Abstract

Health insurance is proposed by several Latin American governments to reach universal health coverage. This is a part of the Second Social Reform. Chile, Colombia and Mexico, that have different models and times of implantation, are analyzed to know the results of health insurance implementation. The three examples are examined to know if they have reached their objectives.
Health insurance has not reached universal population coverage and the medical coverage is limited. Unequal access still persists and tends to a new pattern of inclusionexclusion. The split between funds administration and service provision has led to the commodification of both and has created new economic actors with access to public health funds. The administration of these funds is increasingly complex and expensive. Despite the increase in public health expenditure costs exceed resources. The dominant logic of health insurance is economic and not the satisfaction of health needs.