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Revista Facultad Nacional de Salud Pública

Print version ISSN 0120-386X
On-line version ISSN 2256-3334

Abstract

DE GROOTE, Tony; DE PAEPE, Pierre  and  UNGER, Jean-Pierre. Colombia: in vivo test sector privatization in the developing world. Rev. Fac. Nac. Salud Pública [online]. 2007, vol.25, n.1, pp.106-117. ISSN 0120-386X.

The reform of the Colombian health sector in 1993 was founded on the internationally advocated paradigm of privatization of health care delivery. Taking into account the lack of empirical evidence for the applicability of this concept to developing countries and the documented experience of failures in other countries, Colombia tried to overcome these problems by a theoretically sound, although complicated, model. Some ten years after the implementation of "Law 100," a review of the literature shows that the proposed goals of universal coverage and equitable access to high-quality care have not been reached. Despite an explosion in costs and a considerable increase in public and private health expenditure, more than 40 percent of the population is still not covered by health insurance, and access to health care proves uncreasingly difficult. Furthermore, key health indicators and disease control programs have deteriorated. These findings confirm the results in other middle- and low-income countries. The authors suggest the explanation lies in the inefficiency of contracting-out, the weak economic, technical, and political capacity of the Colombian government for regulation and control, and the absence of real participation of the poor in decision-making on (health) policies

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