A clear indication of the scheme’s success is the high percentage of UCS members
who express satisfaction with it — 90% in 2010, up from 83% in 2003. Also, although
many contracted health-care providers were unhappy with the UCS in its first few
years, their satisfaction rates rose from 39% in 2004 to 79% in 2010.
Despite this impressive list of accomplishments, in some other important areas
that were part of the ambitious UCS reform, such as the strengthening of primary
health care, effective primary prevention and reliable referral systems, there is less
evidence of the anticipated impacts. Moreover, assessing the lack of significant
progress towards harmonizing the three insurance schemes revealed a set of
important challenges related to politics and the power dynamics of institutional
reform.