Chile’s Piñera unveils 3rd major reform since taking office

Chile’s center-right President Sebastián Piñera presented his third major reform bill since taking office in March last year.

The draft legislation overhauls rules governing the country’s health insurance system.

Piñera’s government does not enjoy a majority in either house of congress, where his tax and pension reform bills have stalled amid opposition from left and center-left lawmakers.

His health insurance bill targets the regulatory framework established for private health insurers, known as Isapres. It also amends rules governing the state-run scheme, known as Fonasa.

Under the proposed rules, Isapres cannot demand applicants provide a declaration of health or pre-existing conditions. And as part of measures to help boost transparency and make the decision-making process easier for applicants, all Isapres must offer a so-called universal healthcare plan. These plans must provide the same level of coverage, which regulatory authorities would determine.

Among other changes, Isapres are also barred from determining premiums based on gender.

In terms of Fonasa, which covers the bulk of Chileans, the institution is granted increased powers to procure services within and outside the public system.

The bill proposes improving access to care under Fonasa’s so-called free choice scheme, which allows members to purchase healthcare from the likes of private clinics that accept Fonasa patients. Among other changes, the draft legislation also calls for measures to reduce the financial burden on members.

A Fonasa-registered worker contributes 7% of their gross monthly salary. A worker with an Isapre must contribute 7% plus any additional sum required to pay for their chosen plan.

“Our health system needs a reform to improve opportunities to access to it, the quality of care, the scope of coverage and the quality of financial protection,” Piñera said.

Local paper La Tercera quoted Rafael Caviedes, president of Chile’s association of Isapres, as saying: “We hope that this proposal is oriented to improving the guarantees that the private system provides its members and that we will analyze them in depth as soon as we know the details.”

Chile’s Isapres were under the spotlight recently following a major hike in premiums that sparked widespread condemnation.

The country is home to six Isapres that are open to the general public and six that are open only to workers of certain companies or institutions.

The healthcare sector, as part of a series of free-market reforms, was partially privatized in 1981 to provide more choice to those could afford to pay.