Table Of ContentB A N K I N G O N H E A LT H
The World Bank and Health Sector
Reform in Latin America
SHIRI NOY
Banking on Health
Shiri Noy
Banking on Health
The World Bank and Health Sector
Reform in Latin America
Shiri Noy
Department of Sociology
University of Wyoming
Laramie, WY, USA
ISBN 978-3-319-61764-0 ISBN 978-3-319-61765-7 (eBook)
DOI 10.1007/978-3-319-61765-7
Library of Congress Control Number: 2017944600
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To my parents, Ori and Dalia Noy
A
cknowledgements
One of the reasons I find sociology so useful is that it highlights the
social nature of individual undertakings. This book would not have been
possible without the support of so many people. I owe a great debt of
gratitude to my dissertation committee, as this project began at Indiana
University, Bloomington. Patricia McManus has been an incredibly gen-
erous and formidable mentor throughout the years. Together with the
rest of my committee, Art Alderson, Clem Brooks, Bernice Pescosolido,
and Brian Steensland, she has provided incisive and constructive feed-
back on this project. I am also indebted to Brian Powell, who has always
made himself available for questions and comments. I have also been
fortunate to count on the personal and intellectual support of many
friends and colleagues: Aaron Ponce, Abby Shaddox, Alya Guseva, Ann
McCranie, Anna Zajacova, Carly Schall, Carrie Larson, Casey Oberlin,
Christi Smith, Claudia Geist, Dana Prewitt, Dave Messenger, Dee
Redmond, Dean Noy, Donna Barnes, Emily Bowman, Emily Meanwell,
Evie Perry, Fabio Rojas, Jaime Kucinskas, Jamie and Deb Prenkert,
Jenn and Dave Chonowski, J.D. Wolfe, Jelena Radovic Fanta, Jenny
Stuber, Joe DiGrazia, Joe Harris, John and Carrie Shandra, Julia Obert,
Juliana Martinez Franzoni, Kevin and Kelly Doran, Kyle Dodson, Laura
Hamilton, Mandy Stewart, Marina Gerbin Landau, Malcolm Holmes,
Matthew Painter, Michael Vassuer, Rashawn Ray, Richard Machalek,
Ronen Noy, Sarah Hatteberg, Sharon Hamilton, Tanja Vuckovic Juros,
Tiffany Julian, and Tim O’Brien.
vii
viii ACKNOWLEDGEMENTS
I am especially grateful to all of the people who were so kind to me
in Lima, Buenos Aires, and San Pedro and San Jose where I conducted
my country case-study research. I especially thank my respondents for
their generosity with their time, experiences, and information. In Peru,
I thank Mariana, Adam, and Orit Pollak as well as the dearly departed
Eugene and Aurelia Farkas (who I lovingly knew as Tata and Bobbi) who
so kindly hosted me and made my stay so comfortable and wonderful.
They are my second family, and they graciously open their home to me
each time I visit. I also thank José Alberto Castro Quiroz and Liliana
Vasquez who were especially helpful and whose office in the Ministry
of Health became my headquarters of sort. In Costa Rica, I thank the
Instituto de Investigaciones Sociales (IIS) at the University of Costa
Rica that graciously hosted me during my time there and especially Koen
Voorend and Fran Robles. In Buenos Aires, I thank Nacho Bontempo
who made me feel so welcome and Federico Tobar and Carlos Vassallo,
who were among my first interviewees and opened many subsequent
doors for me. I also thank the several transcriptionists in all three coun-
tries who helped me transcribe these interviews. I would not have been
able to accomplish this research without funding from the Sociology
department, the Center for Latin American and Caribbean Studies, and
the Office for the Office of the Vice President for International Affairs
at Indiana University. I am also thankful for the financial support from
a National Science Foundation Dissertation Improvement Grant, an
American Sociological Association Fund for the Advancement of the
Discipline Grant, and a University of Wyoming Basic Research Grant.
I am grateful to my editor at Palgrave Macmillan, Alexis Nelson, and
editorial assistant Kyra Saniewski who were extraordinarily helpful and
gracious in shepherding this book to publication. I thank my family for
being so encouraging, in particular my brothers, aunts, uncles, cousins,
and grandparents. I dedicate this book to my parents who have always
supported me in everything I do, and are responsible for nurturing my
curiosity—academic and otherwise. Without this sense of adventure, the
desire to know how things work, especially in other places, I never would
have embarked on this research.
c
ontents
1 The World Bank, Development, and Health 1
2 Neoliberalism and the World Bank’s Changing
Approach to Health 45
3 The State of Health in Latin America: Trends
and Correlates of Health Expenditures 65
4 Argentina: Mixed Outcomes While Coping
with Crisis in a Planner State 93
5 Peru: Slow, Steady Health Reform in a Weak State 119
6 Costa Rica: The Challenges of Maintaining
Universalism in a Strong State 145
7 Banking on Health: Variable Approaches
and Contingent Outcomes 169
ix
x CONTENTS
Methodological Appendix: Comparative, Mixed-Methods
Research: Challenges, Opportunities, and Some Practical Tips 189
Works Cited 235
Index 237
l f
ist of igures
Fig. 1.1 Comparison of cases along the analytical dimensions
of state capacity and autonomy in health 30
Fig. 2.1 Development assistance for health globally, 1990–2013 57
Fig. 2.2 Development assistance for health in Latin America
and the Caribbean, 1990–2013 58
Fig. 3.1 Trends in health spending in Latin America and the Caribbean 77
Fig. A.1 World Bank health sector-related projects in Argentina,
Costa Rica, and Peru, approved between 1980 and 2005 204
xi
