: Approaching Universal Coverage Colombia
Philip Musgrove, Health Affairs deputy editor, in
Health Affairs, Supplement 2010; 29(4): 739-740. - doi: 10.1377/hlthaff.2010.0225
From Few to Many: Ten Years of Health Insurance Expansion in
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
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
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
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
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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