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Bolivia Healthcare


Since 1987, the social security system has been divided into two areas of operations, long term (seguro a largo plazo) and short term (seguro a corto plazo). The long-term area covers old-age pensions, death and permanent disability arising from both occupational and non-occupational accidents and sickness, and the short term area covers public healthcare, maternity and temporary occupational disability. Benefits are considered to be low.

The contributory social security system covers all employed persons and those self-employed who contribute voluntarily. A free non-contributory service is given to children under the age of five (basic health service – seguro basico de salud) and to adults of 60 and over (free service for the elderly – seguro gratuito de vejez). These and other limited free services are financed directly by the central government or the municipalities, although the expenditure is very modest. The World Bank reports that it is less than 1% of GDP.

The main benefits are:

• Old age pension;
• Death and permanent disability;
• Temporary disability;
• Healthcare;
• Maternity.


Since 1997 expatriates are covered by the Bolivian pension scheme and have to make contributions. Prior to this foreign nationals were exempt if they could prove that they contributed to an official pension fund in their country of origin. Expatriates' employers are not obliged to make obligatory contributions for them for short-term social security i.e. healthcare.

All employers make an obligatory 10% contribution to the National Health Fund (Caja Nacional de Salud), which provides hospital and healthcare services to workers, their spouses, and children under the age of 15. In some circumstances the service may be extended to the worker's parents, brothers and sisters. The self-employed may contribute voluntarily to the Caja Nacional de Salud.

The public health system upon which the vast majority of the population depends suffers from serious under funding, poorly trained staff and the traditional Bolivian problem, that of excessive bureaucracy. The situation is exacerbated by the fact that water supplies and sanitary facilities are very poor and often primitive. Malaria is a major problem in the tropical departments of Pando and Beni while chagas disease is endemic among adobe hut dwellers and tuberculosis is also found.

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