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Inequality and the Politics of Social Policy Implementation: Gender, Age and Chile’s 2004 Health Reforms

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  • Ewig, Christina
  • Palmucci, Gastón A.

Abstract

Regarding scholarship on the political determinants of inequality, little attention has been paid to policy implementation. We examine the 2004 Chilean health reforms that sought to regulate private insurers, and measure their effects on gender and age inequality. We find that reforms intended to decrease these inequalities largely failed. Analysis of this failure demonstrates the importance of the politics of implementation. When reforms threaten profits, private providers may act to undermine reforms in the implementation process. Given the widespread emergence of private providers in social policy systems, understanding their stakes in implementation is key to more effective, equality-enhancing reforms.

Suggested Citation

  • Ewig, Christina & Palmucci, Gastón A., 2012. "Inequality and the Politics of Social Policy Implementation: Gender, Age and Chile’s 2004 Health Reforms," World Development, Elsevier, vol. 40(12), pages 2490-2504.
    • Handle: RePEc:eee:wdevel:v:40:y:2012:i:12:p:2490-2504
    DOI: 10.1016/j.worlddev.2012.05.033
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    References listed on IDEAS

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    1. Blackburn, Stephen & Espinosa, Consuelo & Tokman, Víctor E., 2004. "Alternativas para reducir la discriminación y la segmentación por riesgo en el sistema de salud chileno," Financiamiento para el Desarrollo 5130, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
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    1. Riumallo-Herl, Carlos Javier & Kawachi, Ichiro & Avendano, Mauricio, 2014. "Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country," Social Science & Medicine, Elsevier, vol. 105(C), pages 47-58.
    2. 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.
    3. Porisky, Alesha & Mohamed, Tahira Shariff & Muthui, Patrick Mutinda, 2023. "Kenya’s ‘Universal’ social pension: The politics of registration in Marsabit County," World Development, Elsevier, vol. 164(C).
    4. Hoey, Lesli, 2017. "Reclaiming the Authority to Plan: How the Legacy of Structural Adjustment Affected Bolivia’s Effort to Recentralize Nutrition Planning," World Development, Elsevier, vol. 91(C), pages 100-112.

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