Unique health insurance and freedom of choice

As of March 11 next year, Gabriel Borek will be president of Chile. Its programmatic proposal in health matters includes a single state insurance, dependent on public health network providers, to be financed through a single health fund that will be established by pooling the mandatory 7% contribution for all along with state contributions.

How will this unique insurance affect you as a user?

First of all, everyone will be affected by the freedom of choice. By imposing a mandatory contribution to the One-State Fund, each individual would be obligated to pay for one state insurance, even if he did not value it (or did not even use it). This anti-private ideology runs counter to citizens’ preferences, with 85% of those surveyed in a recent Cadem poll saying they agree that “in Chile all people can freely choose between a public system or a public system.”

Second, existing beneficiaries of the National Health Fund (FONASA) would be affected. Forcing Isapres affiliates to migrate to FONASA (or to new individual insurance based on public health network providers) will place enormous strain on the public network, which should serve a potential world of over 3.3 million people (+22%). Given the impossibility of increasing infrastructure and public system personnel (it takes more than 10 years to train a physician and over 15 years to build a hospital), existing FONASA beneficiaries will receive lower quality healthcare, with longer delays and less access.

Third, it would hurt existing Isapres affiliates, both in terms of quality, timing, and cost. Only a few associates with greater resources will be able to purchase supplemental or supplemental private insurance to access better quality care than single insurance, although it will not necessarily be of the same quality as the insurance they currently receive. For them, the proposal is a “hidden tax” equal to part or all of their contributions of 7% of taxable income that will go to fund benefits in the public sector that they do not appreciate or use.

But the majority of the middle class that today so effortlessly arrives at the isapre plan will not have sufficient financial means to “pay double” and secure a private “second floor”. They will be held by single state insurance and will have lower quality care and long waiting times that they do not currently experience in the current isapres system.

In conclusion, the proposal in the program of the next government generates false expectations, by promising more justice by raising the standard, when in reality what it will achieve is to lower the level of the vast majority of the people. At the same time, it will exacerbate inequality towards the few, who will be the only ones who will be able to purchase voluntary private insurance.