as discussed in chapter oop in peru represented of total health expenditure a figure significantly above the oecd average although similar to other lac countries but this does not mean that sis in practice can rely on resources that are consistent with the number of its affiliates or the actuarial cost of providing benefits in sis s average expenditure per affiliate was s including all regimes equivalent to usd or eur which represents a mere of the estimated cost similar gaps between the expected cost and actual allocations to sis have been identified almost since the inception of sis prieto et al