Interest mobilization in public health and social insurance: Argentina, Colombia, and Mexico in comparative perspective

AuthorViviane Brachet‐Márquez,Guillermo V. Alonso,Mónica Uribe Gómez
DOIhttp://doi.org/10.1002/pa.1407
Date01 November 2014
Published date01 November 2014
Special Issue Paper
Interest mobilization in public health and
social insurance: Argentina, Colombia,
and Mexico in comparative perspective
Viviane Brachet-Márquez
1
*, Guillermo V. Alonso
2
and
Mónica Uribe Gómez
3
1
El Colegio de México, Mexico City, Mexico
2
Universidad Nacional de San Martín-CONICET, San Martín, Argentina
3
Universidad de Guanajuato, Campus Leon, Mexico
One revealing test for gauging the extent to which pluralist democracy has advanced in the recently (re)democratized
countries of Latin America is to determine the extent to which interest groups have come to participate in policy
making in formal, open, extensive, and accepted ways as they mostly do in advanced liberal democracies. In other
words, is this a new era or more of the same? To provide insights into this question, using six hypotheses, this article
compares social insurance reform in Argentina and Mexico, and public health reform in Colombia.
It appears that the political processes through which the reforms were adopted were fairly democratic, although
aspects of the old regimes in all three countries, particularly corporatist relationships, were indispensable backups.
The weaknesses that were apparent, however, stem less from the old ways of doing political business and more from
the immaturity of the democratic process. Plus, pressures were felt by the executive branches and their allies to show
to the international community that their country was a safe place in which to invest. Copyright © 2012 John Wiley &
Sons, Ltd.
INTRODUCTION
The 1980s and 1990s saw two majordevelopments in
the political economies of Latin American countries.
On the one hand, there was a resurgence of demo-
cratic procedures. This meant a return to electoral
competition, the legitimacy of opposition, and in-
creasing direct public involvement of interest groups
and social movements in the policy process. On the
other hand, the regions countries experienced nan-
cial destabilization, economic restructuring along
neoliberal lines, as well as social welfare reforms, all
of which adversely affected the means of livelihood
and quality of life of millions of Latin Americans,
and do to this day.
This paradoxical situation has been repeatedly
pointed out particularly in connection with the
difculties it presents for the success of democracy
(Bresser Pereira et al., 1993; Acuña, 1995). There is,
however, a need to examine case-by-case how these
widely unpopular neoliberal reforms have been
adopted despite adverse public opinion and the pre-
sence of active and vocal opposition that could no
longer be ignored or suppressed as in the days of
authoritarian regimes. In turn, this leads to ask what
andwhowerethemainforcesinvolvedintheadop-
tion of these reforms, what resources they used to
attain their objectives, and whether, in the pursuit of
their political and policy goals, they respected demo-
cratic procedure or tended to circumvent them.
These questions directly relate to the issue of how
interest groupsin Latin America, whether institution-
alized or emergent, or whether internal or external,
have functioned after (re)democratization. To what
extent have theycome to participate in policy making
in formal, open,extensive, and accepted ways as they
do in advanced liberal democracies, as opposed to
the privileged restricted, unofcial, and clandestine
elite access characteristic of interest activity in
the regions authoritarian past? To draw on the
explanation of the difference between power groups,
interests, and interest groups proposed in the intro-
ductory article to this Special Issue, a way to answer
this question is to assess the extent to which the
*Correspondence to: Viviane Brachet-Márquez, El Colegio de
México, Mexico City, Mexico.
E-mail: brachet@colmex.mx
Journal of Public Affairs
Volume 14 Number 3 pp 346358 (2014)
Published online 14 February 2012 in Wiley Online Library
(www.wileyonlinelibrary.com) DOI: 10.1002/pa.1407
Copyright © 2012 John Wiley & Sons, Ltd.

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