Chile as a leader in the processes of health reform since the 1950’s, when it created the first National Health System in Latin America, have had other key reforms: one in the 1980’s under the Pinochet military government, where the system was reformed to introduce competitive private insurance and private providers.  More recently, Chile has “reformed the reform” with a very innovative approach to prioritizing health expenditures through a system of guarantees for 56 specific health problems but without excluding services as other efforts at prioritizing through limited benefits packages have done. The reforms also involved changes in the rules of private insurance to reduce risk selection. 

In 2007-2008 with support from a DRCLAS Individual Grant, Lecturer Thomas Bossert is preparing a thorough academic investigation of the reforms, a review and evaluation of the current health reform in Chile that is serving as the basis for an article in an international journal, a case study for teaching his course on Health Reform at the Harvard School of Public Health, and the basis for on-going research in specific reform areas for graduate students at Harvard.   The project involved a major effort to collect the published data on the health reform since few outside Chile know much about the innovative aspects of the reforms. 

Since 2004 Thomas Bossert have led groups of 15 graduate students each year for six years on a three week field course in Chile in January on a three week field course in Chile in January.  This course introduces students to the different key actors in the Chilean health system to get brief and intense different arguments about the health system problems and the abilities of the reform efforts to over come those problems. The course had given professor Bossert unusual access during the years to many of the key actors who have differing views on the process and effectiveness of the reforms, allowing him to have a broad perspective of the latest reform.                                                              

Participating Harvard faculty: Thomas J. Bossert, Lecturer on International Health Policy, Director, International Health Systems Program, Harvard School of Public Health
Collaborator: Dr. Jorge Jimenez, former Minister of Health
Collaborative Institutions:  Global Health Internship Program at HIGH, Ministry of Health, Chile; Universidad Católica, Chile; and Universidad de Chile, Chile