Abstract
There are both market and government failures in the Colombian managed competition model of delivering healthcare established by Law 100 of 1993. Following the “Emerging Paradigm” this paper suggests how to adapt the architecture of the current health sector system to those already in place and considered successful in other countries, including identifying institutions, roles and responsibilities. The most important recommendations are: promote a dual system in which managed competition is allowed in densely populated areas and monopolies in less dense geographic areas, and promote a regionalization of the system. In addition, the paper suggests adopting supply regulatory mechanisms such as a certificate of need.
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