Zero Copayment in Chile: From Debate to Evidence (2022-2025)

Abstract

Chile's health system carries a long-standing weakness: household out-of-pocket spending that sits well above the OECD average. It was against this backdrop that the government's 2022 announcement of the “Zero Copayment” policy drew immediate pushback on three fronts, legal, fiscal, and installed capacity, each of which this article re-examines using the public evidence available three years on: 1.9 million beneficiaries and a genuine waiver of hospital revenue, not new fiscal spending, in line with what had been budgeted. The installed-capacity concern has yet to be settled, and national out-of-pocket spending has continued climbing, since the policy leaves out both medications and private care.