Health Plan Payment in Chile

The current structure and organization of health insurance in Chile dates back to the 1970s and is characterized by a mix of public and private initiatives. Between 2000 and 2005, several reforms sought to improve access to affordable coverage, resulting in the introduction of a basic health plan and a risk equalization scheme for private insurers. Though these reforms built a basis for regulated competition, important issues remain. These issues include the current regulatory relation between public and private insurers and providers, community rating without open enrollment, the “minimalistic” basic package, and the incomplete risk equalization scheme for private insurers.