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.

The Spanish reforms on domestic work regulation

This paper analyses the latest Spanish reforms regarding domestic work. The Spanish legislator, doubtlessly influenced by the ILO Domestic Work Convention nº 189 – which, however, was not later ratified in Spain- made a deep reform on domestic work in 2011. This legal reform implied a striking change that affected both working conditions and social security of employees in the family home. The aim of this reform has been to bring the regulation in domestic work closer to the general regulation for other workers, although maintaining certain specialties. Regarding working conditions, their setting as “particular employment relationship” has been held. However, the differences between this relationship and the common ones have been reduced. As for social security, domestic employees have been incorporated into the General Social Security System, but with important specialties, thus erasing the Special Domestic Employees System. The paper also examines the legal changes that have taken place in this field after the new Government arose.