IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v121y2017i5p495-503.html

Neoliberal reforms in health systems and the construction of long-lasting inequalities in health care: A case study from Chile

Author

Listed:
  • Rotarou, Elena S.
  • Sakellariou, Dikaios

Abstract

The aim of this article is to discuss how neoliberal policies implemented in the Chilean health system during the Pinochet regime have a lingering effect on equal access to health care today. The two-tier health system – public and private – that was introduced in the early 1980s as a means to improve efficiency and lower health-related costs, has led instead to inequality of access and dehumanisation of health care. Health has changed from being a right to being a marketable need, thus creating a structural disadvantage for several parts of the population – particularly the poor, the elderly, and women – who cannot afford the better-quality services and timely attention of private health providers, and thus, are not adequately protected against health risks. Despite the recent health reforms that aim at improving equity in health care access and financing, we argue that the Chilean health system is still biased against the poorer segments of the population, while it favours the more affluent groups that can afford private health care.

Suggested Citation

  • Rotarou, Elena S. & Sakellariou, Dikaios, 2017. "Neoliberal reforms in health systems and the construction of long-lasting inequalities in health care: A case study from Chile," Health Policy, Elsevier, vol. 121(5), pages 495-503.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:5:p:495-503
    DOI: 10.1016/j.healthpol.2017.03.005
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851017300660
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2017.03.005?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Jose De Gregorio, 2004. "Economic Growth in Chile: Evidence, Sources and Prospects," Working Papers Central Bank of Chile 298, Central Bank of Chile.
    2. repec:idb:brikps:35838 is not listed on IDEAS
    3. Ricardo Sanhueza & Jaime Ruiz-Tagle, 2002. "Choosing Health Insurance in a Dual Health Care System: The Chilean Case," Journal of Applied Economics, Universidad del CEMA, vol. 5, pages 157-184, May.
    4. Angus MADDISON, 2008. "Shares of the Rich and the Rest in the World Economy: Income Divergence Between Nations, 1820–2030," Asian Economic Policy Review, Japan Center for Economic Research, vol. 3(1), pages 67-82, June.
    5. World Bank, 2016. "World Development Indicators 2016," World Bank Publications - Books, The World Bank Group, number 23969, April.
    6. Homedes, Nuria & Ugalde, Antonio, 2005. "Why neoliberal health reforms have failed in Latin America," Health Policy, Elsevier, vol. 71(1), pages 83-96, January.
    7. Andrés Solimano, 2009. "Three Decades of Neoliberal Economics in Chile: Achievements, Failures and Dilemmas," WIDER Working Paper Series RP2009-37, World Institute for Development Economic Research (UNU-WIDER).
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hannah Kuper & Islay Mactaggart & Carlos Dionicio & Rafael Cañas & Jonathan Naber & Sarah Polack, 2018. "Can we achieve universal health coverage without a focus on disability? Results from a national case-control study in Guatemala," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-12, December.
    2. Gloria Macassa & Cormac McGrath & Mamunur Rashid & Joaquim Soares, 2021. "Structural Violence and Health-Related Outcomes in Europe: A Descriptive Systematic Review," IJERPH, MDPI, vol. 18(13), pages 1-14, June.
    3. Elena S. Rotarou & Dikaios Sakellariou & Rafael Pizarro-Mena, 2025. "Satisfaction with Health Facility Personnel Among Older People with Disabilities in Chile: An Observational Study Based on the 2024 DISCA Survey," IJERPH, MDPI, vol. 22(7), pages 1-17, July.
    4. Contreras, Diana & Bhamidipati, Srirama & Wilkinson, Sean, 2023. "Social vulnerability and spatial inequality in access to healthcare facilities: The case of the Santiago Metropolitan Region (RMS), Chile," Socio-Economic Planning Sciences, Elsevier, vol. 90(C).
    5. Hannah Kuper & Tracey Smythe & Antony Duttine, 2018. "Reflections on Health Promotion and Disability in Low and Middle-Income Countries: Case Study of Parent-Support Programmes for Children with Congenital Zika Syndrome," IJERPH, MDPI, vol. 15(3), pages 1-9, March.
    6. Daniel Barredo Ibáñez & Pedro Molina Rodríguez-Navas & Narcisa Jessenia Medranda Morales & Vanessa Rodríguez Breijo, 2021. "Health Transparency and Communication on the Government Websites of Ibero-American Countries: The Cases of Chile, Colombia, Ecuador, and Spain," IJERPH, MDPI, vol. 18(12), pages 1-16, June.
    7. Emrah Konuralp & Sermin Bicer, 2021. "Putting the Neoliberal Transformation of Turkish Healthcare System and Its Problems into a Historical Perspective," Review of Radical Political Economics, Union for Radical Political Economics, vol. 53(4), pages 654-674, December.
    8. Matus-López, Mauricio, 2025. "Scoping review of the literature on the historical and economic evolution of the health systems of Chile, Uruguay, and Costa Rica," MPRA Paper 124790, University Library of Munich, Germany.
