중남미

The main purpose of this paper is to elucidate the political meaning of health care reform in Argentina. Argentina introduced its health care reforms under neoliberalism in 1990s. Originally, Argentine health care system had strong populist nature by allowing workers in the formal sector to organize their own health care system, Obras Sociales, while the state offered the others public health care. Under the reform, Menem(1989-99) regime tried to implement a dual system where Obras Sociales and private health care compete over beneficiaries, while the state manages public health care for whom the other health insurances do not cover. To do so, Menem regime introduced market principles into Obras Sociales by liberalizing contracts between Obras Sociales and private health providers. Furthermore, with the reform, workers could choose Obras Sociales regardless of their workplace. Needless to say, this reform has negative effects on the economic power, eventually political power, of labor union in Argentina. From these facts, the paper raises some research questions: ‘1) How could the health care reform be possible in Argentina where the labor union has strong political power?, 2) What is the role of the labor union in the process of health care reform? and What is the results of reform in Argentina?’To answer these research questions, the paper scrutinizes the process and results of Argentine health care reform during the Menem regime. In conclusion, the paper argues that particular characteristic of the relations between the Peronist party and the labor union in Argentina determined the type and results of health care reform in Argentina. That is, the strong but dependent relation between the Peronist party and the labor union limits the autonomous power of labor union. Therefore, the labor union in Argentina cannot fully resist against the health care reform, even though the reform would effect adversely on the power of the labor union. In the same vein, the Peronist party cannot fully proceed to the reform, because the labor union is still an important political resource for the party. Therefore, the Argentine health care reform in 1990s resulted in a mixed type in which the competition among Obras Sociales and private insurance companies has been introduced while the labor union keeps the rights to manage Obras Sociales.