The health system in Chile is divided into 3 groups: the public, the private, and the military, the first two being the most used. The public system is based on a social security model, where everyone contributes to a fund and the resources are distributed according to the population's needs, no matter the personal input. FONASA (Fondo Nacional de Salud, National Health Fund) serves about the 70% of the population but only has 30% of the resources (monetary, human and equipment). It has four different levels depending on your income, because your contribution is automatically deducted from your salary. The private sector has the remaining 70% of resources but serves only 30% of the people, who are able to pay for the service.
The public system allocates the majority of the resources to primary health care where most health problems are solved. If an issue isn’t solved someone is referred to a specialist. The primary health care setting is financed by the township, unlike the big hospitals which receive financial support directly from FONASA. This translates to a disparity in the access and quality of health care.
There is also a program called GES (Garantías Explícitas en Salud, Explicit Health Guarantees) which guarantees access to treatment for 80 diseases, diabetes being one of them.
What happens if you need to see a doctor?
It depends on your health care plan. In every system you should be able to access to a doctor in a short period of time, unless you need to be referred to a specialist. In this case it will depend if your issue is included in the GES diseases list mentioned above. Diabetes is on this list, so someone with diabetes will be referred in no more than three days from the diagnosis. For young people with type 1 diabetes specialists are few in number, so many times the three day period is not met.
Who decides what doctors can prescribe?
The Institute of Public Health of Chile (ISP) sits under the Ministry of Health and monitors medicines and other health policies. The medicines that are eligible to be prescribed for diabetes are stipulated in the GES plan. A list of minimal supplies is offered, regardless of your health care plan.
Practically, what is it like to live with type 1 diabetes in Chile?
Just like in other parts of the world, there is a lot of lack of information and misinformation surrounded by myths and misguided stereotypes. Having a T1D diagnosis is not a death sentence, but your care can vary a lot depending on where you live.
What about getting admitted to hospital?
Again, this is covered by GES, so you should only have to pay a small fee.
How does diabetes care vary throughout Chile?
Even though GES operates through a national plan, it varies a lot. In Chile we are a geographically extreme country with more than 4.300 Km of length, so the distances between cities are often very large. The more distant and rural your location is, more difficult is to have access to a specialist. If you live in a rural area you have to travel to the nearest city for a hospital and to get your basic supplies. Even though there is a minimal supplies list for people with diabetes, in the big cities you have access to more options (for example, shorter needle lengths). In other cities or villages it is really rare to have more options than the most basic and minimal.
Franco Giraudo, David Contreras Vásquez, and Antonella Giraudo kindly supported this page by offering information.