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 language | English (US) |
|---|---|
| Pages (from-to) | 39-55 |
| Number of pages | 17 |
| Journal | Health Policy |
| Volume | 67 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2004 |
| Externally published | Yes |
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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
Cite this
Petro-state constraints on health policy : Guidelines for workable reform in Venezuela. / Trujillo, Antonio Jose.
In: Health Policy, Vol. 67, No. 1, 01.2004, p. 39-55.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Petro-state constraints on health policy
T2 - Guidelines for workable reform in Venezuela
AU - Trujillo, Antonio Jose
PY - 2004/1
Y1 - 2004/1
N2 - 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.
AB - 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.
KW - Health care reform
KW - Health economics
KW - Managed competition
KW - Petro-state
KW - Social health insurance
KW - Venezuela
KW - Venezuelan health care system
UR - http://www.scopus.com/inward/record.url?scp=0347355428&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0347355428&partnerID=8YFLogxK
U2 - 10.1016/S0168-8510(03)00084-8
DO - 10.1016/S0168-8510(03)00084-8
M3 - Article
C2 - 14726006
AN - SCOPUS:0347355428
VL - 67
SP - 39
EP - 55
JO - Health Policy
JF - Health Policy
SN - 0168-8510
IS - 1
ER -