2006, Number 6
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salud publica mex 2006; 48 (6)
The essential health reform in Chile; a reflection on the 1952 process
Mardones-Restat F, Azevedo AC
Language: English
References: 14
Page: 504-511
PDF size: 97.41 Kb.
ABSTRACT
The authors claim that the critical health reform in Chilean history was the establishment of the National Health Service (NHS) in 1952. The development of modern Chilean health care since the end of the 19th century is discussed both in terms of the prevailing health situation and the subsequent evolution of institutions and policies, with an emphasis on the social and political conditions that led to the creation of the NHS in 1952. From this analysis and from a comparison of infant mortality rates among Latin American countries during the same period, the authors infer that the 1952 health reform was the social and political benchmark that allowed Chile to exhibit the relatively favorable health situation it still enjoys. Using Cavanaugh’s scheme, it is clear that the "first-generation reform" was the reform imposed by the military regime in the early 1980s, which aimed to change the orientation of the health system. Similarly, the "second-generation reform" was that implemented by the democratic administrations of the early 1990s to reverse the harm done by their military predecessors. The rapid aging of the population and the advent of new technologies pose a challenge to the insurance system’s coverage capacity and threaten the sustainability of all health systems. The implementation of universal, comprehensive, collective health systems, managed under the most integrated authority political conditions will allow, is emphasized as an appropriate solution for developed and developing countries alike.
REFERENCES
Cavanaugh K, Zeballos JL, Savedoff B. A roundtable discussion on international cooperation in health reform in the Americas. Rev Panam Salud Publica/Pan Am J Public Health 2000;8(1/2):140-146.
Azevedo AC. La Provisión de Servicios de Salud en Chile: aspectos históricos, dilemas y perspectivas. Rev Saúde Pública (S. Paulo) 1988;32(2):192-199.
Illanes MA. En nombre del pueblo, del Estado y de la Ciencia – Historia Social de la Salud Pública. Chile 1880 / 1973. Santiago, Chile: Colectivo de Atención Primaria, 1993.
Horwitz CN et al. Salud y Estado en Chile. Antecedentes de la Creación del Servicio Nacional de Salud en Chile. El Contexto Político y Social Chileno. Santiago, Chile: Publicaciones Científicas de la Representación OPS/OMS en Chile, 1995.
Horwitz A. El Servicio Nacional de Salud y la Salud Pública Chilena. in Foro La Salud en el Proceso de Desarrollo Chileno. Santiago, Chile, 18 October 1995. (unpublished). Santiago, Chile: PAHO/WHO, 1995.
Cruz-Coke E. Economía Preventiva y Economía Dirigida, 1938 apud Illanes, op.cit. Cap. 4. La Intelligentsia Técnica. p. 279.
Meneghello J, Rosselot J, Mardones-Restat F. El rol de la Pediatría clínica y social en los avances de la salud y de la familia: Chile 1900-1995. Rev Pediatr al Día 1995;11(4):223-232.
Rosselot J, Mardones-Restat F. Salud de la Familia y Paternidad Responsable. La experiencia de Chile 1965-1988. Rev Med de Chile 1990;118:330-338.
Mardones-Restat F. Salud materno infantil; últimos 30 años. Rev Chil de Pediatr 1990;6(5):281-286.
Mardones-Restat F, Conferencia: Análisis del modelo per cápita. Taller Nacional Discusión del Modelo Per Cápita 4-5 October 1995, Santiago, Chile. Organiza MINSAL/FONASA/Comisión Per Cápita.
Mardones-Restat F. Una Herida en el Sector Salud. Diario El Mercurio. Santiago. 29/08/1993.
Ramirez, M. Centros Diagnóstico Terapéuticos. En: Solimano G, Bergholtz S, eds. Perspectivas de la Red Asistencial en Chile. Chile, Santiago: CORSAPS / OPS-OMS, 1999.
Friend S, Stoughton RB. The Magic of Microarrays. Sci Amer 2002;286(2):34-41.
Informando & Reformando – Avedis Donabedian – Una experiencia directa con la calidad de atención: Boletín Trimestral del NAADIIR/AL Abr/Jun 2001;8:1-2.