The health system in Argentina: an unequal struggle between equity and the market

Abstract

The modern health system of Argentina was developed in 1945-1955, a period of economic bonanza
characterized by industrialization, rapid urbanization and activist labor organizations. During the ensuing
years it evolved in three sectors: public, social security and private, with separate services, population
coverage and funding. While the national Ministry of Health is nominally responsible for general health
policies and regulations, overseeing the general operation of health services, designing preventive medicine
programs and negotiating the coverage and fees of health insurance plans, it has in fact very low leverage to
enforce decisions in the provinces, which are autonomous, as well as in the social security and private sectors,
which are weakly regulated if at all. While the health workforce, medical facilities and level of spending are
acceptable, the fragmentation and segmentation of the system render it highly inequitable and inefficient.
During the 1980s and 1990s, the health system has experienced further transformations, as neoliberal
policies took hold in the country and dictated a reduction of state involvement in social services in favor of
privatization and decentralization of health care. The result has been increased fragmentation, inequity and
inefficacy, as health care is increasingly prey to the economic interests of private corporations (insurance
and pharmaceutical industries), trade union bureaucracies and the medical professional and technology
establishments. The expectation of popular sectors of society are that progressive polices recently enacted
by Congress, and being implemented in the fields of education, retirement pensions and the media, will be
followed with much needed public health policies based on equity and efficiency.