The chilean health model in the context of latin america. 40 years of economic crises, spending policies and reforms

This chapter analyzes the relationship between economic crises and health reforms in Latin America, with an in-depth focus on the Chilean case, from the origins of its health model to the present day, including a reflection on its possible future developments. The Chilean health model, as it is known today, was designed amid the international crises of 1975 and 1982 and the political crisis of the dictatorship, and it was consolidated during the economic growth of the 1990s. Its most significant reform, developed following the Asian crisis of 1997, resulted in the AUGE Plan, adopted in 2005, which increased access to a defined set of health conditions without changing the model's underlying structure. The 2008 global financial crisis, and later the 2019 social crisis, opened a new stage of debate over structural change, in which the segmentation between the public insurer (FONASA) and the private insurers (ISAPRES) has come to be seen as the central obstacle to an equitable and solidarity-based health system. The regional analysis shows that this relationship between crises and reforms is not unique to Chile, but follows a broader Latin American pattern, moving from market-oriented reforms in the 1980s and 1990s toward a growing consensus, strengthened by the COVID-19 pandemic, in favor of universal, solidarity-based public health systems.