Table 4 Financing Arrangements

Bolivia

General government revenues;

District and municipal revenues;

Earmarked revenues from a tax on hydrocarbons [70]

Until 2013: For SUMI, 10% of central government’s transfers to the municipalities; for SSPAM, a premium of 56 USD per older person [53]

Since 2013 under the Integrated Health Services Program: Budget allocations, and 15.5% of municipal fiscal sources

Lump-sum [53]

Full subsidization

Chile

General government revenues, partly earmarked tax revenues: 1% increase in value added tax, tobacco tax, customs revenues; sale of the state’s minority shares in public health enterprises;

Contributions of partially subsidized [71]

Ministry of Finance defines a “Universal Premium” according to available funding and based on inflation-linked currency units [72]

Lump-sum

Full subsidization [27]

Colombia

General government revenue (49% of revenues of subsidized scheme) [73];

Solidarity contributions from the Solidarity and Guarantee Fund (36%) [24];

District and municipal revenues (14%) (including earmarked municipal tax on gambling) [21, 24]

Capitation Payment Unit per subsidized member, prospectively calculated, risk-adjusted based on age (children under 1 year of age, women aged 15–44 and others), sex, and geographic area [74]

The average Capitation Payment Unit was US$302 in 2011 (US$506 for those contributing) [35]

Individual-based

Full subsidization

Costa Rica

Earmarked tax revenues on luxury goods, gambling, alcohol and tobacco (80% of subsidy amount)

Transfers from the Social Development and Family Assignation Fund (20%), with its funds coming from value added tax and a 5% payroll tax [75];

Contributions of the partially subsidized

Negotiated between the National Social Health Insurance and the Ministry of Finance based on the current minimum wage

Individual-based

Full subsidization; partial subsidization: contributions range from 3.75 to 11.00% of income (depending on the earned amount) [76]

Dominican Republic

General government revenues [32]

n/a

Individual-based

Full subsidization

Mexico

Federal funding: Social contribution (~33% of revenues of Seguro Popular) and the federal solidarity contribution (~49.5%) from general taxes

State funding: State solidarity contribution similar in all states (~16.5%)

Household contributions

(~1%, not implemented) [20]

Three steps:

1) Social contribution is a fixed allocation per enrolled family, amounting to US$70 in 2011 [20]

Federal solidarity contribution (FSC): on average 150% of the social contribution (~US$105) [36]

State solidarity contribution: Fixed allocation of 50% of the social contribution (~US$35)

2) FSC adjusted based on enrolled individuals, health needs, and performance

3) FSC addresses inequalities among states: if FSC is lower than general federal transfers to states, FSC turns out as an additional budget transfer [20]

Individual-based

Full subsidization [36]:

Partial subsidization (although not applied in practice): contributions range from US$60 to US$950 [22]

Peru

General government revenues (over 90% of the subsidized scheme’s revenues);

Regional state revenues;

International donor funding;

Contributions from household for the semi-subsidized (less than 5%) [23]

Ministry of Economy and Finance transfers a pre-determined budget on a historical basis and controls its expansion [30, 34]

Individual-based

Full subsidization; Partial subsidization in the semi-contributive regime: about two thirds of the average expenditure per insured, approxi-mately US$67/year per insured [34]

Uruguay

General government revenues [77]

“Health Quota” per subsidized member, adjusted for sex and age using a formula that reflects evolution of domestic prices, exchange rates and wages [77]

Individual-based

Contributions are fully subsidized