Transnational Diffusion of Health Policy Ideas in Uruguay in the Early Twentieth Century

This article analyzes how policy ideas already adopted in Europe, particularly in France, were taken into consideration for the design of Uruguay's National Public Assistance (NPA) policy. Established in 1910, the NPA was a pioneering government social policy for the time and for the region.

Some have argued that the design of the NPA law followed the secular and republican model instituted in France at the end of the nineteenth century when France established the Assistance Publique, particularly regarding the extent of public assistance to the poor, the role of the state in the provision of health care (as opposed to charity-based provision) and the centralization of health-care services (as opposed to a decentralized health-care system).

We analyze how these revolutionary ideas were discussed by the technicians and politicians who participated in the process that culminated in the approval of the law in Uruguay discussed these revolutionary ideas. We explore the factors that motivated the creation of the commission that developed the law. We also review available documentation on the drafting of the bill and the parliamentary debate that culminated in its approval. We find that the design of the NPA included many ideas diffused mainly from France. The French model was not simply emulated, however. Rather, the authors of the NPA thoroughly analyzed and considered the features and main consequences of the Assistance Publique, suggesting that diffusion in this case was more a process of learning than of simple mimicry.