Pandemia, inequidad y protección social neoliberal. Chile, un caso paradigmático

Abstract

El presente estudio tiene como objetivo analizar las políticas de protección social que se dispusieron en Chile para enfrentar la pandemia en el marco de una estructura de bienestar liberal. La protección social se ha visto fuertemente estresada por el impacto de la pandemia del COVID-19, haciendo frente a los graves problemas de desempleo y disminución de ingresos de las familias. El carácter de las medidas dispuestas para la emergencia depende de la estructura de bienestar que han construido los países, siendo Chile un caso paradigmático de régimen neoliberal. Las decisiones para combatir los impactos socioeconómicos han mantenido un carácter subsidiario con fuerte predominio del sector privado, con coberturas focalizadas donde la atención del Estado ha estado centrada especialmente en la población más vulnerable. Las características del reparto de las prestaciones sociales, no han logrado mayores niveles de equidad y cohesión social, sino que por el contrario alejan la posibilidad de proveer prestaciones de carácter universal al no incorporar componentes redistributivos y solidarios en la seguridad social. La continuidad en la estructura de bienestar neoliberal nos lleva a plantear que las políticas sociales, especialmente aquellas vinculadas a la protección social han visualizado y ensanchado las grandes brechas de inequidad en la población.

Access to knee arthroplasty among National Health Fund beneficiaries in Chile between 2004 and 2021

“…Respecto al gasto del bolsillo se estima que un cuarto del costo aproximadamente ha sido asumido por los pacientes del Fondo Nacional de Salud en este periodo, con una tendencia fuerte y significativa al alza en el periodo estudiado, en especial en 2021. Probablemente tres factores influyeron el máximo de acceso a esta cirugía en el sistema privado en 2021: número alto de pacientes demandando la cirugía, disminución significativa de la realización de esta cirugía en 2020 y 2021 en centros de la red pública y la política de los retiros del 10% de los fondos de pensiones que generó liquidez para acceder al sistema privado [16].…”

Unequal Access and Use of Health Care Services among Settled Immigrants, Recent Immigrants, and Locals: A Comparative Analysis of a Nationally Representative Survey in Chile

“…Broader factors and dynamics are also at play regarding the inequities revealed both by the results of the present studies and by previous studies carried out on access and use of healthcare among international migrants in Chile. First, Chile is characterized by a strong private sector that has progressively been handed the provision of essential social protection services, such as pensions, education, and health, with the State providing mainly for the most vulnerable population groups [58]. More specifically, the overall healthcare system in Chile is fragmented between the private and public systems for insurance coverage and the provision of healthcare services.…”

Aging population and mental health vulnerability during COVID-19 in South America

“…Social and health policies were characterized, among other things, by the adoption of models from countries in North America and Europe, largely Italy, Spain and the United Kingdom that had been facing the crisis, or from multilateral organizations (Antognini & Trebilcock, 2021). It should be noted that integrating methods at the different levels of territorial management may play an considerable role in resolving problematic needs and could reduce major crisis.…”

“…It has been projected that by the year 2050 when Argentina will have 50 million inhabitants, 1 in 5 Argentineans will reach 64 years old or approximately 10 million people (Regazzoni, 2010). One of the most controversial policies was the policy called Labor Protection Law (Law 21.227 of April 6, 2020) aimed at workers governed by the Labor Code and affiliated to the unemployment insurance, which considered the temporary suspension of the effects and obligations of the employment contract, i.e., the worker was not obliged to provide services and the employer was not obliged to pay the respective remuneration (Antognini & Trebilcock, 2021). This strategy was strongly criticized by opposition sectors of the government, mainly because of the use of unemployment insurance funds to supplement the income of workers who, due to the health emergency, had to remain at home without the possibility of performing work remotely, as the elders (Antognini & Trebilcock, 2021).…”

“…CHILESince COVID-19 arrived, the government presented in March 2020 an Economic Emergency Plan that committed an investment of US$ 11.750 million to support businesses and households facing the negative impact of the pandemic.The measures provided for the emergency under COVID-19 were mostly of a subsidiary nature with a predominance of the private sector and focused coverage where the State's attention was centered mostly only on the most vulnerable population(Antognini & Trebilcock, 2021). The main axes of the emergency plan were: (a) to reinforce the health system's budget under the constitutional 2% to meet the urgent expenses, (b) to ensure the income of workers, through the access of contributory workers to their resources from unemployment insurance, and the delivery of a monetary transfer (Bono Covid 19) to lower-income households and informal workers, which was aimed at 2 million people with an expenditure of US$130 million, and c) the third axis, aimed at small and medium-sized companies, considered tax measures, including deferrals of tax payments such as monthly provisional payments, corporate income tax, and contributions, among others (Gobierno de Chile, 2020).…”