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Abstract
El sistema de prestación de salud en el régimen contributivo en Bogotá se analiza como una
cadena productiva de prestación de servicios. Se identifican los miembros primarios y secundarios,
su estructura vertical y horizontal y los procesos transversales que se dan en ella. La
descripción de la cadena permite identificar el problema principal que la aqueja: altos costos de
transacción que dificultan el funcionamiento del mecanismo de precios y la competencia perfecta.
Debido a los altos costos de transacción se imponen formas de organización híbridas. Se
plantean temas de la futura investigación con miras a optimizar las formas de gobernación de
las transacciones, abaratar los costos del Sistema y liberar recursos para el régimen subsidiado.
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