Original title: The chilean health model in the context of latin america. 40 years of economic crises, spending policies and reforms
Camilo Cid Pedraza, Mauricio Matus-Lopez · September 2026
Economic troubles often push countries to reshape healthcare, but these shifts do not always fix deep divides. This chapter explores how financial crises shaped healthcare in Latin America, focusing closely on Chile from its beginnings to today. In Chile, leaders built the system during major economic crises in 1975 and 1982, alongside a political dictatorship. Later, after an economic crisis in 1997, Chile created the AUGE Plan in 2005. This plan gave people access to treatment for specific health conditions, yet it left the core setup untouched. Recent crises in 2008 and 2019 sparked debates about structural change, highlighting the split between public and private insurers as a major barrier to fairness. Across Latin America, countries once pushed market reforms, but the COVID-19 pandemic has strengthened a shared push toward universal, public systems.
Imagine a town that has two separate grocery stores: one for rich residents selling fresh food at high prices, and another for poor residents selling lower-quality food. When supplies run low, the rich store still has stock, but the poor store runs out, and the town cannot redistribute food between them. In this paper, Chile's health system is similarly split between a public insurer (FONASA) and private insurers (ISAPRES), so during health emergencies, resources are not shared equally, deepening inequality.
For ordinary Chileans, whether you get good healthcare depends on whether you use the public system (FONASA) or a private insurance company (ISAPRE). This split, born during past crises, makes care unequal. Across Latin America, many countries are now realizing they need to unify their health systems to be fair, and Chile's experience shows how hard that is to achieve.
The abstract does not specify limitations, but the chapter's analysis is historical and regional rather than offering new quantitative evidence or causal claims. It focuses on Chile within Latin America, so conclusions may not apply to other regions. Future developments are speculative rather than prescriptive.
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The chilean health model in the context of latin america. 40 years of economic crises, spending policies and reforms — Camilo Cid Pedraza, Mauricio Matus-Lopez — SocArXiv — doi:10.31235/osf.io/75wje_v1
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper. This is a preprint, so it hasn't necessarily been peer reviewed.