Sociopolitical Determinants of International Health Policy
Citation
De Vos, P. & Van der Stuyft, P. (2015) Sociopolitical Determinants of International Health Policy, International Journal of Health Services, vol. 45, , pp. 363-377,
Abstract
For decades, two opposing logics have dominated the health policy debate: a comprehensive
health care approach, with the 1978 Alma Ata Declaration as its cornerstone,
and a private competition logic, emphasizing the role of the private sector.We present
this debate and its influence on international health policies in the context of changing
global economic and sociopolitical power relations in the second half of the last
century. The neoliberal approach is illustrated with Chile's health sector reform in
the 1980s and the Colombian reform since 1993. The comprehensive public logic- is
shown through the social insurance models in Costa Rica and in Brazil and through the
national public health systems in Cuba since 1959 and in Nicaragua during the 1980s.
These experiences emphasize that health care systems do not naturally gravitate
toward greater fairness and efficiency, but require deliberate policy decisions.