La reinvención neoliberal de la inequidad en Chile: el caso de la salud

Abstract

This paper examines the main changes in the Chilean health system from the 1920s to the present, identifying contradictions, limits, and successes in terms of

From foundling homes to day care: a historical review of childcare in Chile

“…This first period of the return to democracy was also characterized by a major increase in investment in public health and health spending rose to levels that were eight times higher than those in the 1980s. The percentage of the Gross National Income devoted to healthcare, which during the dictatorship had been reduced to 0.85%, rose to 6.5%; however the majority of this funding went to the private system 25 . Studies showed the significant progress in the fight against IMR and malnutrition, while increasingly accurate statistics revealed the persistent problem of social inequality.…”

“…Later, in the beginning of Allende's administration (1970 to 1973), renewed efforts were made to reform the health system. However, once again the idea to create a state-funded unified health system where all citizens have equal access met with fierce opposition from the medical lobby and plans were eventually aborted due to an increasingly adverse political climate 25 .…”

“…Responsibility for primary care was delegated to municipalities creating a number of problems, such as loss of personnel status, disorganization of epidemiological files and longer waiting lists. Furthermore, the creation of Isapres (Instituciones de Salud Previsional) established an element of private health insurance in the system which, together with other gradual reforms, caused unequal access to health care 25 . In the 1990s however health policies took a turn for the better for low income groups and primary health care was once again provided free of charge, and economically vulnerable women received greater financial support and free healthcare before and after delivery 19,25 .…”

“…Furthermore, the creation of Isapres (Instituciones de Salud Previsional) established an element of private health insurance in the system which, together with other gradual reforms, caused unequal access to health care 25 . In the 1990s however health policies took a turn for the better for low income groups and primary health care was once again provided free of charge, and economically vulnerable women received greater financial support and free healthcare before and after delivery 19,25 . This first period of the return to democracy was also characterized by a major increase in investment in public health and health spending rose to levels that were eight times higher than those in the 1980s.…”

“…Studies showed the significant progress in the fight against IMR and malnutrition, while increasingly accurate statistics revealed the persistent problem of social inequality. Various authors showed that IMR was a function of social class, geographical region, and per capita income 25,26,27,28,29 , exposing the continuing role of socioeconomic conditions in public health in Chile. IMR was much higher in poor rural areas than in more affluent communities 25,26,27,30 .…”