Courtesy Ministry of Health

A young boy is examined by Chilean Minister of Health, Osvaldo Artazar.

Since President Lagos took office in 2000, reform of the healthcare system has been one of the top items on his to-do list. Among the primary objectives for Chile’s Minister of Health, Michelle Bachelet, now serving as Minister of Defense, was to implement a new health model ranging from reengineering service provisions to updating statistics and creating prevention procedures. Another target that was laid out was to create a more integrated system between public and private healthcare providers and insurers.

These are still among the goals and objectives of the current Minister of Health, Osvaldo Artazar, a doctor in pediatrics. The Minister’s agenda, which is receiving full presidential impetus, is geared toward the execution of the Plan Auge- the central element of Chilean healthcare reform.

The government intends to continue improving the quality of healthcare services according to the current health needs of Chilean society.

During its first two years in office, the Lagos government has increased the health budget by 10 percent, making it the highest increase within all components of government spending. This has enabled the construction and reconstruction of 12 hospitals, the modernization of 71 hospitals, the creation of 13 new specialized centers, 126 clinics, 117 dispensaries, and 50 primary emergency units.

During the last two years, the Ministry of Health has succeeded in fulfilling a number of its initial objectives. For example: the elimination of long lines in clinics; a reduction of the waiting time for medical attention for those under one year of age and those older than 65; providing free medicines in all medical consultations; extending the working hours of clinics, and successfully establishing an 800-telephone line to provide immediate medical attention.

Nonetheless, Minister Artazar believes that there is much more to be done in order to provide qualitative healthcare services, considered a right of each and every Chilean citizen.

The four central objectives of the system are: to build upon that which has already been achieved; address the current challenges that are derived from on-going societal changes, including an aging population; reducing the inequities in terms of access and service, as well as to provide services that respond to the demands of all Chileans.

Within this set of objects there are numerous targets, such as a continuation of the decrease in infant and mother mortality rates, expanding vaccination programs, and decreasing the incidence of tuberculosis.

As the central instrument in carrying out the national healthcare objectives Plan Auge seeks to enable the government and private sector to meet the health needs of the Chilean population. Its overall purpose includes focusing the healthcare model towards prevention, ambulatory and primary healthcare as well as the modernizing and strengthening the regulatory platform of the system.

Plan Auge is universal and does not discriminate against foreigners or residents. It encompasses the whole process of health promotion, prevention, intervention and rehabilitation. Moreover, it is steadfast on guaranteeing access, opportunity, quality, financial protection and mechanisms to enforce the plan.

According to Minister Artazar, Plan Auge creates priorities in the provision of healthcare services and takes into account all diseases and health conditions. Artazar mentions that, in all, 56 diseases have been identified that will receive prompt attention, depending on their level of urgency and whether or not there is a need to operate.

Among these medical conditions are cancer, HIV/AIDS, cardiovascular conditions, traumas and surgeries. Patients with any of these and other catastrophic diseases will not have to pay more than 20 percent of co-payments and, if they cannot afford to pay, they will be subsidized by the government, via a proposed Solidarity Fund, set up in order to help pay for the healthcare reform.

This fund will be financed through an increase in the alcohol, tobacco and fuel taxes and flexibilizing maternal subsidies and allocating their resources to the Solidarity Fund. During his presidential address in May, President Lagos emphasized that he is sending various bills to Congress in order to begin executing guarantees to some of the identified diseases.

Once implemented by the Ministry of Health, Plan Auge will be adopted and managed by FONASA, the National Health Fund, and by the private sector health insurance plans, known as ISAPRES. The ISAPRES, which were created in the 1980s, provides coverage to about 20 percent of Chileans, while FONASA is responsible for rest of the population, including the indigent.