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Uruguay State and Private Health Care
In 1971 about 82 percent of hospital beds were provided
in
establishments run by the Ministry of Public Health. The
same
public hospitals accounted for 69.5 percent of
hospitalizations.
About 61 percent of visits to general practitioners were
covered
by private health plans known as mutuales
(mutuals). In
the same year, 58.9 percent of the inhabitants of
Montevideo were
covered by these private associations. About 11.8 percent
had the
official health card of the Ministry of Public Health,
entitling
them to free health care. A further 6.8 percent had other
health
plans, usually through their place of work. This left 5.8
percent
with multiple forms of coverage and 16.6 percent with no
coverage
at all.
In 1980 there were 9,089 public hospital beds, about
threefifths in the capital and the remainder in the rest of the
country. During the period of military rule from 1973 to
1985,
the government had shifted health care spending toward
military
hospitals, which were, however, open only to relatives of
the
members of the armed forces. After 1985 the government
made a
sustained effort to increase health care coverage. From
1985 to
1988, public health cardholders increased from 566,000 to
692,000
in the interior but decreased slightly from 323,000 to
310,000 in
Montevideo.
At the end of 1984, there were 918,000 members of
private
health plans in Montevideo and 325,000 in the rest of the
country. By 1988 the numbers had risen to 963,000 and
488,000,
respectively. Overall, this represented a 17 percent
increase in
the membership of the mutuales from 1984 to 1988.
As with
the state health provision, the greatest increase in
coverage
occurred in the interior, where it was most needed.
A concurrent effort was made to increase the proportion
of
infants receiving inoculations. In 1985 there were 503
cases of
whooping cough, and in 1986 there were 1,117; but in the
first
nine months of 1988, there were only 21. Over the same
period,
the number of cases of measles first rose from 160 in 1985
to
1,190 in 1987 but then fell sharply to just 73 in the
first nine
months of 1988. The proportion of infants immunized before
age
one rose from 61 to 79 percent in 1985 to 80 to 88 percent
in
1987, depending on the particular vaccination.
Government investment in health care equipment rose
dramatically after the return to democracy, climbing from
US$564,000 in 1985 to US$2.2 million in 1987. Over the
same
period, expenditures on construction of health care
facilities
rose from US$772,000 to US$2.7 million. Total spending by
the
Ministry of Public Health rose 34 percent in real terms,
while
spending on medications doubled. Grandiose plans for new
hospitals to be financed by foreign development loans were
announced in 1989, but their realization remained a
distant
prospect.
Data as of December 1990
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