Journal
WORLD DEVELOPMENT
Volume 40, Issue 12, Pages 2490-2504Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.worlddev.2012.05.033
Keywords
Latin America; Chile; health reform; political determinants of inequality; implementation; social policy
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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. (C) 2012 Elsevier Ltd. All rights reserved.
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