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

  • Ewig, Christina
  • Palmucci, Gastón A.
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    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.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0305750X12001556
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    Article provided by Elsevier in its journal World Development.

    Volume (Year): 40 (2012)
    Issue (Month): 12 ()
    Pages: 2490-2504

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    Handle: RePEc:eee:wdevel:v:40:y:2012:i:12:p:2490-2504
    Contact details of provider: Web page: http://www.elsevier.com/locate/worlddev

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    1. Giovanni Andrea cornia, 2009. "Income Distribution under Latin America’s New Left Regimes," Working Papers - Economics wp2009_16.rdf, Universita' degli Studi di Firenze, Dipartimento di Scienze per l'Economia e l'Impresa.
    2. Thomas, John W. & Grindle, Merilee S., 1990. "After the decision: Implementing policy reforms in developing countries," World Development, Elsevier, vol. 18(8), pages 1163-1181, August.
    3. Crosby, Benjamin L., 1996. "Policy implementation: The organizational challenge," World Development, Elsevier, vol. 24(9), pages 1403-1415, September.
    4. Gradstein. Mark & Milanovic, Branko, 2002. "Does Liberte = Egalite ? A survey of the empirical links between democracy and inequality with some evidence on the transition economies," Policy Research Working Paper Series 2875, The World Bank.
    5. Brinkerhoff, Derick W., 1996. "Process perspectives on policy change: Highlighting implementation," World Development, Elsevier, vol. 24(9), pages 1395-1401, September.
    6. Doyal, Lesley, 2000. "Gender equity in health: debates and dilemmas," Social Science & Medicine, Elsevier, vol. 51(6), pages 931-939, September.
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