Health budget: efficiency and sufficiency

JAVIER SALVO/ATON CHILE Comments TO THE EDITOR: In recent columns published in this outlet, Jorge Acosta and former minister Jaime Mañalich have raised a discussion we share: Health cannot continue operating on budgets that will have to be supplemented during the year. More realistic bases are needed and, at the same time, management and productivity must be improved. We value that, in a scenario of fiscal constraint, Health grows more than other sectors. But the question is what needs it allows financing and what additional capacity it generates to provide better and more timely care. Bringing the initial budget closer to actual spending —budgetary convergence— is necessary, but its success cannot be measured only by reducing supplements or deficits. It must also be evaluated by its capacity to finance the care the population needs. Efficiency and sufficiency are not alternatives. Efficiency must be verifiable: how much resource or capacity it frees up and what results it generates. It cannot be measured only by performing more services at lower cost, but by improving health outcomes. We need to know where the additional capacity to reduce waiting lists lies, how Primary Care will be strengthened, what will happen with investments, and how public capacity will be increased where there is no private supply that allows meeting the demand. Accountability must operate in both directions: adequately financing health needs and managing those resources with efficiency, transparency, and results. From the Medical Association we will contribute evidence and proposals to advance toward a Health budget that combines efficiency and sufficiency to better respond to people's needs. Anamaría Arriagada President Medical Association of Chile More about: Fiscal constraint Actual spending Efficiency Sufficiency