Modelos de financiamiento de la salud pública en América Latina y su sostenibilidad

Abstract

Introduction: This study aimed to describe public health financing models in Latin America and their long-term sustainability, identifying strengths and weaknesses in health management. Methodology: A narrative review was conducted. Databases such as PubMed, Science Direct, and SciELO were consulted, using MeSH and DeCS descriptors in Spanish and English. Studies published between 2019 and 2024 on public health financing models in Latin American countries, their economic sustainability, and their impact on equity were included. Results: The findings show the coexistence of three main schemes (Beveridge, Bismarck, and mixed) that are applied differently depending on the socioeconomic context of each country. Despite advances in coverage and the implementation of public policies to improve resource allocation, dependence on volatile tax revenues, system fragmentation, and the considerable direct economic burden persist, hindering financial sustainability. Conclusion: While each model offers unique advantages, all face common challenges related to governance, labor informality, and insufficient tax collection. To strengthen the equity and efficiency of healthcare, it is essential to diversify funding sources, modernize management, and strengthen coordination between the various subsystems.