Health and Social Security Reforms in Latin America: The Convergence of the World Health Organization, the World Bank, and Transnational Corporations

Armada, Francisco; Muntañer, Carles; Navarro, Vicente

doi:10.2190/70be-tj0q-p7wj-2elu

Cited by 96 publications

(64 citation statements)

References 82 publications

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“…A reforma adotou uma concepção mercantil da saúde, a participação do setor privado no asseguramento e prestação de serviços, a focalização do financiamento estatal nos pobres e a segmentação de benefícios como estratégias para atingir a cobertura universal do seguro de saúde, acentuando a histórica fragmentação institucional, os traços corporativistas e a segmentação do sistema de saúde anterior. Os resultados deste estudo foram consoantes com trabalho de Cantu 22 , que aponta o papel do mercado como alocador de serviços sociais após as reformas da década de 1990; e com Iriart et al 23 e Amada et al 24 , que argumentam que a agenda de reformas da saúde na América Latina permitiu a expansão de empresas seguradoras privadas na administração dos fundos do seguro de saúde.…”

Section: Considerações Finaisunclassified

Trajetória das relações público-privadas no sistema de saúde da Colômbia de 1991 a 2015

2017

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Section: Considerações Finaisunclassified

Trajetória das relações público-privadas no sistema de saúde da Colômbia de 1991 a 2015

2017

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“…En relación con la salud, sus promotores destacaban que las fallas del SNS para responder a las necesidades de la población, se debían a su centralismo e ineficiencia más que al modelo económico del país o a la falta de recursos financieros, y que era necesario implantar reformas estructurales (1) . Dichas reformas se enfocaron en cinco elementos complementarios: a) el incremento de recursos mediante la creación de cobros al usuario y de seguros obligatorios; b) la expansión del sector privado a áreas como la administración y prestación de servicios públicos que previamente se consideraban jurisdicción exclusiva del Estado; c) la separación del financiamiento y la provisión de servicios de salud; d) la introducción de análisis de costoefectividad como criterio para establecer prioridades de políticas y asignar recursos, y e) la retracción del Estado frente a sus responsabilidades con la salud de la población (1,8) .…”

Section: Las Reformasunclassified

Colombia: ¿qué ha pasado con su reforma de salud?

Gómez-Arias

Nieto

2014

Rev Peru Med Exp Salud Publica

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RESUMENLa reforma de salud adoptada en Colombia en 1993 fue promovida por diferentes agencias como el modelo a seguir en materia de política sanitaria. Siguiendo los lineamientos del Consenso de Washington y del Banco Mundial, el Gobierno de Colombia, con el apoyo de élites políticas y económicas nacionales reorganizó la gestión de los servicios de salud con base en principios del mercado, desmontó el sistema estatal, incrementó las finanzas del sector, asignó la administración del sistema al sector privado, segmentó la prestación de los servicios y promovió la interacción de los actores en un esquema de competencia de baja regulación. Después de 20 años de implantación, el modelo colombiano evidencia serias fallas y es objeto de controversia. El Estado se debilitó como ente rector de la salud; los grupos privados que administran los recursos se configuraron como fuertes núcleos de poder económico y político, y aumentaron las vulneraciones al derecho a la salud. Adicionalmente, la corrupción y el sobrecosto de los servicios han puesto en crisis la sostenibilidad del sistema, y la red estatal se encuentra en peligro de cierre. Pese a su desprestigio en el ámbito interno, varios agentes dentro y fuera del país propenden por mantener el modelo con base en reformas coyunturales. Palabras clave: Reforma de la atención de salud, Colombia; Modernización del sector público; Financiación de la atención de la salud (fuente: DeCS BIREME). ABSTRACTThe health reform adopted in Colombia in 1993 was promoted by different agencies as the model to follow in matters of health policy. Following the guidelines of the Washington Consensus and the World Bank, the Government of Colombia, with the support of national political and economic elites, reorganized the management of health services based on market principles, dismantled the state system, increased finances of the sector, assigned the management of the system to the private sector, segmented the provision of services, and promoted interaction of actors in a competitive scheme of low regulation. After 20 years of implementation, the Colombian model shows serious flaws and is an object of controversy. The Government has weakened as the governing entity for health; private groups that manage the resources were established as strong centers of economic and political power; and violations of the right to health increased. Additionally, corruption and service cost overruns have put a strain on the sustainability of the system, and the state network is in danger of closing. Despite its loss of prestige at the internal level, various actors within and outside the country tend to keep the model based on contextual reforms. Key words: Health care reform, Colombia; Modernization of the public sector; Healthcare financing (source: MeSH, NLM). Simposio: Reforma del Sistema de SaludRev Peru Med Exp Salud Publica Simposio INTRODUCCIÓNLa política sanitaria colombiana suele presentarse en algunos ámbitos como el resultado de un proceso eminentemente técnico, derivado de investigaciones serias...

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“…Attendees at such meetings have included Latin American health care leaders who have received financial assistance from corporations, the World Bank, or both. The trade show approach also has provided justification for the World Bank's and IMF's requirements for structural adjustment programs, such as reforms favoring the privatization of health services in developing countries that have benefited U.S. and European corporations (McMichael and Beaglehole 2000;Armada et al 2001;Sen and Koivusalo 1998;Iriart et al 2000Iriart et al , 2001Stocker et al 1999;Freudenheim and Krauss 1999). International organizations such as PAHO and WHO also favored these reforms and designated representatives to participate in the trade shows on managed care (Armada et al 2001).…”

Section: Corporations and International Health Care Marketsmentioning

confidence: 99%

Multinational Corporations and Health Care in the United States and Latin America: Strategies, Actions and Effects

Jasso-Aguilar¹,

Waitzkin²,

Landwehr³

2005

Commercialization of Health Care

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In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector.The process of globalization raises several problems regarding health care and public health. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund (IMF), and World Trade Organization (WTO) have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector (Stocker et al. 1999;Iriart et al. 2001; Rao 1999;Turshen 1999; World Health Report 2000). These policies in turn have affected policies of the World Health Organization (WHO), the Pan American Health Organization, and the U. In addition to these non-commercial organizations, multinational corporations based in the United States have expanded worldwide. Managed care organizations, health care consulting firms, and pharmaceutical and medical equipment companies have entered foreign markets. U.S. industrial corporations also have operated in foreign countries; the participation of workers and the promotion of products in those countries have raised concerns about the impacts on local economies, environmental health, and occupational health (Kim et al. 2000). The "flight" of multinational corporations to f...

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Health and Social Security Reforms in Latin America: The Convergence of the World Health Organization, the World Bank, and Transnational Corporations

Cited by 96 publications

References 82 publications

Trajetória das relações público-privadas no sistema de saúde da Colômbia de 1991 a 2015

Trajetória das relações público-privadas no sistema de saúde da Colômbia de 1991 a 2015

Colombia: ¿qué ha pasado con su reforma de salud?

Multinational Corporations and Health Care in the United States and Latin America: Strategies, Actions and Effects

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