On either side of the globe, poor people often do not have access to the health services they need. Improvements in health care systems in Asia have lagged behind economic development, and progress in expanding health coverage in Latin America has been skewed across income levels. Health Services in Latin America and Asia takes a close look at how countries in both regions provide health care services, including the strategies that work and the problems that persist. The book documents encouraging progress in Bolivia, Brazil, China and Vietnam, and important preventive care programs in Central America and Thailand. It also examines health services in Chile, Colombia, the Philippines and Malaysia, as well as the health system and insurance model in Japan.Even though public and preventive health require specific and sustained allocations, both regions continue to use health insurance and other supply mechanisms to expand health service coverage. The book recommends broadening the supply of services through family doctors and community health workers, an alternative approach that would likely improve the equity, efficiency and sustainability of services.

Why do some societies fare well, and others poorly, at reducing the risk of early death? Wealth, Health, and Democracy in East Asia and Latin America finds that the public provision of basic health care and other inexpensive social services has reduced mortality rapidly even in tough economic circumstances, and that political democracy has contributed to the provision and utilization of such social services, in a wider range of ways than is sometimes recognized. These conclusions are based on case studies of Argentina, Brazil, Chile, Costa Rica, Indonesia, South Korea, Taiwan, and Thailand, as well as on cross-national comparisons involving these cases and others.

Reshaping Health Care in Latin America: A Comparative Analysis of Health Care Reform in Argentina, Brazil, and Mexico

World Bank Technical Paper No. 274. The preparation of the World Bank's World Development Report 1993: Investing in Health (WDR) included an effort to assemble internationally comparable statistics on a broad range of health and health system indicators. Data had to be compiled from existing sources while analytical efforts were made to improve the quality and comparability of the data. This paper presents an expanded and updated version of the WDR estimates of 1990 health expenditures for the countries of Latin America and the Caribbean. Whereas the population cut-off for inclusion in the WDR was 3 million, these tables include almost all countries in the region. This update of the expenditures results in a substantial upward revision in the estimated percentage of GNP spent on health in the region in 1990 from 4 to 6%.

Spanish summary. The full report examines the public policies of 8 high-performing Asian economies (HPAEs) from 1965 to 1990. It seeks to uncover the role those policies played in the dramatic economic growth, improved human welfare, and more equitable income distribution in Hong Kong, Indonesia, Japan, Malaysia, the Republic of Korea, Singapore, Taiwan (China), and Thailand. HPAEs stabilized their economies with sound development policies that led to fast growth. They were committed to sharing the new prosperity by making income distribution more equitable. Their public policies promoted rapid capital accumulation by making banks more reliable and encouraging high levels of domestic savings. They increased the skilled labor force by providing universal primary schooling and better primary and secondary education. Agricultural policies supported productivity, while requiring only modest taxes. HPAEs kept price distortions in check and welcomed new technology and FDI. Legal and regulatory structures created a positive business environment. Cooperation between governments and private enterprises was fostered. Beyond the fundamentals of accepted macroeconomic management, HPAEs adopted policies at variance with the notion of the level playing field of open-market free enterprise. HPAEs targeted key industries for rapid development. In key areas, resource allocation was strictly managed. Trade in manufactured exports was promoted by government-established marketing institutions. Analysts disagree about the effectiveness of such interventions, but agree that without the foundation of macroeconomic stability and development of human and physical capital, the expansion would not have been so dramatic and sustainable. This report reviews the basic development policies of HPAEs that created macroeconomic stability. It explains why most countries should not use government interventions in today's changing global economy.

Why do some societies fare well, and others poorly, at reducing the risk of early death? Wealth, Health, and Democracy in East Asia and Latin America finds that the public provision of basic health care and other inexpensive social services has reduced mortality rapidly even in tough economic circumstances, and that political democracy has contributed to the provision and utilization of such social services, in a wider range of ways than is sometimes recognized. These conclusions are based on case studies of Argentina, Brazil, Chile, Costa Rica, Indonesia, South Korea, Taiwan, and Thailand, as well as on cross-national comparisons involving these cases and others.

The reform of social security pensions and healthcare is a key issue for the modern world, and in many ways Latin America has acted as a social laboratory for the reform of these systems. This is the first book to comprehensively study these influential reforms in Latin America's pension and health care systems.