    9. Hani Kim & Uros Novakovic, 2021. "Towards Solving Health Inequities: A Method to Identify Ideological Operation in Global Health Programs," IJERPH, MDPI, vol. 18(9), pages 1-13, April.
    10. Jorge A. Acuna & José L. Zayas-Castro & Felipe Feijoo & Sriram Sankaranarayanan & Rodrigo Martinez & Diego A. Martinez, 2022. "The Waiting Game – How Cooperation Between Public and Private Hospitals Can Help Reduce Waiting Lists," Health Care Management Science, Springer, vol. 25(1), pages 100-125, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Banks, William, 2021. "When did Chile fall asleep? An assessment of national and regional income inequality in Chile, 1973-1990," LSE Research Online Documents on Economics 113197, London School of Economics and Political Science, LSE Library.
    2. Jan Fagerberg & Bengt-Åke Lundvall & Martin Srholec, 2018. "Global Value Chains, National Innovation Systems and Economic Development," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 30(3), pages 533-556, July.
    3. Jarosz-Angowska, Aneta & Kąkol, Magdalena, 2016. "Comparative Analysis of Support to Agriculture in the QUAD Countries in 1986-2014," Problems of World Agriculture / Problemy Rolnictwa Światowego, Warsaw University of Life Sciences, vol. 16(31), pages 1-15, December.
    4. Bahta, S. & Temoso, O. & Mekonnen, D. & Malope, P. & Staal, S., 2018. "Technical efficiency of beef production in agricultural districts of Botswana: A Latent Class Stochastic Frontier Model Approach," 2018 Conference, July 28-August 2, 2018, Vancouver, British Columbia 277207, International Association of Agricultural Economists.
    5. Keller, Wolfgang & Utar, Hale, 2023. "International trade and job polarization: Evidence at the worker level," Journal of International Economics, Elsevier, vol. 145(C).
    6. Chrysovalantis Amountzias, 2018. "The Effects of Competition, Liquidity and Exports on Markups: Evidence from the UK Food and Beverages Sector," Journal of Industry, Competition and Trade, Springer, vol. 18(2), pages 187-208, June.
    7. Almeida, Alexandre N. & Bravo-Ureta, Boris E., 2019. "Agricultural productivity, shadow wages and off-farm labor decisions in Nicaragua," Economic Systems, Elsevier, vol. 43(1), pages 99-110.
    8. Alexander W. Cappelen & Benjamin Enke & Bertil Tungodden, 2025. "Universalism: Global Evidence," American Economic Review, American Economic Association, vol. 115(1), pages 43-76, January.
    9. Wigley, Simon, 2017. "The resource curse and child mortality, 1961–2011," Social Science & Medicine, Elsevier, vol. 176(C), pages 142-148.
    10. Iseghohi Judith Omon, 2021. "Migrant Remittances and Health Outcomes in the West Africa Monetary Zones (WAMZ)," Romanian Economic Journal, Department of International Business and Economics from the Academy of Economic Studies Bucharest, vol. 24(81), pages 15-32, September.
    11. David, Oladipo Olalekan, 2019. "Nexus between telecommunication infrastructures, economic growth and development in Africa: Panel vector autoregression (P-VAR) analysis," Telecommunications Policy, Elsevier, vol. 43(8), pages 1-1.
    12. Abdul Malik Iddrisu & Michael Danquah & Peter Quartey, 2017. "Analysis of School Enrollment in Ghana: A Sequential Approach," Review of Development Economics, Wiley Blackwell, vol. 21(4), pages 1158-1177, November.
    13. Tanu M Goyal & Arpita Mukherjee, 2017. "Trade Agreements and Services Value Chain: The Case of India and Thailand," Applied Finance and Accounting, Redfame publishing, vol. 3(1), pages 11-23, February.
    14. Malerba, Daniele, 2020. "Poverty alleviation and local environmental degradation: An empirical analysis in Colombia," World Development, Elsevier, vol. 127(C).
    15. Dorsch, Michael T. & Maarek, Paul, 2020. "Economic downturns, inequality, and democratic improvements," European Journal of Political Economy, Elsevier, vol. 62(C).
    16. Muyambiri, Brian & Odhiambo, Nicholas M, 2017. "The causal relationship between financial development and investment in Botswana," Working Papers 22607, University of South Africa, Department of Economics.
    17. Lars Sorge & Anne Neumann, 2017. "The Nexus of CO2 Emissions, Energy Consumption, Economic Growth, and Trade-Openness in WTO Countries," Discussion Papers of DIW Berlin 1699, DIW Berlin, German Institute for Economic Research.
    18. Martinez-Gutierrez, María Soledad & Cuadrado, Cristóbal, 2017. "Health policy in the concertación era (1990–2010): Reforms the chilean way," Social Science & Medicine, Elsevier, vol. 182(C), pages 117-126.
    19. Elert, Niklas & Henrekson, Magnus, 2017. "Entrepreneurship and Institutions: A Bidirectional Relationship," Working Paper Series 1153, Research Institute of Industrial Economics, revised 05 May 2017.
    20. Bachewe, Fantu Nisrane & Koru, Bethlehem & Taffesse, Alemayehu Seyoum, 2018. "Productivity and efficiency in high-potential areas," IFPRI book chapters, in: The economics of teff: Exploring Ethiopia’s biggest cash crop, chapter 7, pages 149-180, International Food Policy Research Institute (IFPRI).

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:121:y:2017:i:5:p:495-503. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.