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

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  • 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
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    References listed on IDEAS

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    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

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    Cited by:

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    2. 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.
    3. 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.
    4. Goli, Srinivas & Singh, Shreya & Balla, Shalem, 2025. "Glorifying Virchow: Current Debate on Neoliberal Policies and Health Inequalities in India," EconStor Preprints 334356, ZBW - Leibniz Information Centre for Economics.
    5. 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.
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    7. 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).
    8. 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.
    9. 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.
    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.
    11. 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.

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