title: Neoliberal reforms in health systems and the construction of long-lasting inequalities in health care: A case study from Chile.
abstract: The aim of this article is to discuss how neoliberal policies implemented in the Chilean health system during the Pinochet regime have a lingering effect on equal access to health care today. The two-tier health system - public and private - that was introduced in the early 1980s as a means to improve efficiency and lower health-related costs, has led instead to inequality of access and dehumanisation of health care. Health has changed from being a right to being a marketable need, thus creating a structural disadvantage for several parts of the population - particularly the poor, the elderly, and women - who cannot afford the better-quality services and timely attention of private health providers, and thus, are not adequately protected against health risks. Despite the recent health reforms that aim at improving equity in health care access and financing, we argue that the Chilean health system is still biased against the poorer segments of the population, while it favours the more affluent groups that can afford private health care.
authors.affiliation: University of Chile, Department of Economics, Diagonal Paraguay 257, Office 1506, Santiago, 8330015, Chile. Electronic address: erotarou@fen.uchile.cl.
authors.forename: Elena S
authors.initials: ES
authors.lastname: Rotarou
authors.affiliation: Cardiff University, School of Healthcare Sciences, Eastgate House, Newport Road 35-43, Cardiff, CF24 0AB, United Kingdom. Electronic address: sakellarioud@cardiff.ac.uk.
authors.forename: Dikaios
authors.initials: D
authors.lastname: Sakellariou
mesh_terms: D002677:Chile; D005260:Female; D018166:Health Care Reform / Q000191:economics* / Q000266:history / Q000331:legislation & jurisprudence; D006291:Health Policy / Q000191:economics* / Q000266:history; D054625:Healthcare Disparities / Q000331:legislation & jurisprudence*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D012959:Socioeconomic Factors
keywords: Chile; Health care; Health system; Inequalities; Neoliberalism; Public and private health care