Chile's healthcare system is facing a crisis of funding and efficiency, marked by a critical rise in household spending. According to a study by the Institute of Public Health at Universidad Andrés Bello (ISP UNAB), direct family spending grew by 175.7% between 2010 and 2024.
This increase significantly outstrips the expansion of the state budget, which rose from 13 billion to over 33 billion pesos during the same period—a real increase of 142.7%. Researchers Héctor Sánchez and Manuel Inostroza warn that this trend persists despite measures such as Fonasa's 'zero co-payment' policy.
The report, titled “Overview and Evolution of the Chilean Healthcare System between 2010-2025,” identifies waiting lists and low perceived quality as the primary structural challenges. The authors note that increased public funding has failed to improve patient satisfaction.
The impact of waiting lists
Delays in medical care remain at critical levels. By 2025, the waiting list for non-GES (Explicit Health Guarantees) specialist consultations reached 2.73 million people, while 421,535 patients are still awaiting surgical procedures.
Regarding GES-covered conditions, waiting times have regressed since the pandemic. After hitting a low of 66 days in 2019, the average rose to 156.5 days in 2022 and stands at 142 days for 2025, surpassing pre-pandemic levels.
The disparity with international standards is also a cause for concern. Out-of-pocket spending in Chile accounts for 39.1% of total healthcare costs, a figure that is double the OECD average of 18%.
The crisis is further compounded by low hospital productivity and a crisis within the private insurance system. According to the researchers, 61% of Chileans report dissatisfaction with the availability of quality services, necessitating structural reforms to ensure the system's long-term sustainability.