With an election scheduled for November, healthcare policy in Chile is on ice as the country awaits its next government. We expect leftist candidate Gabriel Boric to take the reins, prioritizing a series of top issues within the healthcare system. To start, the country will need to redefine basic rights regarding access to healthcare within its constitution. We also expect the next government to pursue approval of both FONASA and ISAPRE reforms, dramatically expanding access for FONASA patients.
Even with these major actions on the upcoming policy agenda, the initial focus of the new government will be on increasing budgets and other interventions to clear the wait list for procedures in the public sector, while allocating more funding to rare disease reimbursement mechanisms. The next four years look to be a dynamic period for Chile’s healthcare system, with meaningful budget increases and ample space to support patient access to innovation.
Overview for 2022
Chile assigned 5% of its 2020 public healthcare budget to procuring vaccines, well above the average 1–2% seen across emerging markets, which aided its success in quickly vaccinating the population. Despite this, hospitals still saw significant delays in reopening non-COVID activities. With the election in November, the outlook for Ministry of Health (MOH) priorities will swing on the winner’s campaign promises and political capital. We expect changes to the constitution in mid-2022 that include greater guarantees for access to healthcare and a subsequent overarching reform in late 2022 or 2023.
Risks to Forecast
The key risk to our forecast revolves around global copper prices, which are currently elevated compared to their pre-pandemic level. We expect prices to remain near this level over the medium term, helping to provide additional fiscal space for more social spending.
Uncertainty over potential FONASA/ISAPRE reforms will remain elevated for most, if not all, of 2022. At the same time, we expect spending from the next government to focus on addressing the FONASA backlog and enhancing access for patients within the Ricarte Soto Law. This will open opportunities to see large rebounds in procedures well above 2019 levels for much of 2022. However, with rising OOP spending during the pandemic, we also expect further interventions from the next MOH to reduce prices of healthcare products purchased directly by consumers.
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