Chile's demographic and epidemiological transitions are among the most advanced in Latin America. This article documents the new importance of chronic disease and conditions that significantly affect the quality of life of the older population, noting that primary care-sensitive conditions such as poor vision, hearing, and dental care are among the most common unmet health needs of the older population. An overview of the health care system in Chile shows that it is a mixed public-private system in both insurance and provision, but the organization of the system forces most elderly persons into the public system. The dominance of the public system in the care of the aged has the potential to improve the organization and delivery of needed services, but up to now health care for older persons has not been a top priority compared to broader macro system issues. We discuss directions that Chile could take within its current economic and institutional structure that would make it more responsive to the aging population.