Abstract

ESPINAL-PIEDRAHITA, Juan José  and  RESTREPO-ZEA, Jairo Humberto. Financing of the Colombian health system: Trends and challenges. Rev. salud pública [online]. 2022, vol.24, n.1, pp.1-.  Epub Aug 20, 2022. ISSN 0124-0064.  https://doi.org/10.15446/rsap.v24n1.103057.

Financing is a fundamental function that contributes to the purpose of health systems to improve the health status of the population. This function takes the form of fundraising, pooling and allocation, and it differentiates the sources and uses of resources, especially in terms of their public or private nature and the way in which health costs are covered. This article presents a long-term view of health financing in Colombia, identifying the background and evolution since the 1993 reform. Four moments in this evolution are identified: I. significant increase in resources, at the time of issuing Laws 60 and 100 of 1993; II. fiscal containment, in the context of the 1998 and 1999 crisis; IV. greater fiscal effort, especially since 2010, and V. substitution of sources, from contributions to general taxes, which began in 2012. An important development of the financing function is evident, with a strengthening of the System's Resources Administrator (ADRES), a reduction in the dependence on contributions, the process of equalization of the capita among insurance regimes, and a greater contribution of general taxes to seek the balance of the system, all of which implies maintaining public predominance and guaranteeing financial protection in health.

Keywords : Health financing; health spending; revenue collection and redistribution of resources (source: MeSH, NLM).

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