Ramiro Guerrero, and others from the Centro de Estudios en Protección Social y Economía de la Salud in Colombia, wrote an assessment of their country’s progress towards universal health coverage for GNHE.
You can read the full assessment here.
Colombia has made big efforts to fulfil the goal of universal health coverage:
- since 2000, health expenditure as a percentage of GDP has been around 6.8%
- government health expenditure as a percentage of total health expenditure is almost 80%
- in 2010 all health system financial sources were progressive, meaning that higher-income individuals contributed relatively more towards the health system
- in 2013 the contributory and subsidised regimes covered approximately 96% of Colombia’s population, and more than half the population was completely subsidised
- there is a common mandatory benefit package
- The Colombian health system has two major health insurance schemes:
- the contributory regime is mandatory for formal workers and other people with the capacity to pay
- the subsidised regime is for the unemployed, informal sector workers and the poor
- The structure of the health system pools all resources into a common fund that is distributed on a risk-adjusted, capitation basis to a range of public and private health maintenance organisations. People are allowed to choose their health maintenance organisation, and health maintenance organisations are able to choose the providers with which they contract.
- However, 4.6% of households in 2010 incurred catastrophic expenditure (measured using a 40% threshold of non-food household expenditure). Although this was an improvement from 2008, the intensity of catastrophic expenditures is still concentrated in low-income people. Data also suggest that the households that became poor after a financial shock were predominantly those in the subsidized regime and the uninsured.
- In summary, Colombia has made important progress towards universal health coverage but attention still needs to be paid to the differences in access to health care for those with lower incomes and living in rural areas.