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Health insurance as a strategy for access: streamlined facts of the colombian health care reform

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Listed:
  • Jairo Restrepo
  • Andrés Zambrano
  • Mauricio Velez
  • Manuel Ramirez

Abstract

The Colombian reform to the health system (Law 100 of 1993) established, as strategy to facilitate the access, the universality of a health insurance that is acquired by means of the quotation in the contributive regime or by means of the gratuitous affiliation to the subsidized regime, in order to cover all the population with a unique plan of benefits that includes services in all levels of complexity. In this paper we intend to cover the main streamlined facts of the reform as far as coverage and access of the insurance, by means of logit models, the determinants of the enrollment and the access are considered, using data from the Living Standards Surveys of 1997 and 2003. It stands out that the coverage rose from 20% of the population in 1993 to 60% in 2003, although it seems very difficult to reach the universality; the structure and evolution of the coverage show that both regimes complement each other, while the contributive one has greater presence in the cities and among the population with formal employment, the subsidized one has greater weight among the rural population and in those with low levels of income; on the other hand, the insurance has advantages for the subsidized population, with a greater probability for use of the services, although the plan offers less benefits than the contributive one there are some barriers for the access.

Suggested Citation

  • Jairo Restrepo & Andrés Zambrano & Mauricio Velez & Manuel Ramirez, 2007. "Health insurance as a strategy for access: streamlined facts of the colombian health care reform," Documentos de Trabajo 002783, Universidad del Rosario.
  • Handle: RePEc:col:000092:002783
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    File URL: http://repository.urosario.edu.co/bitstream/handle/10336/11016/2783.pdf
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    References listed on IDEAS

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    1. David M. Dror & Alexander S. Preker, 2002. "Social Reinsurance : A New Approach to Sustainable Community Health Financing," World Bank Publications - Books, The World Bank Group, number 15211, December.
    2. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    3. Ramón Abel Castaño & José J. Arbelaez & Ursula Giedion & Luis Gonzalo Morales, 2001. "Evolución de la equidad en el sistema colombiano de salud," Documentos de Investigación 002651, Cepal Naciones Unidas.
    4. Castaño Tamayo, Ramón Abel & Giedion, Ursula & Morales Sánchez, Luis Gonzalo, 2001. "Evolución de la equidad en el sistema colombiano de salud," Financiamiento para el Desarrollo 108, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
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    Cited by:

    1. Johanna Fajardo-Gonzalez, 2016. "Inequality of opportunity in adult health in Colombia," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 14(4), pages 395-416, December.
    2. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517, May.
    3. Grupo GES, 2005. "Macroeconomía y salud en Colombia," Observatorio Seguridad Social 003183, Grupo de Economía de la Salud.
    4. Martha Bottia & Lina Cardona-Sosa & Carlos Medina, 2012. "El SISBEN como mecanismo de focalización individual del régimen subsidiado en salud en Colombia: ventajas y limitaciones," Revista de Economía del Rosario, Universidad del Rosario, December.
    5. Ramón Castaño & Andrés Zambrano, 2007. "Financial protection for the poor in Colombia: the effects of a subsidized health insurance scheme," Documentos de Trabajo 002723, Universidad del Rosario.
    6. Ronald Eduardo Gómez Suárez, 2007. "Cream-Skimming And Risk Adjustment in Colombian Health Insurance System:: The Public Insurer Case," Archivos de Economía 004295, Departamento Nacional de Planeación.
    7. Jhorland Ayala García, 2015. "El acceso a la consulta médica general en Colombia," Revista Economía y Región, Universidad Tecnológica de Bolívar, vol. 9(1), pages 175-207, June.
    8. Grupo de Economía de la Salud & Jairo Humberto Restrepo, 2005. "Macroeconomía y salud en Colombia," Observatorio Seguridad Social 015590, Grupo de Economía de la Salud.

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    More about this item

    Keywords

    health insurance; access; enrollment affiliation; social security; Colombia;
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