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Canadian Journal of Public Health

, Volume 97, Issue 6, pp I19–I24 | Cite as

Challenging the Neoliberal Trend

The Venezuelan Health Care Reform Alternative
  • Carles Muntaner
  • René M. Guerra SalazarEmail author
  • Sergio Rueda
  • Francisco Armada
Article
  • 1 Downloads

Abstract

Throughout the 1990s, all Latin American countries but Cuba implemented to varying degrees health care sector reforms underpinned by a neoliberal paradigm that redefined health care as less of a social right and more of a market commodity. These health care sector reforms were couched in the broader structural adjustment of Latin American welfare states prescribed consistently by international financial institutions since the mid-1980s. However, since 2003, Venezuela has been developing an alternative to this neoliberal trend through its health care reform program called Misión Barrio Adentro (Inside the Neighbourhood). In this article, we introduce Misión Barrio Adentro in its historical, political, and economic contexts. We begin by analyzing Latin American neoliberal health sector reforms in their political economic context, with a focus on Venezuela. The analysis reveals that the major beneficiaries of both broader structural adjustment of Latin American welfare states and neoliberal health reforms have been transnational capital interests and domestic Latin American elites. We then provide a detailed description of Misión Barrio Adentro as a challenge to neoliberalism in health care in its political economic context, noting the role played in its development by popular resistance to neoliberalism and the unique international cooperation model upon which it is based. Finally, we suggest that the Venezuelan experience may offer valuable lessons not only to other low- to middle-income countries, but also to countries such as Canada.

MeSH terms

Barrio Adentro health policy health care reform Venezuela Latin America 

Résumé

Au cours des années 1990, tous les pays latino-américains sauf Cuba ont mis en œuvre à des degrés divers des réformes de leur secteur de la santé soutenues par un système de pensée néolibéral qui redéfinissait les soins de santé comme une marchandise plutôt qu’un droit social. Ces réformes de la santé s’inscrivaient dans les efforts généraux d’ajustement structurel des États-providence d’Amérique latine, uniformément prescrits par les institutions financières internationales à partir du milieu des années 1980. Cependant, depuis 2003, le Venezuela travaille à une solution de rechange à la tendance néolibérale: un programme de réforme des soins de santé appelé Misión Barrio Adentro («dans le quartier»). Dans cet article, nous situons Misión Barrio Adentro dans son contexte historique, politique et économique, et nous analysons les réformes néolibérales du secteur de la santé en Amérique latine d’après le cadre politique et économique du Venezuela. Cette analyse montre que les principaux bénéficiaires, tant des grands ajustements structurels des États-providence latino-américains que des réformes néolibérales de la santé, ont été les intérêts capitalistes transnationaux et les élites des pays d’Amérique latine. Nous présentons ensuite dans le détail les aspects politico-économiques de Misión Barrio Adentro comme facteurs de remise en question du néolibéralisme dans les soins de santé, en soulignant le rôle joué par la résistance populaire au néolibéralisme dans l’élaboration du programme et le modèle de coopération internationale unique sur lequel il repose. Enfin, nous suggérons que l’expérience du Venezuela pourrait être riche en leçons, non seulement pour d’autres pays à faible revenu et à revenu intermédiaire, mais aussi pour des pays comme le Canada.

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Copyright information

© The Canadian Public Health Association 2006

Authors and Affiliations

  • Carles Muntaner
    • 1
  • René M. Guerra Salazar
    • 1
    Email author
  • Sergio Rueda
    • 1
  • Francisco Armada
    • 2
    • 3
  1. 1.Faculty of Nursing and Department of Public Health Sciences, Faculty of MedicineUniversity of TorontoTorontoCanada
  2. 2.Ministerio de Salud y Desarrollo SocialCanada
  3. 3.Venezuelan Ministry of Health)Canada

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