[Public health policies in Chile: seeking to regain trust].
Healthcare represents a key area in the public agenda. In the case of Chile, this central part of citizen demands has emerged with an increasing criticism of the health system, its actors and institutions, while a major democratic and legitimacy crisis in Chilean society unfolds. The starting point of this analysis is the link between the critical and widespread societal dissatisfaction with the legitimacy crisis in the health sector. There is an interdependence and parallelism between these two different aspects of the crisis. The analysis is built around the dimensions of trust and legitimacy as a potential driver of the conflict, taking as an analytical framework the socio-political matrix. Conceptual elements around the ideas of trust and legitimacy in public policies are reviewed. This article focuses on recent situations surrounding the dynamics of the Chilean health system such as the rise of the Instituciones de Salud Previsional (ISAPRE) and the market-driven health system, the failed health care reform of the last decade, conflicts of interest in the formulation of public policies, loss of legitimacy of healthcare authorities, and the role of the health professionals in this process. Finally, a discussion arises seeking to regain public trust as a central issue for the future development and sustainability of health policies.
Programa de Políticas, Sistemas y Gestión en Salud, Escuela Salud Pública, Universidad de Chile, Santiago, Chile. Address: Escuela Salud Pública, Universidad de Chile, Avenida Independencia 939, Independencia, Región Metropolitana, Chile. Email: cristobalcuadrado@med.uchile.cl.
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D002677:Chile; D003695:Delivery of Health Care / Q000458:organization & administration*; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D011634:Public Health; D011640:Public Policy; D035502:Trust