Health systems reforms in latin america: Neoliberal influences and challenges to the sustainable development goals

Abstract

This study analyzes the characteristics of health system reforms in Latin American and Caribbean (LAC) countries, the trend of public health spending, and the achievement of the Millennium Development Goals (MDGs). It also discusses the neoliberal influences on public health reforms and the possible consequences for the upcoming Sustainable Development Goals (SDGs). The study is a comparative, non-exhaus-tive literature review of selected countries, with data extracted from CEPALStat, Global Health Observatory, MDG Indicators platforms, and the Health in the Americas reports available in the Institutional Repository for Information Sharing of the Pan American Health Organization. The reforms were divided into three periods, namely: up to 1990, with a prevailing regulated national solidarity logic; 1990-2000, moving towards a market-oriented competitive logic; 2001-2015, evolving towards public logic programs, main-taining competition between service providers. Public spending fluctuated over time, and the MDG targets analyzed were not completely met. Changes in health systems followed the models prescribed by neoliberalism, with market-orient-ed competitive logic, weakening the care system and the achievement of the SDGs.