Inequalities in the Age of Universal Health Coverage: Young Chileans with Diabetes Negotiating for Their Right to Health

Abstract

While universal health coverage (UHC) has been praised as a powerful means to reduce inequalities and improve access to health globally, little has been said about how patients experience and understand its implementation locally. In this article, we explore the experiences of young Chileans with type 1 diabetes when seeking care in Santiago, within Chile's UHC program, which sought to improve people's access to health care. We argue that the implementation of UHC, within a structurally fragmented health system, did not lead to the promised equitable health care delivery. Although UHC aimed to equitably provide universal care, locally it materialized in heterogeneous configurations forcing individuals into positions of precarity and generating new inequalities. Furthermore, for the young people in the study, UHC intersected with their health insurance and socioeconomic status, impacting on the health care they could access, consequently making diabetes care and management a difficult challenge.

Disentangling socioeconomic inequalities of type 2 diabetes mellitus in Chile: A population-based analysis

“…Similarly, an older study about socioeconomic factors associated with diabetes in adolescents in Chile reported that students coming from families in which the father had only primary school education, were significantly more likely to report having diabetes (odds ratio = 2.03 confidence intervals 1.02–4.04) [ 21 ]. More recently, Gonzalez-Agüero and colleagues [ 22 ] followed the health care trajectories of adolescents with diabetes in Chile and found that the implementation of a universal health coverage (UHC) plan for diabetes in the country did not lead to the promised equitable health care delivery for these patients. These findings are useful from a life course approach, as they inform about poor implementation of UHC for diabetes in Chile from childhood onwards.…”