Ewig Christina, Bello Amparo Hernández
Gender and Women's Studies & Political Science, University of Wisconsin, 110 Ingrahan Hall, 1155 Observatory Drive, Madison, WI 53706, USA.
Soc Sci Med. 2009 Mar;68(6):1145-52. doi: 10.1016/j.socscimed.2008.12.039. Epub 2009 Jan 21.
In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.
1993年，哥伦比亚进行了全面的医疗改革，旨在大幅提高医疗保险覆盖率，并通过创建一个由国家统一监管的医疗体系来减少国家在医疗服务提供方面的参与，在这个体系中，私人实体是主要的保险公司和医疗服务提供商。通过对家庭调查数据的定量比较以及对改革内容的分析，我们评估了哥伦比亚医疗改革对性别平等的影响。我们发现，这些改革的几个方面有望促进更大程度的性别平等，比如由此带来的女性医疗保险覆盖率的提高。然而，由于持续存在歧视女性的费用以及引入了两级医疗体系，其中女性户主和贫困人口集中在质量较低的医疗体系中，改革并未实现性别平等。
