Resumo

MOLINA M, Gloria  e  RODRIGUEZ T, Claudia Milena. Public and private participation in Health Services provision in Colombia 2006. Invest. educ. enferm [online]. 2007, vol.25, n.1, pp.90-99. ISSN 0120-5307.

Objective: This paper tries to contribute to the debate about public and private participation in the provision of health services and discusses the same issues of the Colombian’s health reform, within the international context, some of its achievements and limitations. Summary: In Colombia, the descentralization process and the Social Security System for Health have transformed the whole health system. Market mechanisms, competition and outsourcing the provision of health services, within a framework of limited state stewardship, generates interplay between several actors, institutions and significant economic interests. Conclusions: The review of this topic literature allow us to suggest that the diversity of actors, the wider participation of the private sector, the constraints of the public sector, market mechanisms and competition without enough state stewardship have contributed to market failure provision of health services, damaging accessibility, coverage, quality and public health as a whole. It points out the need of a public policy on inter-institutional alliance and co-operation between the public and private sectors to work together to improve the health system’s performance and the health of the population.

Palavras-chave : Market failure; government failure; quality of health services; accessibility to health services.