THE COLOMBIAN HEALTH INSURANCE SYSTEM AND ITS EFFECT ON ACCESS TO HEALTH CARE

• Published in: International journal of health services Vol. 41; no. 2; pp. 355 - 370
• Main Authors: Alvarez, Luz Stella, Salmon, J. Warren, Swartzman, Dan
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Baywood Publishing Company, Inc 01.01.2011; SAGE Publications
• Subjects: Access to health care; Banking; Colombia; Cost Sharing; Delivery of Health Care - economics; Delivery of Health Care - organization & administration; Delivery of Health Care - trends; Developing countries; Health care; Health Care Reform; Health inequality; Health insurance; Health Services Accessibility - economics; Health Services Accessibility - standards; Humans; Insurance, Health - economics; Insurance, Health - standards; Insurance, Health - trends; International finance; International financial institutions; International monetary fund; Medellin; Medical service; Medicine; Neoliberalism; Private sector; Privatization - economics; Privatization - trends; Privatization of Health Care; Public health; Qualitative Research; Reform; Reforms; Colombia
• ISSN: 0020-7314; 1541-4469
• DOI: 10.2190/HS.41.2.i

In 1993, the Colombian government sought to reform its health care system under the guidance of international financial institutions (the World Bank and International Monetary Fund). These institutions maintain that individual private health insurance systems are more appropriate than previously established national public health structures for overcoming inequities in health care in developing countries. The reforms carried out following international financial institution guidelines are known as "neoliberal reforms." This qualitative study explores consumer health choices and associated factors, based on interviews with citizens living in Medellin, Colombia, in 2005-2006. The results show that most study participants belonging to low-income and middle-income strata, even with medical expense subsidies, faced significant barriers to accessing health care. Only upper-income participants reported a selection of different options without barriers, such as complementary and alternative medicines, along with private Western biomedicine. This study is unique in that the informal health system is linked to overall neoliberal policy change.