A Snapshot of Post-Pandemic Healthcare in Latin America

Despite facing setbacks during the pandemic and some historic shortcomings, healthcare in Latin America has taken major steps over the past few decades to expand its scope. “Before going into the challenges faced by the region’s healthcare systems, it’s important to recognize that many countries have made significant advances in an attempt to achieve universal coverage,” explained Ricardo González García, Director of Analysis, Sectorial Research, and Regulation at MAPFRE Economics.

This progress was recognized by the OECD in a recent report, which mentions Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, and Peru, acknowledging the launch in recent decades of policies to strengthen primary care and make it the center of their healthcare strategy. This work has paid off, with an increase in life expectancy (in 2019, it was 78.5 years in those seven countries, three more than in 2000) and a marked reduction in infant mortality, which has been halved in the last 20 years. 

Nearly all studies analyzing the pandemic’s impact, including the one by MAPFRE Economics, concur that Latin America was one of the regions most affected by the crisis. Two key facts illustrate the hardships faced: Peru and Mexico have the highest mortality rates in the world. And in the seven above-mentioned countries, more people died in 2020 and 2021 than in the five previous years.

Amid an avalanche of COVID-19 cases, the region’s healthcare systems, like most others around the world, faced a “wartime medicine” scenario focused mainly on the treatment and survival of coronavirus patients. Meanwhile, the study of other diseases was set aside, and preventive medicine and primary care were the main sacrifices. For example, in Peru, 50% fewer cases of cancer were diagnosed in 2020 than in the four previous years, while in Chile, treatment of cervical cancer was more than halved in the year the pandemic hit. This data reflects an early detection gap resulting in later diagnoses and more limited treatment options, a bottleneck that has also impacted healthcare professionals due to their increased workload.

“The pressure on primary care services during the pandemic had consequences for their operation that have yet to be overcome, just as it did in most healthcare systems around the world, even the ones considered to be the most advanced,” explained Ricardo González. In Latin America, “there is still a long road ahead” for aspects such as healthcare staffing shortages, the improvement of infrastructures, and the high level of territorial and functional fragmentation, which hinders access to health services and makes it difficult for professionals to access information about patients. Reinforcement is necessary not only in primary care, but also in emergency, secondary, and tertiary care.

These healthcare deficiencies, aggravated by the pandemic, overlap with other important structural challenges that transcend the field of health. Among them, Ricardo González highlighted the growing burden of chronic diseases and the aging of the population, two demographic factors that reflect a region transitioning to a population pyramid more similar to that of the most developed countries. Other challenges are more economic in nature, such as high levels of health disparities, a lack of investment, and significant budgetary restrictions.

Economic issues are key to measuring the status of healthcare. Data from Latin American countries shows that, in general, there is a direct relationship between high excess mortality and higher levels of poverty and extreme poverty. Furthermore, the region’s healthcare systems are characterized by a high percentage of out-of-pocket costs that residents must pay. The OECD estimates that, among the principal nations in Latin America, out-of-pocket spending represents, on average, 28.1% of healthcare spending. In some countries, this surpasses 40%, well above the OECD average (18.1% in 2020), which is indicative of barriers to healthcare access and coverage gaps.

Latin America’s healthcare models differ greatly from one country to the next, as analyzed in this MAPFRE Economics report, but the majority are mixed models. As such, they have characteristics typical of social health insurance systems (like the systems of Chile, Colombia, or Costa Rica), while other features resemble, to a greater or lesser extent, those of national health systems, granting universal and free public coverage for a range of basic services (as in Brazil).

In all countries, private insurance plays a complementary role to public healthcare. Puerto Rico is the only exception in Latin America. Like countries such as the United States, the Netherlands, or Japan, it allows insurers to participate in the mandatory universal coverage system.

In this framework, “the insurance industry’s role in Latin America can be fundamental, supplementing public systems to close the current protection gaps,” said Ricardo González.

With the objective of providing healthcare service of the highest caliber, MAPFRE has reached an agreement with Bupa, the parent company of Sanitas, to offer international health insurance, a service that will be launched in Peru before reaching Uruguay and Paraguay.  The alliance covers the whole Latin American region, so the two companies will consider additional joint opportunities in other countries.

“This alliance between MAPFRE, the number-one insurance company in Latin America, and Bupa, a world leader in health insurance, is an unbeatable combination that reinforces our leadership. It will allow us to expand our range in the region in health, a highly demanded line of business,” according to Jesús Martínez Castellanos, MAPFRE’s CEO for LATAM.

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