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Expenditure on healthcare fluctuated sharply in the 1990s, reflecting macroeconomic volatility and over-reliance on fiscal oil revenue to support spending, but has been more stable since 2000. In spite of windfall oil revenue in recent years, spending on healthcare has stagnated at 3.9% of GDP. At this level Venezuela's healthcare spending is among lowest of all the major Latin American economies. However basic health indicators, such as life expectancy and infant mortality, remain roughly in line with the rest of the region.
Demand for healthcare services and products is expected to grow over the next five years as a result of population growth and increasing life expectancy. Given the government's sagging popularity ratings, it is likely to seek to boost healthcare spending, although other spending commitments will prevent a significant increase. In spite of gradual increases in healthcare expenditure, rising inefficiencies in the provision of public-sector healthcare will continue to undermine the system, sustaining demand for private healthcare among wealthier Venezuelans. The latter has flourished over the past decade and now accounts for a significant portion (over half, according to some estimates) of total hospital bed capacity and total spending.
Venezuela's healthcare system has suffered a severe deterioration in the past two decades, having previously been one of the most comprehensive and well-funded in the region. It has become fragmented, while dependence on volatile oil revenue has led to periods of chronic under-funding. The side effects of an unfinished decentralisation process launched in the mid-1990s have further undermined provision. In theory, the constitution of 1999 guarantees the right to a free healthcare service, but state hospitals are inefficient and under-funded, and poorly paid doctors often strike to press for salary increases and the payment of wage arrears, all of which have an adverse effect on the quality of healthcare. Provision is concentrated in urban centres to the detriment of rural communities. Poor working conditions and low pay helped to depress standards of service.
The Chávez government has focused on extending healthcare service provision in low-income communities. To this end, in 2003 the government launched an initiative under which 8,000 newly-constructed clinics in deprived neighbourhoods provide basic curative and preventive medical services. The programme, which was expanded in 2004-06, has generated some domestic opposition for politicising healthcare and operating as a special programme of the executive, parallel to existing public healthcare institutions. Meanwhile, the authorities do not appear to have made substantive progress in recent years towards a much-needed reform of the IVSS (the national social security institute), which provides healthcare cover for around 60% of the population. Coverage of its hospitals and out-patient network is geographically uneven, and many out-patient centres lack supplies and qualified healthcare professionals. Mr Chávez, however, has rejected plans to phase out the institute and replace it with privately-run, state-regulated healthcare and pension funds.
Life expectancy in Venezuela is relatively high, at just under 75 years, and the country was ranked 58th out of 182 countries in the 2009 edition of the Human Development Index, compiled by the UN Development Programme (UNDP), below Argentina, Chile and Mexico but above Brazil, Colombia and Ecuador. There is a relatively high incidence of diseases caused by inadequate nutrition and poor sanitation and housing, especially in marginal urban and rural areas. A number of transmissible diseases, including malaria, measles, tuberculosis and dengue fever, have reappeared in recent years. Urbanisation and the shift of employment towards more sedentary, office-based activities have also led to an increase in those illnesses more prevalent in developed countries, such as heart disease. According to Espicom Business Intelligence, a research firm, problems relating to the circulatory system (including heart disease) are the leading cause of death, accounting for 30% of all fatalities.
The findings of the Health of Nations Index are presented here, along with accompanying information and data on over 50 countries.
Start by scrolling around the map. Hovering over a country will reveal its index results. Click through to find the underlying data and other profile information. Use the tabbed filters above the map to browse by category filter.
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