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Latin American Research Review 42.2 (2007) 181-201

Social Security In Latin America
Pension and Health Care Reforms in the Last Quarter Century
Reviewed by
Carmelo Mesa-Lago
University of Pittsburgh
Crucial Needs, Weak Incentives: Social Sector Reform, Democratization, And Globalization In Latin America. Edited by Robert R. Kaufman and Joan M. Nelson. (Washington, D.C. and Baltimore: Woodrow Wilson Press and Johns Hopkins University Press, 2004. Pp. 542. $55.00 cloth, $24.95 paper).
El Sistema De Pensiones En Chile En El Contexto Mundial Y De América Latina: Evaluación Y Desafíos. Edited by Oficina Internacional del Trabajo (OIT). (Santiago: Ponencias del Seminario Internacional, 2004. Pp. 174).
Health Sector Reform In Bolivia: A Decentralization Case Study. By World Bank. (Washington, D.C.: A World Bank Country Study, 2004. Pp. 94. $15.00 paper).
Innovaciones En El Sistema De Salud En América Central: Lecciones E Impactos De Nuevos Enfoques. Edited by Gerard M. La Forgia. (Washington, D.C.: Documento de Trabajo del Banco Mundial, No. 60, 2005. Pp. 241. $30.00 paper).
Keeping The Promise Of Social Security In Latin America. By Indermit Gill, Truman Packard, and Juan Yermo. (Stanford: Stanford University Press and World Bank, 2005. Pp. 341. $75.00 cloth, $39.95 paper).
Learning From Foreign Models In Latin American Policy Reform. Edited by Kurt Weyland. (Washington, D.C. and Baltimore: Woodrow Wilson Press and Johns Hopkins University Press, 2004. Pp. 302. $60.00 cloth, $22.95 paper).
Protección Social Y Mercado Laboral. Edited by Fabio M. Bertranou. (Santiago: Oficina Internacional del Trabajo, 2004. Pp. 197).

Social Security in Latin America

During the last quarter century, the most significant social policy transformation in Latin America has been pension and health care reforms. Total [End Page 181] or partial pension privatization has spread to twelve countries in the region, influenced similar changes in Central and Eastern Europe, and become a point of reference in the debate on reform in some Western European countries and the United States. Health care reforms have been implanted in all countries but with less impact abroad. The seven books reviewed in this essay address these issues; two of them also treat unemployment and education, reforms of lesser importance that will not be treated here due to space limitations. Five of the books are edited collections. In total there are more than sixty authors and thirteen countries involved, as well as different approaches to the reforms, therefore, it is impossible in this essay to do justice to these books, let alone touch on all contributions.

The books deal with the following topics: the influence of foreign models in general, and specifically in the pension reforms of Argentina and Brazil, as well as the health reforms in Colombia and Mexico (Weyland); politics of health care reform in Argentina, Brazil, Colombia, Costa Rica, Mexico and Peru (Kaufman and Nelson); relationship between the labor market and employment with social security coverage, focusing on Argentina, Chile and Uruguay (Bertranou); evaluation by three World Bank experts of the results of structural pension reforms in ten Latin American countries in the last decade (Gill, Packard, and Yermo); Chile's pension reform within the Latin American context (OIT); health care innovations involving the private sector and their effects in five Central American countries (La Forgia); and health care reform in Bolivia (World Bank).

Pension Reforms

The 1994 World Bank report, Averting the Old Age Crisis: Policies to Protect the Old and Promote Growth, eventually became the world paradigm for structural pension reforms that totally or partially privatized public systems. The Chilean reform of 1981 preceded said report and together with the international financial institutions (IFIs: the World Bank, International Monetary Fund, and Inter-American Development Bank ) influenced similar structural reforms in nine other Latin American countries in 1993–2006: Argentina, Bolivia, Colombia, Costa Rica, Dominican Republic, El Salvador, Mexico, Peru, and Uruguay. Ecuadorian and Nicaraguan structural reform laws had not been implemented by the end of...


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