1. Road Map to Universal Health Coverage in Peru The SIS experience Julio Pedroza

2. The SIS experience - Peru2 CONTENT Health Coverage in Peru The Seguro Integral de Salud (SIS) The Universal Health Insurance Law Challenges

3. 3 Basic data: Located in the center pacific of South America. Population 28 million Territory 1.26 millions km2 Poverty 26% (10% to 85%) There are 3 big and different regions: Andean, Coastal, and Amazon basin.

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6. Social Investment Education Sector PLAN “HUASCARAN” Training with key technologies Poverty Reduction 2002 Job Sector PROGRAM “A TRABAJAR” Urban & Rural Jobs for unemployed poor Health Sector SEGURO INTEGRAL DE SALUD Health Care for the Poor Poor Population

7. Universal Health Coverage in Peru Access Barriers Financing Segmentation and Fragmentation Geographic Fee for service (26 % Poverty) 4.4% GNP to Health Average Lat.Am = 8% Cross Subsidies Focalization errors

8. 8 Increasing coverage of health insurance in Peru

9. Ejemplo Título9 Universal Health Insurance Law 2009

10. 3 types of health insurance (according to financing) Complementarity between Health Providers Articulation of Health Providers 100% Contributive 100% Subsidized Semi-Contributive Superintendencia Nacional de Aseguramiento en Salud (SUNASA) Universal Health Insurance Law (2009)

11. Road Map to Universal Health Coverage 11

12. Ejemplo Título12 Health Insurance in Peru, 2007-2011

13. Insured vs. uninsured population 13

14. Evolution of the insurance coverage according to type of insurance, 2008 – 2010 (ENAHO) 14 SIS Social Contributive (EsSalud) for formal employees Others, supplementary

15. 15 Health Coverage vs Infant Mortality, 2002-2010

16. Major Challenges  Affiliation.  Health Care Provision. Availability, quality.  Financing. Government resources, payment modalities (per capita/fee for service)  Human Resources. Quantity and Quality. Training.  Supervision. SUNASA

17. THANK YOU Ejemplo Título17