Through a comparative analysis, a critical view was taken at the General System of Social Security in Health - SGSSS, in order to improve the difficulties and the challenges of the system. Methodology: Recourse to original sources is carried out a comparative and critical analysis of the SGSSS. Colombia refers to the health system of Chile. What are the results? Result: It can be affirmed that they are systems with comparable structures, with economic segmentation of the affiliates and the difficulties in the direction and financial design, which has led to; detriment of the public sector; adopt multiple legal reforms; Present a similar but unfavorable behavior for Colombia respect to Chile. Conclusions: both health systems present management and regulatory failures, the dominant position of private insurers and a low control of their actions. Colombia must review the financial design, among others, for not complying with the assumptions of economic growth and employability under which the principle of system solidarity was raised.
