A new report from the Universidad Andrés Bello Public Health Institute warns that productivity in FONASA’s institutional care fell 40.75% between 2013 and 2025, even as staff numbers doubled.
The study, edited by Héctor Sánchez, Manuel Inostroza and Benjamín Ahumada with data closed at 2025, shows FONASA covers nine out of ten Chileans. Between 2019 and 2025 its portfolio grew 15.4%, while that of the Isapres fell 26.6%.
Fiscal contributions to FONASA rose from 58.1% of its revenues in 2011 to 74.6% in 2025. Since 2021 real income has grown below the historical trend, accumulating a gap of about 5.7 trillion pesos. At the same time, household out-of-pocket spending increased from 32.6% in 2021 to 39.1% in 2024.
Between 2013 and 2025 staffing in FONASA institutional care rose 95.5% and weekly hours worked grew by a similar magnitude. Yet productivity per employee fell 40.75%. The Isapres produce almost five times more services per beneficiary than FONASA. Spending on medical licenses grew 50.3% in real terms between 2019 and 2025, and waiting lists total more than 600,000 additional cases as of December 2025.
