Globalization, International Financial Institutions and Health Expenditure in Latin America and the Caribbean

• In Event: 286 - Section on Sociology of Development Roundtable Session (one-hour).
  In Paper Session: Table 05. Policy

Abstract

Welfare state research on social spending and the welfare state has focused on developed countries. Both political and medical sociologists have noted that even in this context, health policies and spending have been marginalized. Scholars have traditionally suggested that globalization creates new downward pressures on social, among them health, spending – with countries competing for foreign investments – resulting in a race to the bottom and a reduction in public commitments to health. In particular, international financial institutions (IFIs) are seen as promoting a neoliberal logic that has steadily gained traction in national policymaking since the 1980s – emphasizing a reduction in social provision by government. More recently, however, scholars have noted that the logic of human capital investment might promote spending on health. This paper tests these propositions by examining the determinants of overall, public and private health spending in Latin America and the Caribbean between 1995 and 2008. Results suggest that demographic factors driving changes in health spending, consistent with modernization theories. World Bank conditions are not associated with lower spending, which is consistent with discussions of its promotion of human capital investment though IMF programs are associated with lower spending. I discuss the implications of these results which indicate that we need to further unpack the effects of these neoliberal organizations on health expenditure and that these institutions may sometimes be working at cross-purposes.

Author

• Shiri Noy, University of Wyoming