Qué enseña la reforma colombiana sobre los mercados de salud

Resumen

Reform of the health sector, adopted in Colombia in 1993, implied important institutional changes: It opened insurance to competition; promoted free choice among users and service providers; pursued the adoption of a single service plan for the whole population; and favored contractual mechanisms between insures and providers for the provision of such a service. After the first decade of the adoption of a general system of social health insurance, several lessons can be learned from an economics perspective that provide adjustments for it and guidance to reforms in other countries, at the same time that the experience can be registered as part of the academic production in the Economics of Health. The main lessons refer to the insufficient provision of public health, access barriers, insurer concentration and differentiation, incomplete markets and inefficient decentralization. In this article, the successes and difficulties of these phenomena are documented, with several evidences and hypothesis for research.