Health reform in the social security system: the peruvian case

Since the middle of 1997, a health reform in the Peruvian social security system was implemented in order to improve the efficiency in the sector, to raise the quality of its services, and to extend its coverage to uncovered sectors, within a framework solidarity and equality. However, after almost three years of the implementation of this reform, the system is even further away from accomplishing these objectives. Current statistics show that many Peruvian citizens do not have a health insurance, and that the new Private-Public framework is not wide enough to cover the majority of the population, specially the poorest people. Private insurance companies (EPSs) seem to be oriented to insure large companies rather than small ones (the majority in Peru) while the public insurance would cover the low-income population. Other characteristics of the Peruvian reform are the scarce participation of these private insurance companies in the provinces and its minimum participation in voluntary insurance. Those facts would mean that the reform is still far away from accomplishing its objectives.