ABSTRACT
The International Labour Office stresses “the need to extend health care coverage to the whole of the population and to ensure universal access to basic health care,” “the design of appropriate financing mechanisms” and “the establishment of efficient and effective means and institutions for the financing as well as the delivery of health care services.” In general, for a social security scheme, as for a health care scheme, the choice of how to divide roles between the public and the private sectors is of particular importance. In developing and emerging countries the aim is mainly to provide the entire population with access to basic health care. Virtually all the national social security systems are accompanied by supplementary forms of protection offered by state or quasi-state institutions, or by private insurers. In Nicaragua the Social Security Institute of Nicaragua has drawn up a new model for health care in the framework of new social security legislation.
