Author: Thomas Hall
Position: Physician and Academic
Institution: Dept. of Epidemiology & Biostatistics, UCSF School of Medicine, and Global Health Education Consortium
E-mail: thall@epi.ucsf.edu
Submitted Date: May 21, 2008
Published Date: May 21, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

I read with great interest the recent PLoS article on Chile's health care system. I lived in Chile for 3.5 years during the latter 1960s and directed a national health workforce study carried out by the National Health Service (SNS) during the last years of the Christian Democratic government. One of the main sources of information used was the results of a survey in which we tacked on 26 questions to the quarterly national labour force survey. Our sample size was over 45,000, providing us with a gold mine of information about the relative utilization of different types of health services and the unmet demands for services according to reason for non-use, all analyzed (and later projected) according to 648 different population segments [age, sex, residence, income level, educational level, and insurance status. The findings, including workforce supply and requirements projects, were published by the SNS in: Ministerio de Salud Publica y Consejo Nacional Consultivo de Salud. Recursos humanos de salud en Chile: Un modelo de analysis, Santiago, 1970, 325 pp.. It is sad to see that over the years the Chilean system has evolved the same sort of inefficient high cost private sector while shortchanging its relatively efficient, low-cost public sector as is found in many other countries. And despite the return to democratic institutions it still has high inequities in income distribution.