Abstract

The high cost of health procedures can cause financial problems for individuals and their families, becoming a catastrophic expense when it exceeds 40% of the family budget. In this regard, in Chile in 2015, Law 20,850 was enacted, which provides a Financial Protection System for High-Cost Diagnoses and Treatments. Aim: Analyze the phenomenon of study based on the modeling of the existing literature around the public policy of the Ricarte Soto Law in its formulation process. Methodology: Idiographic case study mediated by a theoretical and empirical, transdisciplinary documentary review; bibliographic search (2010-2023, English and Spanish languages) on the concepts related to this public policy. After the theoretical analysis, the information is classified according to the stages of public policy formulation; six indicators are grouped into three dimensions: resources, conflict, and impact, according to Pechmann. Results: 50 articles were analyzed. The Ricarte Soto Law creates a financial protection system for the diagnosis and treatment of high-cost diseases; from its formulation to its implementation as a public health policy in 2015, it has revealed some strengths and complexities that have impacted said protection, covering 27 pathologies at this moment. Conclusion: In recent years, there has been an increase in interest on the part of health systems in implementing more transparent, ethical, scientific, evidence-based decision-making processes for the coverage of these diseases. In this, the case study presented allowed to analyze the formulation of the public policy of the Ricarte Soto law, as well as present different opportunities for improvement in the face of the current threats of the socio-political environment and sociodemographic challenges. © 2025 Sociedad Medica de Santiago. All rights reserved.