T
his relatively small European country has seen huge changes to their healthcare system over the
last century, the most major development probably being the establishment of the National Health Service (NHS) in 1974 and the government healthcare reforms back in 2002, when the systems have been made more efficient and effective compared to previous years. Portugal’s economic rescue package, announced in May 2011 from EU/IMF, will impact all aspects of Portugal’s economy – meaning healthcare is not likely to escape cuts. The Portuguese health system is
characterized by three coexisting systems: the National Health Service (NHS), special social health insurance schemes for certain professions (health sub-systems) and voluntary private health insurance. The NHS provides universal coverage. The Ministry of Health is responsible for developing health policy as well as managing
the NHS. Decentralization efforts have aimed at shifting financial and management responsibility to the regional level. In practice, however,
the autonomy of regional health administrations over budget setting and spending has been limited to primary care. The NHS is predominantly funded through general taxation. The major health determinants in
Portugal reflect the late adoption of a western way of life among the general population after the 1974 revolution. The Portuguese population in general has high levels of alcohol consumption, low levels of physical exercise and rapidly changing dietary habits. Similar to other Western European countries, most Portuguese die from non-communicable diseases with cerebrovascular disease being the single biggest killer in Portugal (17%). Portugal has the highest mortality rate for diabetes in the Eur-A, with a sharp
increase since the late 1980s. Portugal also has one of the highest prevalence of HIV infection in Europe. Expenditure projections in pharmaceuticals has seen an increase of 3.8% in US dollar terms US$4.77bn in 2010 to US$4.95bn in 2011. Healthcare is up 5.4% from 2010 to 2011 and Medical Devices enjoy a 11.4% increase, from US$1.04bn in 2010 to US$1.15bn in 2011.
C
hile has maintained a dual healthcare system in which citizens can opt for coverage
with either the public National Health Insurance Fund or a private health insurance company. However, the two systems operate essentially separate from each other rather than collaborating on common healthcare goals. Since 2000, healthcare reform
in Chile has been one of the major political issues in order to reduce the inequality in healthcare access that currently exists. The government is attempting to guarantee the population a minimum level of care for 56 priority illnesses. Chile currently spends approximately 7% of its GDP on healthcare and has yearly increased its health budget since 1990. By 2002,
healthcare funding was increased by 10% and it formed one of the largest components of government spending. The Ministry of Health is responsible
for the overall running of the healthcare system, but 29 regional health services control healthcare at a more local level. The government’s current plans are to invest US$40 million in healthcare with around half of this devoted to medical equipment. Millions of dollars has been allocated to the purchasing of new mammogram machines, ambulances, mobile dental clinics, and refurbished operating rooms for regional hospitals. Its medical sector is small but extremely competitive. Chile produces very little medical equipment, so the market is largely supplied by imports.
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