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Assessing Health Reform in Colombia: From Theory to Practice


  • Alejandro Gaviria


  • Carlos Medina
  • Carolina Mejia


In 1993, Colombia implemented an ambitious health reform. Its key component was a radical transformation of the manner in which health care provision, particularly care that was directed toward lower-income individuals, was financed. We first describe the institutional aspects of the reform and discuss the difficulties that transferring funding from supply- to demand-side channels entailed. We emphasize that while the reform substantially increased health insurance coverage, progress was slower than forecast and entailed a substantial increase in expenditure. The second part of the paper evaluates the impact of the subsidized regime that the reform introduced to benefit the low-income population. We explore the subsidized regime´s effect on health outcomes measured through self-reports on health status and on the number of days in which individuals were unable to perform regular activities, the use of medical services, household consumption of nonhealth goods, and labor force participation.

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  • Alejandro Gaviria & Carlos Medina & Carolina Mejia, 2006. "Assessing Health Reform in Colombia: From Theory to Practice," ECONOMIA JOURNAL OF THE LATIN AMERICAN AND CARIBBEAN ECONOMIC ASSOCIATION, ECONOMIA JOURNAL OF THE LATIN AMERICAN AND CARIBBEAN ECONOMIC ASSOCIATION, vol. 0(Fall 2006), pages 29-72, August.
  • Handle: RePEc:col:000425:008647

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    Cited by:

    1. Jorge Andrés Tamayo & Jairo Núñez & Carlos Medina, 2013. "The Unemployment Subsidy Program in Colombia: An Assessment," IDB Publications (Working Papers) 4622, Inter-American Development Bank.
    2. Carlos Medina & Leonardo Fabio Morales, 2007. "Demanda por Servicios Públicos Domiciliarios en Colombia y Subsidios: Implicaciones sobre el Bienestar," Borradores de Economia 467, Banco de la Republica de Colombia.
    3. Martha Bottia & Lina Cardona & Carlos Medina, 2008. "Bondades y Limitaciones de la Focalización con Proxy Means Tests: El Caso del Sisben en Colombia," BORRADORES DE ECONOMIA 005185, BANCO DE LA REPÚBLICA.
    4. Adriana Cardozo & Melanie Grosse, 2009. "Pro-Poor Growth Using Non-Income Indicators: An Empirical Illustration for Colombia," Courant Research Centre: Poverty, Equity and Growth - Discussion Papers 9, Courant Research Centre PEG.
    5. Roberto Steiner & Irene Clavijo & Natalia Salazar, 2008. "Colombia´s Efforts at Achieving Inclusive and Sustainable Growth: The Road Traveled and the Challenges Ahead," INFORMES DE INVESTIGACIÓN 009058, FEDESARROLLO.
    6. Medina Carlos & Leonardo Morales, 2008. "Demanda por servicios públicos domiciliarios y pérdida irrecuperable de los subsidios: el caso colombiano," REVISTA DESARROLLO Y SOCIEDAD, UNIVERSIDAD DE LOS ANDES-CEDE, February.

    More about this item


    demand subsidies; targeted social services; instrumental variables;

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs


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