MarketWatch: Colombia's Universal Health Insurance System

Health Affairs

Volumn 28, Issue 3, 2009, Pages 853-863

  Giedion, Ursula ^a   Uribe, Manuela Villar ^b  

^a BROOKINGS INSTITUTION   (United States)

^b WORLD BANK GROUP   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COLOMBIA; DISASTER; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SERVICE; HUMAN; INCIDENCE; INCOME; LOWEST INCOME GROUP; RURAL AREA; COMMUNITY CARE; DEVELOPING COUNTRY; ECONOMICS; FINANCIAL MANAGEMENT; HEALTH CARE DELIVERY; INSURANCE; UTILIZATION REVIEW;

COLOMBIA; DEVELOPING COUNTRIES; FINANCING, GOVERNMENT; FINANCING, PERSONAL; HEALTH CARE REFORM; HEALTH POLICY; HEALTH SERVICES; HEALTH SERVICES ACCESSIBILITY; HUMANS; INSURANCE BENEFITS; UNCOMPENSATED CARE; UNIVERSAL COVERAGE; UTILIZATION REVIEW;

EID: 66749136442     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.28.3.853     Document Type: Article

References (29)

1. See, for example, J. Hadley, "Sicker and Poorer - The Consequences of Being Uninsured: A Review of the Research on the Relationship between Health Insurance, Medical Care Use, Health, Work, and Income," Medical Care Research and Review 60, no. 2 Supp. (2003): 76S-112S.
2. Data for 2005 are from D. Pinto and W.C. Hsiao, "Colombia: Social Health Insurance with Managed Competition to Improve Health Care Delivery," in Social Health Insurance in Developing Nations, ed. W.C. Hsiao and P. Shaw (Washington: IBRD/World Bank, 2007), 105-131.
3. D. Pinto, "Colombia: Good Practices in Expanding Health Care Coverage," in Good Practices in Health Financing, ed. P. Gottret et al. (Washington: World Bank, 2008), 137-182.
4. In 2008, the premium was 430,488 Colombian pesos in the CR and 242,370 Colombian pesos in the SR. The exchange rate in May 2008 was 1,767.4 Colombian pesos to one U.S. dollar.
5. Although approved in December 1993, the SR did not begin until 1996.
6. See Hsiao and Shaw, eds., Social Health Insurance in Developing Nations.
7. A. Gaviria et al., "Evaluating the Impact of Health Care Reform in Colombia: From Theory to Practice," Working Paper (Bogotá: Economic Development Research Center, 2006).
8. G. Barón, "Cuentas de salud de Colombia, 1993-2003: El gasto nacional en salud y su financiamiento" (Bogotá: Ministerio de la Protección Social, 2007).
9. Gaviria et al., "Evaluating the Impact."
10. P.E Gottret et al., Health Financing Revisited: A Practitioner's Guide (Washington: World Bank, 2006).
11. T. De Groote, P. De Paepe, and J.P. Unger, "Colombia: In Vivo Test of Health Sector Privatization in the Developing World," International Journal of Health Services 31, no. 1 (2005): 125-141. (Pubitemid 40315844)
12. WHO, "Achieving Universal Health Coverage: Developing the Health Financing System," Technical Briefs for Policy-Makers no.1 (Geneva: WHO, 2005).
13. Oxfam International, "Health Insurance in Low-Income Countries," Joint NGO Briefing paper no. 112, May 2008, http://www.oxfam.org/uk/resources/policy/health/downloads/bp112-insurance.pdf (accessed 25 March 2009).
14. U. Giedion et al., "The Impact of Subsidized Health Insurance on Access, Utilization, and Health Status: The Case of Colombia" (Washington: World Bank, forthcoming);
15. U. Giedion et al., "The Impact of Health Insurance in the Mandatory Contributory Regime on Access and Utilization: The Case of Colombia" (Washington: World Bank, forthcoming);
16. and C.E Flórez et al., "The Impact of Health Insurance in Colombia on Financial Protection" (Washington: World Bank, forthcoming).
17. DHS surveys were carried out by PROFAMILIA (a nongovernmental organization providing family planning services) and jointly financed by PROFAMILIA, the Instituto de Bienestar Familiar (Institute for Family Welfare), the U.S. Agency for International Development (USAID), the Ministry of Social Protection, and the United Nations Population Fund (UNFPA). The LSMS was carried out and financed by the Departamento Nacional de Estadísticas (DANE, National Department of Statistics). A table summarizing the data sources and methods is available online at http://content.healthaffairs.org/cgi/content/ full/28/3/853/DC1.
18. R. Blundell and M.C. Dias, "Evaluation Methods for Non-Experimental Data," Fiscal Studies 21, no. 4 (2000): 427-446.
19. More details are provided in a technical appendix, as in Note 15.
20. The administrative data included, among other indicators, the distance of the municipality from the capital of the department, the level of political unrest as measured by the number of attacks by irregular armed forces, the average education level at the municipal level, the percentage of the population with unmet basic needs, total resources allocated to health, per capita income, and health insurance coverage at the municipal level. Block-level census data from 1993 (prior to the implementation of the health reform) included the following variables: percentage of households with access to public services, proportion of household members over age twelve, average number of household members, and percentage of female-headed households.
21. M.L. Escobar "Health Sector Reform in Colombia," May 2005, http://www1.worldbank.org/devoutreach/may05/article.asp?id=295 (accessed 1 June 2008).
22. WHO, Health Systems: Improving Performance (Geneva: WHO, 2000).
23. World Bank, Healthy Development: The World Bank Strategy for Health, Nutrition, and Population Results, World Health Report (Washington: World Bank, 2007).
24. An employed person works for a private company or government. A self-employed person is a day or unskilled laborer, an independent professional, an independent worker of any other type, an employer, or an independent farmer.
25. Services were deemed "formal" if a person having a health problem during the past month obtained the services of a general physician, specialist, dentist, health facility, nurse, or medical caretaker. Informal health care refers to respondents who had a health problem during the past month and obtained the services of a pharmacist, apothecary, traditional healer, and the like.
26. See Giedion et al., "The Impact of Subsidized Insurance," Annex Table 3.
27. Constitutional Court Ruling no. T-760, J. Magister Manuel Jose Cepeda Espinosa, Bogotá, 31 July 2008.
28. J.C. Echeverry et al., "Monthly Report: Health System Crisis with Macro Consequences" (New York: Latin Source, 30 August 2008).
29. See the online appendix, as in Note 15.