Neoliberalism in Latin America: effects on health system reforms

ABSTRACT OBJECTIVE To analyze the recommendations of international organizations based on the Washington Consensus on health system reforms of selected countries in Latin America and the Caribbean in the 1980s and 1990s and to investigate the effects of the competitive market logic on public actio...

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Main Authors: Leila Bernarda Donato Göttems, Maria de Lourdes Rollemberg Mollo
Format: Article
Language:English
Published: Universidade de São Paulo 2020-07-01
Series:Revista de Saúde Pública
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100508&tlng=pt
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author Leila Bernarda Donato Göttems
Maria de Lourdes Rollemberg Mollo
author_facet Leila Bernarda Donato Göttems
Maria de Lourdes Rollemberg Mollo
author_sort Leila Bernarda Donato Göttems
collection DOAJ
description ABSTRACT OBJECTIVE To analyze the recommendations of international organizations based on the Washington Consensus on health system reforms of selected countries in Latin America and the Caribbean in the 1980s and 1990s and to investigate the effects of the competitive market logic on public action in the health system. METHODS Comparative analysis of the characteristics of health system reforms conducted in the 1980s and 1990s, still seen in Brazil, Argentina, Chile, Colombia, Mexico and Peru. Data were collected by documental analysis and literature review. The systems were described based on the characteristics of: co-payment, privatization mechanisms, decentralization, fragmentation of the system, integration of funding sources and coverage of the population (universal or segmented). RESULTS The reforms were implemented differently, worsening inequalities in health service delivery systems. Changes related to the neoliberal idea of transforming public action in the direction of private logic point to the predominance of competition rules and the reduction in economic costs in all countries analyzed, contrary to the logic of universal health systems. CONCLUSION The reduction in economic costs, the fragmentation of systems and inequalities in the provision of health services, among others, may mean other future costs resulting from low protection to the population’s health. A striking and multidimensional counter-reform is essential to make health a right of all again, in a solidarity system that can lead to the reduction in inequalities and a more democratic society.
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spelling doaj.art-0268f6b92893475e90a91535f97fec0d2022-12-21T21:29:07ZengUniversidade de São PauloRevista de Saúde Pública1518-87872020-07-015410.11606/s1518-8787.2020054001806Neoliberalism in Latin America: effects on health system reformsLeila Bernarda Donato Göttemshttps://orcid.org/0000-0002-2675-8085Maria de Lourdes Rollemberg Mollohttps://orcid.org/0000-0002-4303-6914ABSTRACT OBJECTIVE To analyze the recommendations of international organizations based on the Washington Consensus on health system reforms of selected countries in Latin America and the Caribbean in the 1980s and 1990s and to investigate the effects of the competitive market logic on public action in the health system. METHODS Comparative analysis of the characteristics of health system reforms conducted in the 1980s and 1990s, still seen in Brazil, Argentina, Chile, Colombia, Mexico and Peru. Data were collected by documental analysis and literature review. The systems were described based on the characteristics of: co-payment, privatization mechanisms, decentralization, fragmentation of the system, integration of funding sources and coverage of the population (universal or segmented). RESULTS The reforms were implemented differently, worsening inequalities in health service delivery systems. Changes related to the neoliberal idea of transforming public action in the direction of private logic point to the predominance of competition rules and the reduction in economic costs in all countries analyzed, contrary to the logic of universal health systems. CONCLUSION The reduction in economic costs, the fragmentation of systems and inequalities in the provision of health services, among others, may mean other future costs resulting from low protection to the population’s health. A striking and multidimensional counter-reform is essential to make health a right of all again, in a solidarity system that can lead to the reduction in inequalities and a more democratic society.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100508&tlng=ptHealth SystemsHealth Care ReformHealth PolicyLatin America
spellingShingle Leila Bernarda Donato Göttems
Maria de Lourdes Rollemberg Mollo
Neoliberalism in Latin America: effects on health system reforms
Revista de Saúde Pública
Health Systems
Health Care Reform
Health Policy
Latin America
title Neoliberalism in Latin America: effects on health system reforms
title_full Neoliberalism in Latin America: effects on health system reforms
title_fullStr Neoliberalism in Latin America: effects on health system reforms
title_full_unstemmed Neoliberalism in Latin America: effects on health system reforms
title_short Neoliberalism in Latin America: effects on health system reforms
title_sort neoliberalism in latin america effects on health system reforms
topic Health Systems
Health Care Reform
Health Policy
Latin America
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100508&tlng=pt
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