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Evaluating The Impact Of Health Care Reform In Colombia: From Theory To Practice

  • Alejandro Gaviria

    ()

  • Carlos Medina

    ()

  • Carolina Mejía

    ()

This article presents an evaluation of an ambitious health reform implemented in Colombia during the first half of the nineties. The reform attempted to radically change public provision of health services, by means of the transformation of subsidies to supply (direct transfers to hospitals) into a new scheme of subsidies to demand (transfers targeted at the poorest citizens). Although the percentage of the population having medical care insurance has notably increased, mostly among the poorest, problems of implementation have been numerous. It has not been possible to achieve the transformation of subsidies to supply into subsidies to demand. At the same time, competition has not made it possible to increase the efficiency of many public hospitals, which continue to operate with very low occupation rates, while receiving hefty money transfers. Subsidies increased demand for medical consultations, but have curbed demand for hospitalizations. Nonetheless, subsidies might have adversely affected female´s labor market participation and even household consumption. As a whole, evidence suggests that the health reform has been effective in rationalizing households´ demand for health, but not in rationalizing public supply, and neither in increasing the efficiency of service providers.

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File URL: http://economia.uniandes.edu.co/publicaciones/d2006-06.pdf
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Paper provided by UNIVERSIDAD DE LOS ANDES-CEDE in its series DOCUMENTOS CEDE with number 002647.

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Length: 57
Date of creation: 24 Jan 2006
Date of revision:
Handle: RePEc:col:000089:002647
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  1. repec:pri:cepsud:71rosen is not listed on IDEAS
  2. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," Working Papers 197, RAND Corporation.
  3. Hanratty, Maria J, 1996. "Canadian National Health Insurance and Infant Health," American Economic Review, American Economic Association, vol. 86(1), pages 276-84, March.
  4. Craig William Perry & Harvey S. Rosen, 2001. "The Self-Employed are Less Likely to Have Health Insurance Than Wage Earners. So What?," NBER Working Papers 8316, National Bureau of Economic Research, Inc.
  5. Jack, William, 2000. "Health insurance reform in four Latin American countries : theory and practice," Policy Research Working Paper Series 2492, The World Bank.
  6. Janet Currie & Jonathan Gruber, 1995. "Health Insurance Eligibility, Utilization of Medical care, and Child Health," NBER Working Papers 5052, National Bureau of Economic Research, Inc.
  7. Craig W. Perry & Harvey S. Rosen, 2001. "The Self-Employed Are Less Likely To Have Health Insurance Than Wage Earners: So What?," Working Papers 129, Princeton University, Department of Economics, Center for Economic Policy Studies..
  8. James J. Heckman & Jeffrey Smith & Nancy Clements, 1997. "Making The Most Out Of Programme Evaluations and Social Experiments: Accounting For Heterogeneity in Programme Impacts," Review of Economic Studies, Oxford University Press, vol. 64(4), pages 487-535.
  9. Janet Currie & Jonathan Gruber, 1997. "The Technology of Birth: Health Insurance, Medical Interventions, and Infant Health," NBER Working Papers 5985, National Bureau of Economic Research, Inc.
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