Petro-state constraints on health policy: guidelines for workable reform in Venezuela

    Authors

    A. J. Trujillo

    Comments

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    Abbreviated Journal Title

    Health Policy

    Keywords

    social health insurance; managed competition; petro-state; Venezuela; health care reform; Venezuelan health care system; health economics; INCOME INEQUALITY; LATIN-AMERICA; CARE; MARKET; DEMAND; Health Care Sciences & Services; Health Policy & Services

    Abstract

    This article reviews the performance of the Venezuelan health care sector and suggests guidelines for workable health policy under difficult conditions. Two special circumstances constrain policy options. First, Venezuelans share a traditional value, solidarity, which includes a strong desire for equity. Reforms must comply with this norm to succeed. Second, foreign sales of state-controlled oil constitute the bulk of the government budget and the gross domestic product (GDP). Petroleum market fluctuations expose the country to extreme economic cycles. In response, policy making and stakeholders adopt a rentier attitude, focusing on preserving or enlarging entitlements to government oil monies. The side effects of this largesse include poor productivity, a weak private sector, a widespread sense of entitlement without accountability, and a crippled state which controls most of the available resources yet is unable to effectively tax, regulate, steer the economy, or pursue long-term policies. The health care sector shares these problems. As a result, Venezuela's health systems are fragmented, poorly coordinated, excessively centralized, inequitable, and ineffective. Policies to improve public health and public and private medical care must take into account these constraints. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

    Journal Title

    Health Policy

    Volume

    67

    Issue/Number

    1

    Publication Date

    1-1-2004

    Document Type

    Article

    Language

    English

    First Page

    39

    Last Page

    55

    WOS Identifier

    WOS:000188880200004

    ISSN

    0168-8510

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