Jean-Pierre Unger and Pierre De Paepe are in the Department of Public Health, Institute of Tropical Medicine , Antwerp , Belgium .
Giorgio Solimano Cantuarias and Oscar Arteaga Herrera are in the School of Public Health–Faculty of Medicine, University of Chile , Santiago , Chile

PLoS Med 5(4): e79 doi:10.1371/journal.pmed.0050079 – April 2008

Available online at: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050079

Summary Points:

·         The Chilean health system underwent a drastic neoliberal reform in the 1980s, with the creation of a dual system: public and private health insurance and public and private provision of health services.

·         This reform served as a model for later World Bank–inspired reforms in countries like Colombia .

·         The private part of the Chilean health system, including private insurers and private providers, is highly inefficient and has decreased solidarity between rich and poor, sick and healthy, and young and old.

·         In spite of serious underfinancing during the Pinochet years, the public health component remains the backbone of the system and is responsible for the good health status of the Chilean population.

·         The Chilean health reform has lessons for other countries in Latin America and elsewhere: privatisation of health insurance services may not have the expected results according to neoliberal doctrine. On the contrary, it may increase unfairness in financing and inequitable access to quality care.