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Colombia case study : the subsidized regime of Colombia's national health insurance system (Inglês)

This case study provides an overview of the contribution of Colombia's compulsory health insurance, particularly its Subsidized Regime (SR), to universal health care coverage in the country, and the current challenges the SR faces. The case study is based on discussions with stakeholders from academia and the public and private sectors. The report is divided into four sections: (1) country context and health outcomes; (2) the SR within the institutional architecture of the national health insurance system; (3) the subsidized regime: considerations on equity in the context of the public debate on the right to health care in Colombia; and (4) policy decisions and key areas of the agenda for the short and medium term.


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    Montenegro Torres, Fernando Acevedo, Oscar Bernal

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    América Latina e Caribe,

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    Colombia case study : the subsidized regime of Colombia's national health insurance system

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    health insurance coverage;equitable access to health care;access to health care service;access to primary health care;Municipalities;national health insurance;legal and regulatory framework;primary health care services;life expectancy at birth;formal sector;Private Health Care Provider;provision of health service;united nations general assembly;access to quality services;access to health service;portability of health insurance;disability adjusted life years;Delivery of Health Care;law;compulsory health insurance;fiscal resource;scope of service;health insurance system;expansion of enrolment;continuum of care;public health service;health care networks;number of births;earmarked payroll tax;health insurance benefits;flow of fund;private health insurance;human rights perspective;public policy debate;mechanism for protection;social security fund;general government expenditure;education and health;total public spending;epidemiologic surveillance system;public health intervention;per capita basis;health care facility;source of income;source income;health care facilities;local tax revenue;Supplementary Health Insurance;Governance and Accountability;private sector provider;purchasing power parity;affordable health care;country case study;quality health care service;provision of care;public sector reform;Program of Activities;Universal Health Care;inequality in income;competition among provider;provision of service;Check and Balances;cost of treatment;public sector provider;social insurance arrangements;secretary of health;Public Sector Enterprises;supply of service;gap in access;large metropolitan areas;tax reform proposal;portability of coverage;health insurance market;efficiency and quality;risk of fraud;public health network;Access to Electricity;health system performance;ambulatory health care;comprehensive health care;crude death rate;acute respiratory infection;total fertility rate;crude birth rate;managed competition;benefit package;public provider;legal framework;public fund;private provider;health outcome;Infant Mortality;fraudulent activity;public authority;noncommunicable diseases;statutory law;income inequality;tertiary level;live birth;rural area;supply-side constraints;health facility;Demographic Transition;public resource;important share;institutional architecture;financial supervision;federal government;municipal government;autonomous entity;financial resource;inpatient care;private expenditure;private spending;primary care;poor household;fundamental right;specialized care;public hospital;population pyramid;public confidence;concentration index;public entity;strategic purchasing;Health Promotion;legal form;nutritional need;real gdp;social indicator;financial arrangement;operational tool;fiscally sustainable;unequal distribution;diarrheal disease;Child Mortality;external environment;Maternal Mortality;financial sustainability;Labor Market;outpatient service;public intervention;security situation;Health policies;human capital;annual capitation;risk adjustment;delivering services;special district;Elderly People;direct payment;catastrophic expenditure;household income;expenditure ratio;private insurance;pocket expenditure;financial protection;specialized services;hospital service;procurement rule;hospital bed;occupancy rate;secondary level;legal capacity;competitive contract;ambulatory service;targeting mechanism;pharmaceutical treatment;labor arrangement;high school;insurance service;transaction cost;red tape;low-income strata;health reform;position limit;administrative datum;financing system;middle-income household;governmental entity;physical therapy;chronic condition;older adult;demographic projection;public hearing;negative effect;adequate supervision;municipal authority;monitoring procedure;private entity;monopolistic practice;public revenue;municipal tax;individual risk;fraudulent use;Cardiovascular Disease;population increase;vulnerable group;insurance companies;market force;decentralization process



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