Jens Holst

The assessment of co-payments in the Chilean healthcare system reveals that the private sector coverage of “non-traditional” chronic illness, of psychiatric and other chronic disorders is insufficient compared to the public system. Even the best plans fall short of fulfilling the needs of effective and sustainable social protection against many current health disorders. New epidemiological challenges require at least a profound adaptation of today’s co-payment structure in Chile. In order to over-come the inherited social injustice of health care financing and to establish a high level of fairness it seems recommendable to cut down and possibly abolish all kind of out-of-pocket-payments in Chile. The implementation of a guaranteed package of free health care services for all citizens in every health insurance plan would resolve the negative effects of user charges. The definition of the mandatory coverage any insurance company has to provide will reduce individual risks and improve people’s confidence in social protection.