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Peru faces the challenge of the financial transition of its health system, which consists of replacing a scheme highly dependent on out-of-pocket spending to a pooled system where health system users use pre-payment systems and/or health insurance to share the financial risk of health care. In Peru, unlike other countries in the region, the prevalence of out-of-pocket expenses, which continued to finance 37% of total health spending in 2012, has not decreased. Moreover, the majority of the non-poor population continues to lack access to social security benefits because they do not work in the formal labor market.