Health reforms in Latin America: processes and results

Two types of health reforms in Latin America are analysed: one based on insurance and service commodification and the one referred to the unified public systems of progressive governments. Health insurance with explicit service packages has not fulfilled their purposes of universal coverage, equal access to necessary health services and improvement of health conditions but has opened health as a field of profit making for insurance companies and private health providers. The national health services as a state obligation have developed territorialized health services and widened substantially timely access to the majority of the population. The adoption of an integrated and wide social policy has an impact on population well fare. It faces some problems derived from the old health systems and the power of the insurance and medical complex.

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.

5 Jahre seit der normativen Konsolidierung der Stabilität des Staatshaushalts in Spanien. Kritische Analyse, Bilanz und Zukunftsperspektiven

Diese Arbeit führt in erster Linie eine kritische Analyse der normativen Gestaltung in Bezug auf die Stabilisierung des Staatshaushalts während der letzten 5 Jahre unter dem Einfluss des EU-Rechts durch. Anschließend werden die Wirkung und die Auswirkungen dieses Gesetzes bewertet. Abschließend werden einige Vorschläge und Erwägungen zur Zukunft geäußert.

The elderly care and domestic services sector during the recent economic crisis. The case of Italy, Spain and France.

Over the past ten years in Italy, Spain and France, the demographic pressure and the increasing women’s participation in labour market have fuelled the expansion of the private provision of domestic and care services. In order to ensure the difficult balance between affordability, quality and job creation, each countries’ response has been different. France has developed policies to sustain the demand side introducing instruments such as vouchers and fiscal schemes, since the mid of the 2000s. Massive public funding has contributed to foster a regular market of domestic and care services and France is often presented as a “best practices” of those policies aimed at encouraging a regular private sector. Conversely in Italy and Spain, the development of a private domestic and care market has been mostly uncontrolled and without a coherent institutional design: the osmosis between a large informal market and the regular private care sector has been ensured on the supply side by migrant workers’ regularizations or the introduction of new employment regulations . The analysis presented in this paper aims to describe the response of these different policies to the challenges imposed by the current economic crisis. In dealing with the retrenchment of public expenditure and the reduced households’ purchasing power, Italy, Spain and France are experiencing greater difficulties in ensuring a regular private sector of domestic and care services. In light of that, the paper analyses the recent economic conjuncture presenting some assumptions about the future risk of deeper inequalities rising along with the increase of the process of marketization of domestic and care services in all the countries under analysis.    

Immigration in Spain: Integration with Feet of Clay?

The aim of the paper is to analyze the impact of the economic crisis on the integration of the immigrant population in Spain. The Spanish case is singular because during the years of intense immigration achieved a remarkable degree of socio-cultural integration. The paper argues that such integration it has been the result of the confluence of exceptional factors rather than the result of the policy making. From a mixed methodology approach, it shows that, during the period of expansion, two factors of the immigration contribute to their coexistence with native population: finding job and access to public services. But the economic crisis, with its impact in terms of job losses and austerity policies, expose the weaknesses of the Spanish model of integration.

De la moral del sacrificio a la conciencia de la precariedad. Un análisis cualitativo de los discursos sobre la evolución de la crisis en España

La larga crisis económica que padece España está teniendo importantes consecuencias sociales. La más comentada por académicos, mass media y parte del arco político es la fractura social que se está abriendo en el país, ante el aumento de las desigualdades económicas que generan el enorme desempleo y las duras políticas de ajuste del gasto público. Sin embargo, más allá de cuestiones económicas la crisis está haciendo mella de forma muy profunda en el imaginario social del país en relación a las razones y consecuencias de la crisis, tanto a corto como a largo plazo. El objetivo de este artículo es el realizar una valoración de esas percepciones sociales de la ciudadanía en relación con la crisis, centrándonos en un aspecto como es el de la relación de la población española con el consumo de bienes y servicios públicos, en un escenario de hegemonía de la austeridad como única receta anti-crisis. Para ello, realizaremos un análisis de los discursos recogidos en una investigación cualitativa realizada en el año 2014 mediante grupos de discusión. Los resultados muestran un pesimismo enorme de la población en relación al futuro del Estado del Bienestar y de la propia clase media española, junto a una frustración que puede anunciar futuros ciclos de movilización social.

Keynes’s "Treatise on Money" and the role of the State

Este artículo hace una reconstrucción crítica de la visión de Keynes sobre la relación entre gasto público, tipo de interés, salarios y desempleo, tal y como se formula en su Tratado sobre el Dinero. El trabajo defiende que el enfoque de Keynes lleva a propuestas de política económica que enfatizan la necesidad de intervención estatal directa en la provisión de bienes y servicios. Esta conclusión se deriva de una interpretación circuitista de su obra.

Cultural policy models and cultural facilities models: from national to local models. Analysis of Barcelona’s case

The development of cultural policy analysis by social science has been produced a theorization about cultural policy models from sociology and political science. This analysis shows the influence of the national model of cultural policy on the forms of governance and management of cultural facilities. However, in this paper we will defend that currently the local model of cultural policy decisively influences the model of cultural institutions. This is explained by the growing importance of culture in local development strategies. In order to demonstrate this we will analyze the case of the Barcelona Model of local development and cultural policy, that is characterized for the level of local government leadership, multilevel governance, the use of culture in urban planning processes and a tendency to use public-private partnership in public management. This Model influences the genesis and development of the cultural facilities and it produces a singular and relatively successful model.

Conditional cash transfer programs and the representations of poverty in Bolivia and Peru

Bolivia and Peru adopted the same instruments of social policy —conditional cash transfer programs— to solve the same public problems under different political regimes. By means of the qualitative methodology of discourse analysis, this paper studies the representations of poverty and State made by key actors of those social programs. Underlying more differences than similarities, one demonstrates that the same social policy is linked to opposite social representations of poverty and the State role in every country. The main explanation for this is, far from being imposed by international organizations, those programs are adopted and adapted by each political regime.

El diagnóstico de la crisis de la cultura en España: del recorte público a la crisis sistémica

Desde su invención en los años cincuenta, la política cultural ha sido objeto de análisis y reflexión por parte de las ciencias sociales. No obstante, en España presenta una serie de características diferenciadoras frente a las democracias occidentales europeas como consecuencia del periodo franquista. Con la recuperación de la democracia España adquiere el paradigma dominante de una política cultural democrática basada en la libertad, el pluralismo y el derecho a la cultura. Sin embargo, tras décadas de gobiernos democráticos el diagnóstico de la política cultural en España presenta rasgos de crisis sistémica, además de los efectos de la crisis global financiera de inicios del siglo XXI. En este contexto, los autores diagnostican, aplicando la metodología Delphi y recurriendo a fuentes secundarias, un conjunto de discursos sociales y narrativas que parecen funcionar como recursos cognitivos solucionistas en la esfera artística y cultural y que no están exentos de contradicciones y aporías, fruto de su contraste empírico.