[EQ] Colombia: Approaching Universal Coverage

Colombia: Approaching Universal Coverage

Book Review:
Philip Musgrove, Health Affairs deputy editor, in Bethesda, Maryland.
Health Affairs, Supplement 2010; 29(4): 739-740. - doi: 10.1377/hlthaff.2010.0225

Website: http://content.healthaffairs.org/cgi/content/full/29/4/739?rss=1

From Few to Many: Ten Years of Health Insurance Expansion in Colombia
Edited by Amanda L. Glassman, María-Luisa Escobar, Antonio Giuffrida, and Ursula Giedeón, with colleaguesWashington (DC):
Inter-American Development Bank and Brookings Institution, 2009. 188 pp.

 

“…..During the past two decades, several middle-income countries have achieved universal health insurance coverage or made substantial progress toward that goal. The Colombian reform that began with Law 100 in 1993 is the most radical and interesting of these experiences. Instead of gradually adding beneficiaries to existing, small-scale insurance, as in Korea and Taiwan; creating a new scheme for the uninsured poor, as in China, Mexico, and Thailand; or making private insurance match public coverage, as in Chile, Colombia introduced a managed competition model in which for-profit and nonprofit providers and insurers insure and deliver care.

 

The intent was to move from the inefficiencies and inequity of budgeted funding of public providers—in effect, supply-side financing—to a form of demand-side financing in which money follows the patient, using both existing and newly created insurance organizations. The reform created a "contributory" program for those who could afford a reasonable premium and a subsidized program with half the premium and reduced benefits for those unable to pay. These changes were to occur simultaneously with a major decentralization of responsibilities to department and municipal governments for health care financing and delivery. ^….”

 

From Few to Many -Ten Years of Health Insurance Expansion in Colombia

Edited by Glassman, Amanda L.; Escobar, María-Luisa; Giuffrida, Antonio; Giedion, Ursula
Dec, 2009 | ISBN: 9781597820738
Inter-American Development Bank - Co-published by The Brookings Institution

Available online  at: http://idbdocs.iadb.org/wsdocs/getdocument.aspx?docnum=35026183

“  a comprehensive look at Colombia's 1993 health system reforms. It describes the implementation of universal health insurance, including a subsidized system for the poor, and examines the impact of this and other reforms during a time when Colombia experienced crushing recession and internal conflict that displaced half a million people

Prior to the reforms, a quarter of the Colombian population had health insurance. Subsidies failed to reach the poor, who were vulnerable to catastrophic financial consequences of illness. Yet by 2008, 85 percent of the population benefited from health insurance.

“…describes the challenges and benefits of implementing social health reforms in a developing country, exploring health care financing, institutional reform, the effects of political will on health care, and more. The reforms have provided important lessons not only for continued reform in Colombia, but also for other nations facing similar challenges….”

http://www.iadb.org/topics/topic.cfm?lang=es&id=heal – link to full text book in Spanish (see under Publicaciones)

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