Abstract In this study, we develop a taxonomy to categorize health systems in Latin American countries into four distinct groups based on their principal characteristics. Using standardized metrics from Bancalari et al. (2023), we examine disparities in healthcare access and health outcomes among these systems. Our findings reveal that Beveridge-type health systems are associated with lower levels of inequality compared to Bismarckian systems. However, no consistent pattern emerges across the proposed taxonomy, suggesting the presence of influential unobserved health system variables that may play a more significant role in health and healthcare disparities than the taxonomy's general characteristics. Additionally, we investigate the disparities within countries, analysing differences in healthcare use and health outcomes of those individuals covered by contributory and non-contributory health subsystems. Through Oaxaca decompositions, we identify the key factors driving these disparities, offering additional insights into the complex interplay between health system structure and health inequality in Latin America.