The 130th Annual Meeting of APHA

Abstract #42204

Francisco Armada, MD, MPH, Ministry of Health and Social Development, Apartado 3449, Carmelitas, Caracas, 1010, Venezuela, 58-414-3026847, farmada@jhsph.edu, Carles Muntaner, MD PhD, Behavioral and Community Health, University of Maryland, 655 West Lombard Street, Baltimore, MD 21201, and Oscar Feo, MD, MSc, Health Policy, Instituto Altos Estudios Arnoldo Gabaldon, Escuela de Malariologia, Av. Bermudez, Maracay, Venezuela.

During the last decades most Latin-American countries have experienced health reforms, under political guidance from international financial institutions such as the World Bank. They have reinforced the role of the private sector in the financing and delivering of health services. Venezuela has not been an exception and a reform passed through its congress in 1997. However, the adoption of a new political constitution in 1999 recognized the right to health and introduced a different health policy. Contrary to the 1997-law, the constitution envisioned the development of a NHS to be publicly financed and managed. It also established major guidelines including: prohibition of cost-recovery; equity in the promotion of health; decentralization; prioritization of preventive activities; and prohibition of privatization of public-owned health services. In the year 2000 the executive branch of the government led a legislative initiative for the drafting of new health legislation and consigned a draft to the Congress. We compare the 1997-health bill and the 2000-health draft that underscores major policy differences between two competing approaches (i.e., neoliberal and socialdemocratic), emphasizing possible impacts on health and health services inequalities. We also analyze the scope of specific policies included in the law such as advertising restrictions, development of a drug industry, patient rights, alternative medicine, and indigenous populations health. We identify the major stakeholders and some of their means to support or oppose the bill. Finally, we discuss the strengths and weaknesses of the bill and their possible repercussion in the region as an alternative approach to health reform.

Learning Objectives:

• Describe the major features of the latest Venezuelan Health Reform.
• Discuss the political context of health reform in Latin America during the 1980s and 1990s.
• Recognize the difference between the neoliberal and the social-democratic approach to health reform in Latin America

Keywords: Politics, Health Care Reform

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Ministry of Health and Social Development (Venezuela)
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment