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When Curbing Spending Becomes the Top Priority: Colombia Tries to Balance Health Needs and Fiscal Capacity, 2013 – 2017

In 2012, Colombia's public health system was headed for bankruptcy. The country had made significant progress on important public health priorities: expanding immunizations, reducing infant mortality, and attaining near-universal insurance coverage. But a Constitutional Court ruling that the government had to pay for almost all health services and technologies for those it subsidized, combined with rising pharmaceutical prices, was pushing the budget into deficit. Economist Alejandro Gaviria became minister of health and social protection amid that simmering crisis. To contain spiraling costs while enabling the sector to focus on some of its priorities, he worked to create new legislation that would limit the services the government would cover, regulate the drug market, and adjust an incentive structure that had lowered accountability and encouraged excess. In parallel, budget officials in the health ministry, the Ministry of Finance and Public Credit, and the National Planning Department tried to improve financial management of the system in order to increase efficiency and reduce costs. In the end, Gaviria's efforts began to pay off and the ministry averted immediate insolvency, but as of 2018, ensuring the continued financial viability of the health-care system remained a challenge, even as performance indicators improved.

Colombian Minister of Health and Social Protection, Alejandro Gaviria, announces plans to regulate the prices of medical devices.

Applying to Graduate School in the U.S.? 

Some of our readers asked us to provide some guidance and occasional schedule reminders for applying to graduate school in the United States. Here is how to prepare. 

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Innovations for Successful Societies (ISS) is a program of Princeton University's
Woodrow Wilson School of Public and International Affairs