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https://ajph.aphapublications.org/doi/full/10.2105/AJPH.91.10.1592#_i7
“How effective is government spending on public health in Latin America."
I. Introduction
A. Background information on public health in Latin America
Government spending on public health
in Latin America has been a topic of debate for
many years. While some argue that it is
effective in improving the overall health
outcomes of the population, others believe that
there are significant challenges and limitations
to its effectiveness. Where the help they are providing do not cover all the expenses due to
mismanagement. This paper will cover if government spending is helping or hurting public
health the Latin American community in the studies due to fiscal spending.
II. Overview of government spending on public health in Latin America
Latin America has had many fluctuations with economic spending through the years and
where they have allocated their money According to the public Expenditure in Latin America:
Trends and Key Policy Issues Prepared by Benedict Clements, Christopher Faircloth, and Marijn
Verhoeven they go into depth on their fiscal spending on trends in public expenditure in Latin
America from the mid-1990s to 2006 and discusses key policy issues. As recorded there push in
public spending has not have had public health a priority where social protection and education
take a higher investment then health does in Latin America as seen on Table 7. It displays that
they are second smallest region next to emerging Asia that contributes percent of their GDP to
health, with emerging Asia total GDP is smaller than Latin America.
III. Discussion on how government spending has improved healthcare facilities and
infrastructure in Latin American countries.
Latin America has had many programs that have tried to jumpstart their public health.
For example the article “NCD Prevention and Control in Latin America and the Caribbean” The
Carmen Network of National Chronic Disease Program Managers, WHO Collaborating Centers,
and NGOs has recently undergone a significant strengthening and expansion, now encompassing
32 countries.
V: Examples of specific programs and initiatives implemented by governments in Latin America
to improve public health
In the NCD Prevention and Control in Latin America and the Caribbean it online the
initiatives undertaken by the Pan American Health Organization (PAHO) to facilitate
advancements in the planning and execution of country-driven measures aimed at combating
noncommunicable diseases (NCDs). Additionally, it highlights the mechanisms endorsed by
PAHO to encourage countries in the Americas to exchange and leverage each other's experiences
in addressing NCDs. ( James Hospedale, page 175)
In the article Health and Expenditure in Latin America and the Caribbean this article
presents the results of a study commissioned by the Latin American and Caribbean Technical
Department of the World Bank to document and analyze health expenditures in Latin America
and the Caribbean. In 1990, the countries of this region spent US$ 69 billion on health, with an
average per capita health expenditure of US$ 162. On average the article present that the Latin
America countries have spent 6.2% of their GDP on health, with the expenditures divided about
equally between the public and private sectors. In both the public and private sectors, per capita
health expenditures were positively and significantly related with per capita income. However,
this relationship holds only for the public sector, when health expenditures are measured as a
proportion of GDP. With increasing income, the countries relied more on public expenditures to
finance healthcare. Based on the limited time series data, it’s shown that there was a variation
among countries regarding the proportion spent on capital investments, primary health care, and
drugs, but not on salaries. ( Ramesh Govindaraj, page 158) In the article it is clear that external
assistance plays a minor role in overall health financing in the Latin America region, comprising
just under 1 percent of the total health expenditure. However, there is significant variability in
foreign aid dependence among the countries of Latin America
V. Chile Reform
Private health insurance companies, known as Instituciones de Salud Previsional
(ISAPREs), were introduced, allowing individuals to opt out of the public system by contributing
7% of their salary to their chosen ISAPRE. These ISAPREs offered various health plans, but
until the early 1990s, they could restrict or void contracts for beneficiaries with expensive or
chronic health problems.
The creation of ISAPREs has led to socioeconomic division, with wealthier individuals
opting for private insurance. About 22% of the population in Chile is enrolled in ISAPREs,
accounting for 43% of all health expenditures. Despite being younger, healthier, and more
educated, ISAPRE beneficiaries spend more than the rest of the population. Additionally,
geographical convenience and better-equipped public services sometimes lead ISAPRE
beneficiaries to use government healthcare facilities. ( N. Homedes, A. Ugalde / Health Policy
71 (2005) Page 88)
IV. Changes in Latin American Social medicine
In the article, Social Medicine Then and Now: Lessons From Latin America elaborated
on how social medicine organizations across Latin America have underscored the impact of
global policies. Traditionally, the government in Latin America efforts inquired into the
repercussions of the exploitation of cheap labor, and the extraction of raw materials. In more
recent times, these groups have shifted their focus to international macroeconomic policies and
the influential role played by multinational corporations and lending agencies. The issue of
foreign debt as discussed. in Third World countries has become a major concern, with attention
directed towards public sector cutbacks, the privatization of public services where public health
has had a cut back. The entry of multinational corporations into healthcare markets have been
shrunk down as well. Studies in this area highlight the adverse effects on service access as the
public sector's "safety net" weakens.
V. Conclusion
Final thoughts on the overall effectiveness and importance of government spending on public
health in Latin America