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Delivering Cost-Efficient Public Services in Health Care, Education and Housing in Chile

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  • Diego Moccero

Abstract

The Chilean authorities plan to raise budgetary allocations over the medium term for a variety of social programmes, including education, health care and housing. This incremental spending will need to be carried out in a cost-efficient manner to make sure that it yields commensurate improvements in social outcomes. Chile’s health indicators show that it fares relatively well in relation to comparator countries in the OECD area and in Latin America. But this is less so in the case of education, where secondary and tertiary educational attainment remain low, despite a significant increase over the years, and performance is poor on the basis of standardised test scores, such as PISA. Even though comparison with countries in the OECD area is difficult, a sizeable housing deficit has yet to be closed in Chile. To meet these various challenges, efforts will need to be stepped up to: i) narrow the disparities in performance that currently exist among schools with students from varying backgrounds through use of the “differentiated” voucher scheme and additional measures to improve the quality of teaching and management; ii) improve risk sharing among private and public health insurers, while increasing the coverage of health insurance to a broader variety of pathologies under AUGE; and iii) continue to tackle the shortage of housing, while enhancing the quality of subsidised housing units and their surrounding neighbourhoods for the poorest segments of society. This paper relates to the 2007 Economic Survey of Chile (www.oecd.org/eco/surveys/chile). Pour des services publics efficients dans le domaine des soins de santé, de l'éducation et du logement au Chili Les autorités prévoient d’augmenter les dotations budgétaires à moyen terme pour divers programmes sociaux touchant notamment aux secteurs de l’éducation, de la santé et du logement. Elles doivent faire preuve d’efficience dans l’utilisation de ce surcroît de dépenses, de façon à s’assurer que les résultats sociaux s’améliorent de manière proportionnelle. Les indicateurs de santé de la population montrent que la situation est relativement bonne au Chili par rapport aux pays pris comme comparaison dans la zone OCDE et en Amérique latine. Elle est moins favorable dans le secteur de l’éducation, où les résultats dans le secondaire et le supérieur restent faibles, malgré une progression sensible au fil des années, et où la performance telle que la mesurent les notes obtenues à des tests normalisés du type PISA est peu satisfaisante. Même s’il est difficile de faire des comparaisons avec les pays de l’OCDE, le Chili doit encore faire face à une importante pénurie de logements. Pour relever ces différents défis, il lui faudra redoubler d’effort afin de : i) réduire les disparités de résultats qui existent actuellement entre les établissements publics, privés subventionnés et totalement privés grâce à l’utilisation du dispositif de chèques-éducation « différenciés » ; ii) mieux partager les risques entre les assureurs publics et les assureurs privés, tout en élargissant la couverture de l’assurance maladie à des pathologies plus diverses ; et iii) continuer à faire face à la pénurie de logements tout en améliorant la qualité des logements subventionnés au profit des catégories les plus pauvres de la société. Ce document se rapporte à l’Étude économique du Chili 2007 (www.oecd.org/eco/etudes/chili).

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Bibliographic Info

Paper provided by OECD Publishing in its series OECD Economics Department Working Papers with number 606.

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Date of creation: 14 Apr 2008
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Handle: RePEc:oec:ecoaaa:606-en

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Keywords: Public spending efficiency; social housing; data envelopment analysis; Chile; health; education; éducation; santé; Chili; logement social; efficience de dépenses publiques; méthode DEA;

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