| Country |
Up to 1990 |
1990-2000 |
2001-2015 |
| |
Prevalence of regulated solidary national logic |
Advancement of competitive market logic |
Specific programs of public and community rationael, maintaining the competition of service providers |
A
r
g
e
n
t
i
n
a |
1944 - Creation of Social Works; 1977 - Extension of social works to workers’ families.
1984 - 75% of the population covered by the expanded social works. |
1990 - Trade liberalization, privatization, fiscal concerns, funding cuts, provinces responsible for providing health services.
1995 - Introduction of the health insurance sector, choice by the worker.
1999-2002 - Low response capacity of Social Works in the face of economic crisis. |
2003-2007 - Adjustments to the mixed public-private pension system and the Federal Health Plan: national pharmaceutical policy, maternal and child health, public health insurance, specific programs and Public Health Coverage (PHC).
2008 - 90% coverage of the population with the renationalization and unification of the mixed public-private pension system.
2011 - Prepaid Medicine Law.
2015- Segmented and fragmented health system, with low levels of efficiency and equality. National, provincial and municipal services. |
B
r
a
z
i
l |
20th century - Focus on the control of specific diseases and on a segment of workers.
1960-1970 - State subsidies to the private sector and expansion of social security coverage for rural workers.
1974 - National Health System.
1988 - New Federal Constitution defines health as a right and creates the Unified Health System (SUS). |
1995-2002 - Federal government decentralization to municipalities. Family Health Program, mental health, HIV/AIDS control, and tobacco control.
1998 - Regulation of the private subsector (Regulation Law).
2000 - Creation of the National Supplementary Health Agency. |
2003 to 2014 - Strengthening of the PHC/ESF; Mais Médicos Program, oral health, emergency and pharmaceutical care; national production of strategic inputs for health, education and management of work in health and regulation of health plans and insurance.
2011 - Decree 7508 regulating LOS No. 8.080/1990.
2012 - Law 142 regulates EC No. 29 with the definition of minimum percentages for states and municipalities to apply in health.
2014-2015 - Law authorize the opening of the health sector to foreign capital. |
C
h
i
l
e |
1924 - Creation of the Ministry of Hygiene, Social Assistance, and Labor.
1948 - Creation of the Chilean Medical Association.
1952 - Law establishing compulsory insurance against the risks of illness, disability, old age, and death and creation of the NHS.
1980 - Military dictatorship, privatization of insurance and medical care |
1990 - The Fondo Nacional de Salud (National Health Fund, FONASA) is created, financed by public resources and contributions from beneficiaries. The Institutos de Salud Previsionales (Pensions Institutes of Health) ISAPRE) is created.
1995 - PHC Statute Law No. 19.378
2000-2006 - Strengthening of the public system, with dual configuration. |
2003 - Financing Law No. 19.888: increase in the value of VAT.
2005 - Law on Instituciones de Salud Previsional - ISAPRE Nº 20.015.
2012 - Law on Health Rights and Duties No. 20.584.
2017 - Guidelines for Network Planning and Programming, based on the RISS logic. |
C
o
l
o
m
b
i
a |
1975 - National, departmental and municipal NHS, integrating the public, private, and social security subsectors, and the Instituto Colombiano de Seguros Sociales (The Colombian Institute of Social Insurances, ICSS).
1977-1980 - Laws nº 1650, 1651, 1652, and 1653 of 1977, convert the ICSS into Instituto de Seguros Sociales (Institute of Social Insurances, ISS) with administrative decentralization measures. |
1990 - Law N° 10 that delimited national and territorial powers and responsibilities of the nation, departments, and municipalities, in terms of health management.
1991 to 1993 - FC and Laws Nº 60 and Nº 100, define resources, responsibilities of territories in health, unification of mandatory contributions and benefit plans and new funding sources: specific taxes and participation in oil revenues. |
2000-2015 - The structure and organization of health services apply the guidelines of N° Law 100/1993.
2001 - Regulation of the decentralization process through Law N° 715/2001.
2007 - Law N° 1122 introduced adjustments to the Colombian health system to promote universal access.
2015 - The Congress of the Republic enacted Statutory Law N° 1751.
|
M
e
x
i
c
o |
1943-1959 - Establishment of the Mexican Institute of Social Security (IMSS) and the Institute of Security and Social Services for State Workers (ISSSTE).
1977 - Creation of the General Coordination of the National Plan for Depressed Zones and Marginalized Groups (Coplamar).
1979 - IMSS-Coplamar - agreement for the coordination of social solidarity services
1983 - Constitution recognizes the right to social health protection.
1982-1988 - Reform with emphasis on rationalization, decentralization and diversification of service providers. The Mexican Health Foundation (FUNSALUD) and the National Institute of Public Health (INSP) were created. |
1988-1994 - IMSS-Coplamar Program changes to IMSS-Solidaridad with expansion of health services to marginalized locations, with growth of service infrastructure.
1995 - Beginning of the second wave of decentralization to expand state responsibilities in financing, managing and providing services. IMSS reduces the participation in the States and transfers the responsibility to them for some services. |
2002 - IMSS-Solidaridad is renamed IMSS-Oportunidades
2003 - General Health Law nº 37 created the Social Protection Health System (SPSS) - with Popular Health Insurance, Universal Catalog of Essential Health Services, and Catastrophe Health Fund. Federal, state, and affiliate funding.
2011-2013 - IMSS-Oportunidades starts to provide health care to beneficiaries of the Popular Insurance, resumes participation in States and expands services.
|
C
u
b
a |
1960s - FC endorses the humanist and solidarity principles of Public Health, construction of the service network, the Faculty of Medicine, the Ministry of Health, and the pharmaceutical industry.
1961 - Creation of an integrated NHS, with full fiscal financing, universal access, and free care.
1963 - International Medical Cooperation.
1975 - Health care for all citizens in the Constitution. |
1990 - The Cuban Health System emphasizes: Primary Health Care. |
2001 - Cuba carries out international cooperation with several countries.
2002 - Health Revolution Programs, Reformulation of the organizational structure of health services, in particular the PHC, deepening the work of the family doctor and nurse.
2004 - University Polyclinic, as a new training model. |
P
e
r
u |
1978 - Formation of the National Health Services System, around the Peruvian Social Security Institute (IPSS), offering health services through cooperation with private entities.
1980s - economic management difficulties and low economic contribution of the State. |
1990 - Creation of the NHS by Legislative Decree No. 584.
1997- General Health Law created dual system with universal access to public health and a private subsector; eliminates guarantees of absolute financing by the State, creates the Health. Service Provider Institutions (IPRESS), which manage public, private and mixed health centers registered with SUNASA. |
2002 - Law N° 27.813 establishes the National Coordinated and Decentralized Health System (SNCDS).
2009 - Law N° 29.344 and its regulatory Decree redesigned the system with separation of functions of assurance and provision of services, incorporating market mechanisms and space for the performance of the private sector.
2015 - Law N° 1751 Universal Health Assurance Framework - modifies the fundamental right to health and the policy of access to the system. |
