IIEP   24411
INSTITUTO INTERDISCIPLINARIO DE ECONOMIA POLITICA DE BUENOS AIRES
Unidad Ejecutora - UE
artículos
Título:
Overcoming social segregation in health care in Latin America
Autor/es:
DANIEL COTLEAR; OCTAVIO GOMEZ DANTES; FELISA KNAUL; OSCAR CETRANGOLO
Revista:
LANCET
Editorial:
ELSEVIER SCIENCE INC
Referencias:
Año: 2014 vol. 385 p. 1248 - 1259
ISSN:
0140-6736
Resumen:
Latin America continues to segregate different social groups into
separate health-system segments, including two separate public sector
blocks: a well resourced social security for salaried workers and their
families and a Ministry of Health serving poor and vulnerable people
with low standards of quality and needing a frequently impoverishing
payment at point of service. This segregation shows Latin America´s
longstanding economic and social inequality, cemented by an economic
framework that predicted that economic growth would lead to rapid
formalisation of the economy. Today, the institutional setup that
organises the social segregation in health care is perceived, despite
improved life expectancy and other advances, as a barrier to fulfilling
the right to health, embodied in the legislation of many Latin American
countries. This Series paper outlines four phases in the history of
Latin American countries that explain the roots of segmentation in
health care and describe three paths taken by countries seeking to
overcome it: unification of the funds used to finance both social
security and Ministry of Health services (one public payer); free choice
of provider or insurer; and expansion of services to poor people and
the non-salaried population by making explicit the health-care benefits
to which all citizens are entitled.