Assessment and recommendations

Colombia has a well-designed health system, with broadly effective policies and institutions that other countries could learn from and that deserves to be better known internationally. Colombia has achieved financial protection against excessive health care costs for almost all citizens, as well as an equal basket of services for those in and out of formal employment. Insurance coverage has risen rapidly from 23.5% of the population in 1993 to 96.6% in 2014, with individual’s out-of-pocket spending on health care falling from 52% in 1993 to 14.4% of total national spend on health in 2013, one of the lowest figures in the region. Per capita allocation of funds for health care is equal for those in contributory and publicly-subsidised insurance schemes. Annual consumption of health care for those enrolled in contributory schemes, however, appears less equal at USD PPP 834 per year (2013), compared to USD PPP 449 for those enrolled in publicly-subsidised insurance (although the former figure includes transaction costs). Population health parameters are improving rapidly: life expectancy is now 72.1 years for men and 78.5 years for women (2013), around four years less than OECD averages, and infant mortality has fallen from 40 deaths per 1 000 live births (1970) to 12.8 in 2013 (OECD average 4.1).