Health service in Colombia has been continually transformed through various models and institutional changes, which deserves considerable and important analysis. Although, at least in theory, these models have sought to improve the quality of service delivery from different approaches, and according to the identified needs in the implementation period, it is clear that, historically, Colombians do not perceive service delivery as efficient. It is therefore necessary to identify both internal and external shortcomings in service delivery with the purpose of establishing an opinion about its future.