Abstract

This paper is divided into three parts. The first traces the evolution of health care under social security in Chile from 1918 to the present. The early period saw the unplanned proliferation of almost 50 funds, each with its own unique characteristics. This was followed by a period of consolidation and reform highlighted by passage of the Preventive Medicine Law (1938), the creation of the National Health Service (1952), and passage of the Curative Medicine Law for Employees (1968). The significance of these legislative milestones is discussed. The second section examines the degree to which social security coverage affects the utilization of health services. Based on the results of the 1968 health survey it may be concluded that a strong positive correlation exists between social security coverage and the utilization of medical and dental services, along with an inverse correlation between coverage and the unmet demand for care and on health expenditures. The paper concludes with a discussion of the tasks facing the new government as it seeks to integrate Chile's different systems of publicly sponsored health care so as to improve efficiency and to make comprehensive services available to all Chileans.

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