Chapter Two: Universalism in Healthcare and Social Citizenship in Chile, Uruguay and Costa Rica

Abstract

This chapter examines the idea of ‘universalism’ by focusing on three democratic, Latin American countries, which each claim to have universal healthcare. Chile, Uruguay and Costa Rica vary according to welfare regime type, suggesting disparities in the underlying principles of universalism and social citizenship. Taking Marshall’s conceptualisation of universalism as the equal status of individuals with regard to access to benefits and participation—according to accepted standards of democratic societies—institutional features of healthcare systems are examined and compared, particularly in terms of how various population groups are treated. The results suggest there are ‘varieties of universalism’ in healthcare, which do not necessarily conform to the expectations derived from welfare regime type. Moreover, this investigation suggests universalism in healthcare is more complex than generally assumed, containing various lines of division, with differential treatment for specific social groups.