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The health insurance market: lessons on the conflict between equivalence and solidarity

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Date
2012-12
Author
Uthoff, Andras
Campusano, Rolando
Sánchez, José Miguel
UN Symbol
LC/G.2549-P
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Abstract
Health-care systems are highly diverse, sometimes even sharing few basic aspects of design. In developing countries, demographic profiles, poverty, the labour market and public finances are such that a comprehensive approach to solidarity -combining contributory and non-contributory mechanisms- is essential. In 1981, Chile redesigned the contributory component of its system by means of private health-insurance companies. The rationale of private, individual insurance runs counter to the ethical imperatives of contracts based on social rights. In Europe, this dilemma has been tackled using risk-levelling mechanisms that resolve the conflict between accessibility, efficiency and selection. In Chile, competitive health insurance companies (Isapres) coexist with a solidarity-based State alternative, the National Health Fund (FONASA). The Isapres engage in aggressive risk selection. The challenge for health policy is to integrate the two systems to balance the principles of equivalence and solidarity.
Translation
El mercado de seguros de salud: lecciones sobre el conflicto entre equivalencia y solidaridad
Published in:
CEPAL Review   No.108

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Serie
CEPAL Review
ECLAC Subtopics
HEALTH ; FINANCING AND EXTERNAL DEBT ; MORTALITY AND HEALTH
United Nations Subtopics
HEALTH ; HEALTH INSURANCE ; HEALTH SERVICES ; FINANCING ; SOLIDARITY ; RISK ; RIGHT TO HEALTH ; PUBLIC SECTOR ; PRIVATE SECTOR ; CASE STUDIES
Country / Region
CHILE
URI
https://hdl.handle.net/11362/11608
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