Abstract
Health care system preparedness did not correlate consistently with policy performance during the COVID-19 pandemic. In Brazil and Peru, the preparedness of health care systems was inversely related to the perceived political risks associated with the spread of COVID-19. Lack of preparedness of the Peruvian health care system heightened fears of a system crash and thus encouraged a more stringent initial response by President Martín Vizcarra, the political actor both most accountable and able to act. In Brazil, the combination of a robust health care system and the highly fragmented political system enabled President Jair Bolsonaro to politicize the pandemic and prioritize economic growth while blaming his opponents for what he considered excessively costly public health measures. La preparación del sistema de atención de salud no se correlacionó de manera consistente con el desempeño de las políticas durante la pandemia de COVID-19. En Brasil y Perú, la preparación del sistema de salud estaba inversamente relacionada con los riesgos políticos percibidos asociados a la propagación de COVID-19. La falta de preparación del sistema de salud peruano aumentó los temores de un colapso del sistema de atención médica y, por lo tanto, dio lugar a una respuesta inicial más estricta por parte del presidente Martín Vizcarra, el actor político más responsable y capaz de actuar. En Brasil, la combinación de un sistema de salud robusto y un sistema político altamente fragmentado permitieron que el presidente Jair Bolsonaro politizara la pandemia y priorizara el crecimiento económico mientras culpaba a sus oponentes por lo que consideraba medidas de salud pública excesivamente costosas.
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