Abstract
Recent literature on comparative welfare states has recognised the central role international financial institutions (IFIs) play in shaping social policy. Particularly in low‐ and middle‐income countries (LMICs), where constraints often lead to reliance on foreign resources, IFIs can act as agenda‐setters, transferring their ideas to vulnerable governments. The neoliberal model promoted by IFIs at the end of the 20th century reveals their influence on domestic policy in South America. This study analyses the impact of World Bank (WB) prescriptions on healthcare reform legislation in five South American countries: Argentina, Bolivia, Colombia, Paraguay, and Peru. In doing so, it attempts to answer the following questions: Are LMICs receptive to IFIs’ healthcare system prescriptions? More precisely, have WB policy prescriptions been adopted in healthcare reform legislation in South American countries? If so, in what way? Through content analysis, this study examines domestic healthcare legislation vis‐à‐vis the WB’s prescriptions. The main findings show that countries are receptive to IFIs prescriptions, making them a legitimate source of policy recommendations. Further, the results suggest a correlation between economic development and reliance on foreign resources and the degree to which countries adhere to IFIs prescriptions.
Highlights
At the centre of recent comparative literature on the welfare state is the role of international financial insti‐ tutions (IFIs) in shaping domestic policymaking
For low‐ and middle‐income countries (LMICs), which can sub‐ stantially rely on foreign resources, IFIs can use their prominence to influence countries to adopt specific agendas (Clements et al, 2013; Kaasch, 2013)
This research examined how IFIs policy agendas, that of the World Bank (WB), were adopted in domestic legislation in South American LMICs and addressed the following questions: Are LMICs receptive to IFIs’ health‐ care system prescriptions? Have WB policy prescriptions been adopted in healthcare reform legislation in South America? If so, in what way? To answer these ques‐ tions, a content analysis was conducted of key domes‐ tic healthcare reform legislation in Argentina, Bolivia, Colombia, Paraguay, and Peru, vis‐à‐vis the prescriptions set by the WB’s World Development Report: Investing in Health (1993)
Summary
At the centre of recent comparative literature on the welfare state is the role of international financial insti‐ tutions (IFIs) in shaping domestic policymaking. To answer these ques‐ tions, a content analysis was conducted of key domes‐ tic healthcare reform legislation in Argentina, Bolivia, Colombia, Paraguay, and Peru, vis‐à‐vis the prescriptions set by the WB’s World Development Report: Investing in Health (1993). This approach allows for the comparison of reforms in countries with distinct domestic conditions but similar international economic and ideological con‐ texts within a specific timeframe, when a uniform neolib‐ eral agenda was proposed to address the consequences of economic crises in the region. The analysis results are examined, and the findings are used to evaluate how WB policy prescriptions were translated into domestic healthcare legislation
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