Professional Ideology and the Health Care System in Chile

Doctors' ideology and the role the medical profession plays in the organization and development of health services of a particular country are subjects of scientific interest. This article examines the case of Chile, where doctors centralized administrative and professional power over the last 30 years, and illustrates how doctors' ideology had a major influence over the type of health services provided to the population. Changes in this ideology throughout the century have been reflected in changes in the system of medical care. A shift can be traced from a professional ideology emphasizing socialized medical services during the first half of the century toward the current position favoring the abolition of free medical care and a return of “fee per service” medicine.

The possible explanation for these changes is that medical ideology has altered through the combined influence of the class position of physicians and the development of the profession itself. Increasing polarization of the political forces in Chile led doctors to act according to their class affiliation, regardless of their original professional positions. Some historical facts are provided at each stage of analysis as a way of clarifying the conflicting influences upon the doctors' position.