Accepted paper:

The consolidation of universalism in Latin America?: The cases of the healthcare systems of Cuba and Mexico


Ricardo Velázquez Leyer (Universidad Iberoamericana)
Lissette Aldama Anguita (Universidad Iberoamericana)

Paper short abstract:

The article analyses the progress towards an authentic universalism in Latin America, by comparing healthcare in Cuba and Mexico. Findings show that internal and external economic and political pressures put at risk the consolidation of universalism in both cases.

Paper long abstract:

The advancement towards a universal model of social policy has formed part of public and political agendas of Latin American countries for several years. This article aims to understand the degree in which that objective has been achieved. The research compares the outputs of healthcare policy in Cuba and Mexico. Healthcare was chosen because it is commonly an area that governments prioritise to expand coverage towards universal coverage. The selected countries represent opposite case studies. On the one hand, Cuba has long been regarded as an extraordinary case of universalism in healthcare in the Global South. Mexico's healthcare system, on the other hand, was characterised throughout the 20th century by its high degree of fragmentation and limited coverage, although in recent years there has been attempted to break with its truncated nature. The analysis adopts the framework of social policy architectures, which compares funding, eligibility, benefits, providers and outside options. By reviewing the recent history of both systems and examining key indicators, the study attempts to stablish the extent in which the systems today achieve the goal of an authentic universalism. Findings show that in spite of the a universalist discourse and recent efforts to strengthen healthcare provision, strong economic and political pressures put at risk the construction of a universal system in Mexico, and the achievements of the Cuban system.

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International social policy and welfare state transitions: towards universalism 2030? (social policy-development studies dialogues)