RESUMEN
Currently, there is no discussion on the need to improve and strengthen the institutional health care modality of FONASA (MAI), the health care system used by the public services net and by most of the population, despite the widely known and long lasting problems such as waiting lists, hospital debt with suppliers, lack of specialists and increasing services purchase transference to the private sector, etc. In a dichotomous sectorial context, such as the one of healths social security in Chile (the state on one side and the market on the other), points of view are polarized and stances tend to seek refuge within themselves. As a consequence, to protect the public solution is commonly associated with protecting the status quo, creating an environment that is reluctant to change. The author proposes a solution based on three basic core ideas, which, if proven effective, can strengthen each other if combined properly. These are: network financing management, governance of health care services in MAI and investments and human resources in networked self-managed institutions. The proposal of these core ideas was done introducing a reality testing that minimizes the politic complexity of their implementation.
Asunto(s)
Atención a la Salud/organización & administración , Reforma de la Atención de Salud , Servicios de Salud/normas , Sector Público/economía , Chile , Servicios de Salud/economía , Hospitales Públicos/organización & administración , HumanosRESUMEN
Currently, there is no discussion on the need to improve and strengthen the institutional health care modality of FONASA (MAI), the health care system used by the public services net and by most of the population, despite the widely known and long lasting problems such as waiting lists, hospital debt with suppliers, lack of specialists and increasing services purchase transference to the private sector, etc. In a dichotomous sectorial context, such as the one of healths social security in Chile (the state on one side and the market on the other), points of view are polarized and stances tend to seek refuge within themselves. As a consequence, to protect the public solution is commonly associated with protecting the status quo, creating an environment that is reluctant to change. The author proposes a solution based on three basic core ideas, which, if proven effective, can strengthen each other if combined properly. These are: network financing management, governance of health care services in MAI and investments and human resources in networked self-managed institutions. The proposal of these core ideas was done introducing a reality testing that minimizes the politic complexity of their implementation.
Asunto(s)
Animales , Humanos , Ratas , Proteínas Quinasas Activadas por AMP/metabolismo , Antioxidantes/uso terapéutico , Autofagia/efectos de los fármacos , Transducción de Señal/efectos de los fármacos , Sirtuina 1/metabolismo , Estilbenos/uso terapéutico , Línea Celular Transformada , Relación Dosis-Respuesta a Droga , Doxiciclina/farmacología , Regulación de la Expresión Génica/efectos de los fármacos , Insecticidas/toxicidad , Microscopía Inmunoelectrónica/métodos , Proteínas Asociadas a Microtúbulos/genética , Proteínas Asociadas a Microtúbulos/metabolismo , Mutación/genética , Poli(ADP-Ribosa) Polimerasas/metabolismo , ARN Interferente Pequeño/farmacología , Rotenona/toxicidad , Factores de Tiempo , alfa-Sinucleína/genética , alfa-Sinucleína/metabolismoRESUMEN
This is a comparative review of sick leave and wage replacement policies among countries of the Organization for Economic Co-operation and Development (EOCD), an organism that Chile joined recently. This review also deals with the main transfor-mations applied to the system to improve its effciency and the variables that explain such changes. The Chilean system is analyzed from the perspective of substitution rates, waiting time and protection length. According to these parameters, Chile is located below countries such as Scandinavian countries, that provide a universal protection, and over those countries that provide a focalized protection according to workers needs.