ABSTRACT
The ‘segmented’ health system of many Latin American countries has been described in brief in Chapter 21. In these countries the system is composed of a series of subcomponents: tax- nanced services, social insurance, private insurance and out-of-pocket private health care markets for rich and poor. Population groups with no access to any of these coexist. Box 22.1 presents more detail on the range of patterns of provision within this group of countries. Chapter 21 also discussed the parallel coexistence of a range of ‘sub-systems’ within the overall system of a number of other poorer countries. This tends to occur where the public system has failed to play the role originally envisaged for it. In these countries, the con guration of ‘sub-systems’ is different from those of the ‘segmented’ Latin American countries, in particular containing a much less important, if any, social insurance component. Finally, the United States, while discussed substantially in Chapter 21 as a private health system, can also be considered as a parallel health system which includes a more extensive private voluntary insurance sector than other countries, but also includes important components of public nance and public provision.
