Looking Out, Working In: Health Systems Models in Argentina, Costa Rica, and Peru

• In Event: 401 - Regular Session. Development 2

Abstract

While research has pointed to the importance of foreign models in local policy-making the details of how these models are conceptualized by policymakers are little understood. I draw from over interviews with national policy makers, civil society actors, and international organization personnel working in health in Argentina, Costa Rica, and Peru which ask them what healthcare models they think their country should follow. In doing so, I uncover the state of policymakers’ thinking: do they compare their countries’ health system to their neighbors’ and other regional countries as suggested by some existing research? Or do they expand beyond their surroundings, citing those countries with more advanced welfare states and health systems, notably European countries? Results reveal that the attributes and legacies of these countries’ health systems, as well as the positions and training of the policymakers themselves affect how and whether they are willing to rely on foreign models. In Costa Rica, a country with a strong healthcare system, policy makers are less willing to rely on foreign models, though they do cite desirable traits abroad. In Argentina, the political structure—its status as a federal state, guides many of policymakers’ comparisons. In Peru, on the other hand, policymakers are much more willing to articulate foreign (both Latin American and developed country) models for emulation. I conclude by discussing the importance of considering policymakers’ conceptual frames for understanding policy change and diffusion, especially in the developing world.

Author

• Shiri Noy, University of Wyoming