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

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  • Ewig, Christina
  • Palmucci, Gastón A.

Abstract

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.

Suggested Citation

  • Ewig, Christina & Palmucci, Gastón A., 2012. "Inequality and the Politics of Social Policy Implementation: Gender, Age and Chile’s 2004 Health Reforms," World Development, Elsevier, vol. 40(12), pages 2490-2504.
    • Handle: RePEc:eee:wdevel:v:40:y:2012:i:12:p:2490-2504
    DOI: 10.1016/j.worlddev.2012.05.033
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    References listed on IDEAS

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    1. Tokman, Víctor E. & Blackburn, Stephen & Espinosa, Consuelo, 2004. "Alternativas para reducir la discriminación y la segmentación por riesgo en el sistema de salud chileno," Financiamiento para el Desarrollo 5130, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    2. Mark Gradstein & Branko Milanovic, 2004. "Does Libertè = Egalité? A Survey of the Empirical Links between Democracy and Inequality with Some Evidence on the Transition Economies," Journal of Economic Surveys, Wiley Blackwell, vol. 18(4), pages 515-537, September.
    3. Doyal, Lesley, 2000. "Gender equity in health: debates and dilemmas," Social Science & Medicine, Elsevier, vol. 51(6), pages 931-939, September.
    4. Giovanni Andrea Cornia, 2010. "Income Distribution under Latin America's New Left Regimes," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 11(1), pages 85-114.
    5. Brinkerhoff, Derick W., 1996. "Process perspectives on policy change: Highlighting implementation," World Development, Elsevier, vol. 24(9), pages 1395-1401, September.
    6. Crosby, Benjamin L., 1996. "Policy implementation: The organizational challenge," World Development, Elsevier, vol. 24(9), pages 1403-1415, September.
    7. 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.
    8. Timmons, Jeffrey F., 2010. "Does Democracy Reduce Economic Inequality?," British Journal of Political Science, Cambridge University Press, vol. 40(4), pages 741-757, October.
    9. Jacob S. Hacker & Paul Pierson, 2010. "Winner-Take-All Politics: Public Policy, Political Organization, and the Precipitous Rise of Top Incomes in the United States," Politics & Society, , vol. 38(2), pages 152-204, June.
    10. Lipset, Seymour Martin, 1959. "Some Social Requisites of Democracy: Economic Development and Political Legitimacy1," American Political Science Review, Cambridge University Press, vol. 53(1), pages 69-105, March.
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    1. Riumallo-Herl, Carlos Javier & Kawachi, Ichiro & Avendano, Mauricio, 2014. "Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country," Social Science & Medicine, Elsevier, vol. 105(C), pages 47-58.
    2. Martinez-Gutierrez, María Soledad & Cuadrado, Cristóbal, 2017. "Health policy in the concertación era (1990–2010): Reforms the chilean way," Social Science & Medicine, Elsevier, vol. 182(C), pages 117-126.
    3. Porisky, Alesha & Mohamed, Tahira Shariff & Muthui, Patrick Mutinda, 2023. "Kenya’s ‘Universal’ social pension: The politics of registration in Marsabit County," World Development, Elsevier, vol. 164(C).
    4. Hoey, Lesli, 2017. "Reclaiming the Authority to Plan: How the Legacy of Structural Adjustment Affected Bolivia’s Effort to Recentralize Nutrition Planning," World Development, Elsevier, vol. 91(C), pages 100-112.

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