This chapter provides an overview of the development of the public-private mix in healthcare in Mexico, Chile, and Peru. It outlines the development of the private sector in the 1980s and 1990s when the public health systems in all three countries struggled to provide insurance coverage to the majority of their population as well as access to healthcare services. This situation prompted the coexistence of the public and private sectors in a system characterized by fragmentation. One of the main consequences of these fragmented systems is the high out-of-pocket expenditure citizens face. The governments of these countries have sought aid from private providers to guarantee access to healthcare services for their populations. However, the governmental purchase of private services still remains marginal in the three countries. The important role of the private sector in the healthcare systems of Mexico, Chile, and Peru in terms of provision, insurance, and funding resembles a common trend in the Latin American region.