TBY talks to Aníbal Velásquez Valdivia, Minister of Health, on goals to achieve universal healthcare coverage, the role of private insurance in Peru's health sector, and improving the healthcare infrastructure.

Aníbal Velásquez Valdivia
Aníbal Velásquez Valdivia is an epidemiologist with vast experience in health sciences research, in the design and implementation of public health policy, as well as the evaluation of social programs and projects and national and international health. He has occupied high-level management roles in public, private, and international institutions. He is a member of the Committee of Experts advising on the Plan for the Reduction of Chronic Malnutrition and Anemia for the Ministry. He is also a lecturer in postgraduate studies at a number of universities.

How much progress has Peru made in achieving its goal of reaching universal healthcare coverage?

We expect to achieve universal coverage in 2021. Right now we are seeing an increase in insurance coverage. The biggest advance so far is that every child born without any other insurance will be affiliated with the SIS, which is the government insurance program that covers low-income children up to five years old.

What are the main challenges that the country is facing in order to reach universal coverage?

First, we must increase the insurance affiliation. It is important to modify the law that created the SIS. The SIS was created to help poor people, but we have to broaden the target population to reach other vulnerable populations. Nowadays, the SIS helps more than 15 million affiliates. We have to make the SIS available to the most vulnerable people; that is the main challenge. The reality is that better, universal healthcare provides net benefits on a national level.

What role do you see for private insurance in Peru's health insurance mix?

People will have the opportunity to choose. As the economic formality rate increases, the amount of people with access to insurance will grow. That path depends on the country's economy, but it should not restrict insurance access. As long as there are people with informal jobs, public insurance will be needed. We want to promote and support private insurance. The important matter is that citizens have the opportunity to choose, depending on their conditions. The private sector still has many advantages, but the gap between the public and private systems is shrinking.

What efforts is the government making to improve healthcare infrastructure?

Instead of constructing more hospitals, we have tried to upgrade then to improve the quality of service. One of the first things we tried to do was improve the personnel and the equipment quality. We want to specialize at the regional hospitals, and create intermediate facilities. The Ministry wants to transform the health posts into health centers, which will improve the operative capacity. We estimate that the construction of 11 new national hospitals, 23 regional and 170 provincial ones will require an investment of more than $3 billion. We want to make more specialized centers because high complexity hospitals are already overcrowded with ordinary emergencies that could be handled elsewhere. Peru also lacks specialists. We are now working on a system that allows specialists to work more hours, or in other locations. Our system also includes a team of 15-20 specialists that visit hard to access locations every 15 days, where they undertake complex procedures. If we do not have the ability to solve a problem, the SIS will find a solution in the private system. It is very difficult to construct and offer services in the most remote areas, so we have developed alternate solutions. One of our strategies is to invest in transport infrastructure. We are working with the Ministry of Defense and Interior to develop a system of air transport to extract critical cases from the least accessible areas in the case of an emergency.

What are your objectives for the future?

The Ministry wants to improve the quality of our services across the board. We have created the National Superintendence of Health, which will supervise the quality of the services, and protect the rights of the citizens. People were not protected before, and their only means of defending themselves was through the courts. Now, complaints are also handled by the superintendence, which has personal dedicated to attend those demands.