As the healthcare system faces increasing pressures, such as an aging population, a rise in chronic diseases, and persistent waiting lists, it becomes increasingly evident that the response cannot be solely reactive at the hospital level but must focus on strengthening primary care. Primary Health Care (PHC) must be consolidated as the structural axis of the Chilean health system. A recent study presented by the Pan American Health Organization and the World Bank evaluated the Universal PHC ministerial program, an initiative aimed at allowing individuals who are not beneficiaries of the National Health Fund (FONASA) to enroll in Family Health Centers (Cesfam) and access their services for free.
The results are interesting. In the 28 pioneering municipalities where the strategy was implemented, coverage increased mainly due to FONASA-affiliated individuals who began to actively use their services, without this increase affecting the care of the previously enrolled population. The study highlights the high appreciation of users regarding innovations such as extended hours, remote demand management through telehealth, and home care; the implementation of the comprehensive care model centered on people (ECICEP), which allows for continuous and personalized management of the physical, mental, and social health of those living with chronic diseases; and the implementation of a comprehensive social management that strengthened the coordination between health, education, and social development at the community level.
The advances translated into improvements in resolution capacity, greater compliance with health goals, and a contribution to the reduction of avoidable hospitalizations. It should also be noted that during 2025, there was an unprecedented call to universities to strengthen health training around the values of PHC, and a cross-party agreement—driven alongside the Medical College and with technical support from the PAHO—that reaffirms that primary care must be consolidated as a state policy. Beyond specific programs or political cycles, strengthening PHC is a strategic decision.
For nearly fifty years, international evidence has shown that it is the most efficient and humane way to address health problems. In the face of the challenges of aging and chronic diseases, there is no other path than to anticipate harm, prevent disease, and avoid complications that lead to mortality, deteriorate quality of life, and increase healthcare costs.