Suchergebnisse

The paper accounts for the failure of public social spending in Latin America to reach poor and vulnerable groups of the population. It considers the level and allocation of expenditure, the distribution of entitlements across the population and the capacity of different groups to mobilize these entitlements. Whilst total spending levels compare favourably with other developing regions, only a small share is allocated to programmes with greatest potential for poverty reduction. (DSE/DÜI)

Der Aufsatz stellt einen Zusammenhang zwischen sozio-ökonomischem Wandel, staatlicher Politik und dem Wohlergehen älterer Menschen her. Besonders berücksichtigt wird hierbei ein Aspekt der sozialen Mobilität, nämlich die Land-Stadt Migration der älteren Generation. (DSE/DÜI)

This paper highlights the problems of administering health insurance programmes in Latin America and the difficulties of imposing effective reforms. It examines the development, financial collapse and subsequent restructuring of a health insurance programme specifically targeting elderly people in Argentina. By the 1990s the Integrated Healthcare Programme (PAMI) had become one of the largest components of the country's public welfare system, managing an annual budget of US $2.5 billion. It provided elderly people with a wide range of services, including free and discounted medical care and a national network of day centres. The Programme was widely praised as efficient and innovative both within Argentina and beyond and was considered a model which other developing countries might emulate.However, in 1994 it was discovered that PAMI had accumulated a deficit of US $1.3 billion and was suffering from a large number of serious structural weaknesses. These included a complete absence of financial accountability (both internally and externally), the piecemeal expansion of services, employment featherbedding, political patronage and corruption. Also, the Programme had contributed to long‐standing inequalities between different geographical regions and between insured and uninsured populations. Since then, numerous attempts have been made to reform the Programme, some of which have received funding from the World Bank, but these initiatives are only being very gradually implemented.

This article analyses the role of the public sector in

providing social insurance and assistance to the elderly in Argentina

between the late nineteenth century and the present day. It assesses

the extent to which this involvement embodied clear-cut development

paradigms or was driven by political pressures. Between the 1940s and

1970s the public sector enjoyed a monopoly of insurance and assistance


provision, with the private and voluntary sectors largely excluded.

These monopolies failed to provide satisfactory levels of a welfare

and proved financially unsustainable. By the 1980s a gradual process

of pluralisation had begun, which culminated with the partial

privatisation of social insurance in 1994.