Health Care Reform in Mexico and Brazil: The Politics of Institutions, Spending, and Performance

Abstract

Health care reform in Latin America has been a continuous process over recent decades, and several countries have implemented programs of universal care. This dissertation looks at the implementation of universal care programs in Brazil and Mexico, and highlights the politics of implementing these reforms. In the first paper, I evaluate the implementation of infrastructural reforms as part of Seguro Popular in Mexico. I conclude that the reforms were partially successful, but that success varied considerably by region. In the second paper, I show that spending on health care in Brazil is strongly related to political partisanship, and that the reform process has not significantly changed this relationship. In the third paper, I suggest that individual characteristics, and not political variables, best explain variations in the quality of care patients receive in Brazil. As a whole, these papers serve to highlight the understudied role of politics in the implementation of health care reform.