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Eficiencia y equidad en el sistema de salud chileno

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  • Larrañaga, Osvaldo

Abstract

Resumen El sistema de salud chileno presenta características únicas en el mundo. En efecto, en el país existe un mandato que obliga a los trabajadores activos y pasivos (pensionados); a cotizar un 7% de su ingreso para adscribirse junto a sus dependientes a un sistema de seguros de salud. Este puede ser el sistema público, el cual se organiza a través de una modalidad solidaria de seguridad social, o bien el sistema privado, el cual ofrece seguros de salud que obedecen a una lógica de tipo individual. El sistema dual conserva las fortalezas y problemas de las modalidades de seguro y provisión de servicios de salud utilizados. En particular, el sistema privado está afecto a los problemas usuales de los seguros individuales (selección de riesgos, cobertura de corto plazo, elevados gastos de administración y ventas, falta de transparencia de planes y beneficios);, mientras que las deficiencias del sistema público se concentran en los problemas de atención a los usuarios típicos de los esquemas de organización burocráticos y financiados sobre la base de la oferta. Adicionalmente, la conjunción de ambos sistemas separa a la población en grupos segmentados según las variables socioeconómica y de riesgo de salud. El objetivo de este trabajo es realizar una presentación sistemática de los rasgos característicos del sistema dual de salud chileno y proveer un bosquejo de los cambios necesarios de introducir para mejorar las dimensiones de eficiencia y equidad del sistema. El trabajo se organiza en cuatro capítulos. El primer capítulo provee una descripción del sistema en cuanto su organización, financiamiento, cobertura y desarrollo temporal. El segundo capítulo examina los aspectos de eficiencia asociados al sistema dual de salud. El capítulo tercero hace lo propio respecto de las materias de equidad. Las conclusiones del trabajo, así como los lineamientos de los cambios necesarios de introducir en el sistema chileno de salud, se presentan en el capítulo cuarto.

Suggested Citation

  • Larrañaga, Osvaldo, 1997. "Eficiencia y equidad en el sistema de salud chileno," Financiamiento para el Desarrollo 5252, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    • Handle: RePEc:ecr:col035:5252
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