Healthcare in Chile is provided by the government via Fondo Nacional de Salud (FONASA) and by private insurers via Instituciones de Salud Previsional (ISAPREs). History Chile was one of the first Latin American countries introducing health care for the middle class funded through mandatory deductions from the salary, as in the Bismarckian welfare state. In the 1950s it introduced a national health care system, headed by the agency Fondo Nacional de Salud (FONASA). During the last decade of the military dictatorship a two tier system developed as people could opt out and buy private health insurance from private insurance companies called Instituciones de Salud Previsional (ISAPREs) for care by private providers at private clinics and private hospitals, which cost up to twice as much. Starting in 1990, the civilian government increased public funding, especially for hospitals, without further reform for more than a decade. In the early 2000s, President Ricardo Lagos strengthened the public-sector. Private health care became more and more expensive and as of 2015 covers only 19% of the population, down from a peak of 26%. The so-called "Explicit Guarantee System (Acceso Universal con Garantías Explícitas, or AUGE), developed several guarantees for 56 health problems for the insured. It prescribed clinical guidelines and "no longer wait than preset periods for diagnosis, treatment, or follow-up", a maximum of out-of-pocket expense cap and a maximum designated waiting time, after which private providers for the services were an option. The Lagos reform had earlier succeeded to reduce mortality rates especially with communicable diseases and mortality, even myocardial infarction it did so at the expense of chronic diseases. In 2010, the Constitutional Court of Chile declared the private insurance system's premiums adjustments for health risk by age and gender as discriminatory, disallowed it, but did not suggest an alternative mechanism. Health care consumer satisfaction has been decreasing since 2007 to its lowest point in 2014. Healthcare system All workers and pensioners are mandated to pay 7% of income for health insurance (the poorest pensioners are exempt from this payment). Workers choosing not to join an Isapre are covered by Fonasa. Fonasa also covers those receiving unemployment benefits, uninsured pregnant women, the dependent family of insured workers, those with mental or physical disabilities, and the poor or indigent. FONASA beneficiaries may use public or private health facilities if the private health facility or health professional is associated with Fonasa in one of three