportive environments with initiatives like Healthy Municipalities and Communities. Chile implemented progressive health promotion policies and programs. Some have achieved impressive improvements of population health. Cuba increased life expectancy, decreased infant mortality, and reduced diabetes, cardiovascular disease and cancer-related deaths. Conclusions: Latin American health systems' organization, finance and delivery may provide innovative solutions to the US healthcare crisis.