Improving efficiency in the public health system of Chile

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How can we improve efficiency in the public health system of Chile? I am proposing a managerial modernisation reform. My impression is that the method of plan and control has been abused without really knowing the solution which led to all the prior reforms to the failure. Sometimes I think we do not even understand the problem well. Thus, the solution is not clear to me now. I thought I knew the solution, but the truth is that it would be better to try an adaptive method or even PDIA to work on it. Because if we want to succeed, it is better to invest at the beginning of identifying the solution well, at a lower cost of time, economic and human resources and political capital.

I think that the challenge must be addressed in different ways. In this sense, the project needs some flexibility before implementing “the solution”, and even a relevant margin of flexibility during the implementation process. Initially, I would use an adaptive method to design the functionalities, in the case of non-satisfactory results, I would pass to PDIA. In any case, once having clarity of the problem and possible solutions I would try to manage its implementation to a more similar format to plan and control, that can resort to adaptive methods when issues arise. This blended challenge requires being cunning and creative to achieve short, medium- and long-term results that are politically sustainable and that the political authority is willing to support.

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