The Law and Policy of Healthcare Financing
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The Law and Policy of Healthcare Financing

An International Comparison of Models and Outcomes

Edited by Wolf Sauter, Jos Boertjens, Johan van Manen and Misja Mikkers

Examining the ways and extent to which systemic factors affect health outcomes with regard to quality, affordability and access to curative healthcare, this explorative book compares tax-funded Beveridge systems and insurance-based Bismarck systems. Containing contributions from national experts, The Law and Policy of Healthcare Financing charts and compares the merits of healthcare systems throughout 11 countries, from the UK to Colombia.
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Chapter 10: Country report: Colombia – approach to healthcare financing in Colombia and its impact on quality, affordability and competition

Catalina Góngora Torres


Dating back to 1992, healthcare in Colombia is characterized by a managed competition model, where citizens may choose between one of the health insurance companies. Insurers are financed by premiums and tax revenues. Healthcare services are largely provided by private care providers, but there are also public hospitals. Access to secondary care is dependent on a GP referral and the insurer’s authorization. Remuneration of services (emergency care excepted) depends on a contract between provider and insurer. Services are usually contracted on a fee-for-services basis, in some areas a fee per capita is used. The Colombian healthcare system recently has made significant advances, for example regarding universal coverage (covering more than 95.6 per cent of the population). Some serious challenges remain, notably regarding a clearer delineation of the coverage, an increase of insurer’s financial sustainability and actual or potential anticompetitive behaviour.

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