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

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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.

Original languageEnglish (US)
Pages (from-to)39-55
Number of pages17
JournalHealth Policy
Volume67
Issue number1
DOIs
Publication statusPublished - Jan 2004
Externally publishedYes

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Keywords

  • Health care reform
  • Health economics
  • Managed competition
  • Petro-state
  • Social health insurance
  • Venezuela
  • Venezuelan health care system

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy

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