Chile's Universal Health Care Scheme

The Government of the Republic of Chile launched the Universal Access with Explicit Guarantees (AUGE) health care scheme in 2006 in order to guarantee the right to health care for all citizens. Funding required for AUGE was secured through the 2003 Finance Law that increased the value added tax as well as the taxes on tobacco and customs. In addition, funding for AUGE has also been obtained through the selling of assets that the Ministry of Health had invested in private health institutions.

The AUGE is accessible to all residents and covers a list of diseases and health conditions for which appropriate services have become universally guaranteed. In 2013, the list of diseases and health conditions that are covered includes 80 different types of pathologies that account for 60 per cent of the diseases by which Chilean people are mostly affected. The AUGE system also includes four explicit guarantees: i) an explicit guarantee of access, meaning that both public and private health institutions have the obligation to guarantee health services that form part of the Regime of Explicit Health Guarantees (GES); ii) explicit guarantee of quality, meaning that healthcare providers must be accredited by the Superintendent of Health and offer attention according to pre-defined protocols; iii) explicit guarantee of timeliness, which defines the maximum waiting period allowed for receiving attention under both public and private health insurances; iv) explicit guarantee of financial protection, which defines the maximum payment that the affiliated must make, which is equivalent to 20 per cent of the service costs. It is estimated that AUGE has been used by 3.2 million people, or about 20 per cent of the Chilean population. It is estimated that more than 9 millions Chileans will make use of the expanded guarantees in years to come.

In Chile, health insurance is provided by public and private institutions; however, severe gaps between their services resulted in health sector reforms beginning in 2000. At that time the public system received less funding than the private system and 12 per cent of the population did not have any coverage at all. The AUGE has been established as part of these reforms, to respond to the gaps between the public and private systems and ensure the highest level of physical and mental health while promoting equality and solidarity in financing for the health sector. Since its launch in 2006 AUGE’s mandate has grown to cover a wider scope of health problems and, thus, demonstrates political will ensuring the right to health care for all residents.

 

Further Reading: