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Ítem La sinfonía incompleta: La reforma al Sistema de Salud de Colombia(Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2012-09-01) Chernichovsky, DovEste documento hace un análisis crítico de la reforma al Sistema de Salud que emprendió Colombia con la entrada en vigor de la Ley 100 de 1993. El documento expone por qué, a pesar un diseño creíble y visionario de modelo, la implementación de la reforma sigue incompleta. El documento propone una serie de cambios que puedan hacer de las instituciones existentes un Sistema de Salud más eficiente y más equitativo que el actual. Las recomendaciones incluyen la integración inteligente de los recursos, la reconsideración del modelo de competencia regulada en áreas marginales y cambios en los entes responsables por la promoción de la salud y la atención preventiva.Ítem Diseño y reforma del Plan Obligatorio de Salud en Colombia.(Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2012-05-01) Guerrero Carvajal, RamiroThe way a benefits package is implemented in a health system is as important as its content. This article focuses on the way a package is designed and implemented, rather than on its medical content. It starts by defining the packages and presenting the different ways of designing them, and the implications of the latter on equity and access. Some international experiences are presented and commented, with special emphasis on recent reforms in Chile and México. The concepts and cases presented in the paper are then discussed in the Colombian context in order to identify relevant lessons and insights for the current process of reforming and updating the Colombian benefits package.Ítem Case Study: HIV/AIDS in the Context of the Colombian Health Care Reform(Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2012-07-01) Castro, HéctorStarting in the early nineties, Colombia, the third most populous country in Latin America, implemented a profound reform of its health system. A universal social health insurance system was created. The new system collects funds centrally, and allows for multiple competing plans that receive risk adjusted capitated payments and are responsible for delivering a basic and legally mandated basket of services. This case reviews how the HIV/AIDS epidemic has been managed in the context of this reform. The inclusion of Antiretroviral (ARV) in the mandated basic basket proved a powerful mechanism for ensuring access to care. Results are less clear, and to some extent disappointing, for prevention activities.