[Controversy and reforms about the health system in Chile]

A worrying stabilization of infant mortality (19/1000) and maternal mortality (0.5/1000) rates has been observed in the last few years in Chile. The well known decrease in mortality from cardiovascular disease and cancer observed in developed countries has not taken place in Chile. An unacceptable 40% of people coming electively to peripheral clinics cannot get medical care and must seek attention in the emergency services. This deterioration of medical care to the Chilean population can be related to a cutback in national funds allocated to the public health system. The development of a private insurance system (ISAPRES) and the turnover of peripheral clinics to local government authorities has not been able to compensate for this. As a consequence an increasing discrimination of the quality of health care between the poor and rich sectors of the population has emerged. The wealthiest 10% of the population is consuming over 1/3 of the health resources. Poor districts are not able to provide the minimum to cover for medicines, vaccines and wage replacements during illness. The private sector spends 20% in administration and has not contributed to build new hospitals or to increase the number of beds available in the country. A significant modification of the current situation is urgently needed.