Long-Term Health Financing in Chile: A Historical Analysis of the Segmented System, 1981–2024

Mauricio Matus-Lopez and Camilo Cid Pedraza

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Abstract: The objective of this article is to present the results of reconstructing the historical series of health expenditure in Chile from the creation of the segmented model in 1981 to 2024, and to briefly analyze its evolution in historical context. To this end, data were collected and digitized from primary sources: the Statistical Bulletins and Public Accounts of FONASA (1989–2016; 2020–2024), the Statistical Series of the Isapre System (SUPER, 1990–2024), and the Public Finance Statistics of DIPRES (2004–2025). The results show accelerated growth in private spending until the 1990s, followed by a sustained increase in public health expenditure associated with higher fiscal contributions and mandatory contributions. However, the long-term analysis reveals periods of slowdown in public spending coinciding with the expansion of private infrastructure, revealing the persistence of a segmented and unequal financing system. The trajectory of Chilean health expenditure shows significant variation in proportions and pace, conditioned by political and economic contexts. Alongside this analysis, we make the complete series used available to researchers in open access.

Date: 2026-09-16
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Persistent link: https://EconPapers.repec.org/RePEc:osf:socarx:prhkv_v1

DOI: 10.31235/osf.io/prhkv_v1

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