NO LESS THAN 5!
ALAMES Ecuador
The Covid-19 pandemic exposed the structural weaknesses of health systems in Ecuador and most Latin American countries. Decades of consolidation of the private health sector made a joint and effective response to the worst health threat in our history impossible.
The progressive dismantling of public, state and community health systems in favour of the market has elements in common throughout the region. In some cases, services were directly privatized; in others, the State and social security were used as levers to transfer resources to private companies, through the scheme of outsourcing1. The truth is that, after four decades of applying neoliberal policies, alternating with populist and progressive nuances, the private health sector has a decisive weight in the definition and/or application of public policies.
The high out-of-pocket spending of the population is one of the most harmful consequences of this process and one of the causes for increasing social inequalities. By 2016, average out-of-pocket spending in Latin America and the Caribbean was 39.5%, three times the average spending of the populations of rich countries (13.8%)2. If we take into account that this spending is equivalent, on average, to 80% of all private spending, the population is assuming a disproportionate burden on its family economy.
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