Letter from Chile: Re-establishing health care in ChileBMJ 1993; 307 doi: https://doi.org/10.1136/bmj.307.6906.729 (Published 18 September 1993) Cite this as: BMJ 1993;307:729
- Jorge Jiménez
Chile's long term social policy has produced very impressive outcomes in general health indicators, with a national health service established as early as 1952. During the years of the Pinochet dictatorship (1973-89) public health institutions were greatly affected, with sharp diminution in financing which affected investment and salaries. The democratic government initiated in 1990 faced a difficult situation, with underpaid staff and decrepit hospitals. The ministry took immediate action to improve salaries and start an ambitious health sector reform including investment in infrastructure, technology, and modern management. Decentralisation and autonomy, changes in payment for service mechanisms, and a public-private mix are the main objectives of this reform, keeping the public role as predominant in the proposed structure. This process has been affected by union unrest and public opinion dissatisfaction, which tend to present obstacles to progress in this complicated issue.