Health market failures: Colombian case

Abstract

Introduction: Major insurance flaws can be found in the delivery of health services, both by the public and the private sector, worldwide. Objective: To review the current status of the health system in Colombia based on the description, organization and analysis of market failures. Materials y methods: A classification of health market failures in Colombia was made based on the information collected through bibliographical references and papers available on economics in Colombia and Latin America in the past two decades. Results: The insurance and health delivery service markets are complex enough as to ensure the perfect competition posed by the neoliberal model. The need for natural monopolies, the problems of asymmetric information for users and providers, the moral risk and evasion in the insurance, the adverse selection made by insurers and providers, and the corruption in the management of public resources are the causes of this behavior. In addition, the current health model fails structurally in three dimensions: 1) the supply and demand for services, 2) the access and quality of services, and 3) the financial sustainability. Conclusion: There are significant failures in the Colombian health market which make the system inefficient and inequitable; this situation demands for reconsideration of an economic model for financing and operation under a new paradigm.