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Healthcare in Uruguay


The government of Uruguay has done much to improve its health conditions. Under the national constitution, the State is responsible for all medical functions in Uruguay, and provides free medical care for those who qualify for it, particularly for the aged and those who cannot afford medical costs. This is done by the 'Ministerio de Salud Publica', Ministry of Health, who owns and operate a network of hospitals and clinics all over the country. The biggest one, called Hospital de Clinicas depends of the Medicine Faculty of the University of the Republic (Uruguay). As a result, over time it changed from having one of the highest mortality rates in Latin America to one of the lowest. For example, in 1995, infant mortality was 19.6 per 1,000 in 1995, 17.5 per 1,000 in 1996 to 11.61 per 1000 in 2006, showing a steady and continuous drop in the future.

For the region, life expectancy is high and infant mortality is low; and the ratios of doctors and beds to the population are exceptionally good. In 2000, 98% of the population had access to safe drinking water and 95% had adequate sanitation. At the end of 1999, the number of healthcare providers, with number per 1,000 people, was as follows: 12,486 physicians (4), 2,613 professional nurses (0.8), and 4,050 dentists (1.3).

The government also continues to expand various forms of medical practice to offer the population diverse options of medical treatment in the nation's 65 medical facilities, as well as various forms of state-sponsored insurance plans, on which much of the population depends.

The Commission for the Fight against Tuberculosis is under the jurisdiction of the Ministry of Health; as a result of its efforts, tuberculosis is almost unknown in Uruguay today. In 1999, there were 29 cases of tuberculosis per 100,000 people. No polio or neonatal tetanus cases were reported in 1995. The commission also deals with the social and economic effects of various diseases.

The major causes of death are heart diseases, cancer, and digestive disorders. Degenerative diseases rank higher as a cause of death in Uruguay than in most other Latin American countries.

Social Security

The social security programme in Uruguay is based on the principal of universality and as such embraces all the population. The underlying accepted cultural fact is the general understanding that the active members of the population should contribute towards and care for the inactive members of the population.

This programme encompasses family care, disability, unemployment, old age pensions and survivors. The two-tier system is made up of the underlying governmental social security programme with its universal reach managed by the BPS (Banco de Prevision Social), and a separate section consisting of individual pensions savings accounts held and managed by private entities known as AFAP (Administradoras de Fondos de Ahorro Previsional). This arrangement has worked extremely well in the five years that it has been operational.

The employee healthcare contribution of 3% per month will go towards his/her healthcare coverage provided by an approved provider or mutual referred to elsewhere in this report. By this mandatory payment the employee is strongly encouraged to enrol with one of the many mutual healthcare facilities or lose the 3% contribution. Additionally the employer has to pay an additional affiliation charge.

Contributions are made on a pay-as-you-go basis. In additions to retirement pensions, the basic social security contributions also finance sickness and maternity benefits, unemployment and family allowances. All payments are made to the social security system, which then channels payment to the private pension fund managers and healthcare providers.

The general public accept that the relatively high contributions levels are necessary in order to achieve the level of benefit desired.

Private Healthcare

Mutual associations and private medical schemes handle private healthcare in Uruguay. Over 50% of the population enjoy some form of privately managed healthcare.

Mutual associations, known locally as Instituciones de Asistencia Medica (IAMCs), had their origins in the diverse groups of immigrants that flocked to the country in the late 19th century and during the first 50 years of the 20th century. Initially the associations were formed to provide the immigrant population with a social and economic outlet, but as the need arose the associations commenced providing basic medical attention and developed into the current major private healthcare system.

There are three types of IAMCs, which are private non-profit organisations that provide services through prepaid health insurance.

Mutual assistance associations, which are based on the principles of co-operation and use a system of mutual insurance to provide medical care to their members.
Professional co-operatives providing medical care to their members and associates, in which the respective professionals contribute corporate capital.
Health services created and financed by private companies or quasi-governmental entities to provide non-profit medical care to personnel and family members.

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