During the COVID-19 pandemic Chile stood out globally for an exceptional vaccination campaign with one of the fastest immunization programs against the disease. The remarkable progress was the outcome of a conjoint effort between government and society, with a well-coordinated system and the willingness of the population to get immunized. This recent example is not the only health care category in which Chile stands out. The South American country hosts one of the leading hospitals in Latin America and the Caribbean, ranking on top in terms of quality along with hospitals in Brazil, Argentina, and Colombia. In terms of general health, Chile has the highest healthy life years expectancy in the region together with Costa Rica, with a total of 70 years. However, not each of the country’s health care indicators are positive. Though still below a regional average, in recent years Chile’s death rate has been constantly increasing, reaching 6.35 deaths per thousand inhabitants in 2020.
The Chilean health care system
Behind the country’s health care outcomes is, among other factors, the Chilean health care system. The Chilean health care system is contributive and consists of two main insurance schemes. The National Health Fund (Fondo Nacional de Salud) known as FONASA and Private Health Insurance Institutions (Instituciones de Salud Previsional) known as ISAPRES. FONASA consists of a health plan where services are provided by the government, and covers workers, dependent family members, and people without an income source, among other beneficiaries. The program is divided in four main groups which determine the kind of services received by each population and that depend on characteristics such as income and working status. A share of beneficiaries can choose between two different modalities, one of which gives people the possibility to make use of private services when fulfilling certain criteria. On the other hand, ISAPRES are private health care insurers that provide beneficiaries with health services under three different modalities based on the kind of clinics and doctors covered.
Though a great share of the population is insured, a third of Chileans consider quality of health care in the country as poor. According to a survey carried out in the South American country, eight in ten people thought many cannot afford good health care. In addition, more than seven in ten people acknowledged that waiting times to get an appointment with doctors are too long, while just over one in ten regarded the system as providing the same standard of care to everyone. As a result, a restructure of the health care system is being discussed in the context of the drafting of a new constitution resulting from a referendum that took place by the end of 2020.
More than investments in capacity
Beyond a functioning health care system and other social and economic policies, health is dependent on a variety of risk factors resulting from an interconnection of environmental and personal characteristics and habits. Among other determinants, smoking and overweight prevalence, along with food insecurity, are known to negatively affect health outcomes. In Chile, while smoking prevalence has been decreasing in recent years, the share of the country’s overweight population has been constantly rising, and is forecast to further increase, reaching nearly 70 percent of the population by 2025. On the other hand, food insecurity in Chile currently stands at around 20 percent. As a result, better health outcomes will depend not only on the constitution of an improved health care system, but also on investments aimed at developing a preventive culture working alongside the population, as was the case during the COVID-19 vaccination campaign.
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