Identifying barriers to move to better health coverage: preferences for health insurance benefits among the rural poor population in La Guajira, Colombia

Abstract

SUMMARYEven though access to health insurance in Colombia has improved since the implementation of the 1993 health reforms (Law 100), universal coverage has not yet been accomplished. There is still a segment of the population under the low-income (subsidized) health insurance policy or without health insurance altogether. The purpose of this research was to identify preferences and behavior regarding health insurance among the subsidized rural population in La Guajira, Colombia, and to understand why that population remains under the subsidized health insurance policy. The field experiment gathered information from 400 households regarding their socioeconomic situation, health conditions, and preferences for health insurance characteristics. Results suggest that the surveyed population gives priority to expanded family coverage, physician and hospital choice, and access to specialists, rather than to attributes associated with co-payments or premiums. That indicates that people value healthcare benefits and family coverage more than health insurance expenses, and policy makers could use these preferences to enroll subsidized population into the contributory regime.

Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

“…[50] Colombia has also been plagued by underfunding of its subsidized POS component, as well as high rates of informal workers evading their health contributions. Insu cient funding has furthered health inequities [24]. This research has shown that, under these conditions, even with FOSYGA crosssubsidization it does not guarantee the adequate funding.…”

“…Since inception of Plan Nacer, the low birth weight mortality rates have dropped 9%, while neonatal mortality has fallen 22%. [18,19] [18,19] Central government transferred more than USD 234 million to provinces to fund primary health strategy over SUM\AR [19] HIS is still in development and the country lacks of connectivity across the entire health [18] [19] Strong criticisms about underfunding of SUS [30] Federal spending on healthcare unchanged over 15 year period, slight increase of 0,7% GDP in public health expenditure over 5 year period [21] and still under subsidized causing effect inequalities [24] Labor contributions are based on fixed proportion of the income collected by the government under FOSYGA [ Enhancing the primary care network in Argentina, they introduced preventive health programs, such as those addressing sexually transmitted infections, cardiovascular disease, diabetes, and other chronic conditions. It also increased the number of deliveries attended by skilled healthcare workers, especially for those living below the poverty level.…”

“…[22] As enrollment in the subsidized component grew by 24% between 2000 and 2011, access to health services expanded to more people living at the poverty level. [23,24,36] In 2015, both components were uni ed under the Ley Estatutaria de Salud [Statutory Health Law], which standardized health bene ts, controlled resources, and limited the number of Tutelas [lawsuits] pursuing coverage for technologies not included in the insurer's bene t packages. [22] Mexico Mexico's healthcare is provided through the social security system, the public health sector, and private health plans.…”

Best Practices in Achieving Universal Health Coverage: A Scoping Review

“…The results of the present study show that quality interventions with 18 cases had the least report. While studies on UHC have identi ed the quality of care and regulatory mechanisms for quality as one of the most in uential factors in achieving UHC [33,49,96,97,140]. One of the reasons for low interventions in this dimension could be the over-emphasis of countries on the quantity of services provided and coverage of the majority of the population.…”

Private Healthcare Institutions and Insurance Companies: from Cooperators to Market Competitors

“…Modern consumers are seeking information about various health insurance types and health care providers(Deloitte, 2008) in order to compare different options and make affiliation decisions(Becker &Zweifel, 2008). In such cases, consumers choose certain organizations based on their evaluation of various attributes of the offer, such as: package of services, high quality of medical services, efficiency of service provision and a waiting period to receive healthcare services, politeness of medical and non-medical staff, family coverage, access to specialists, right to choose a doctor, etc (Amaya et al, 2014)…”