However, as an expert on the history of public health in Argentina[12], I believe Milei could face stiff resistance if he tries to undo a long-standing consensus on the need for the government to provide universal health care and other social services.
A shock to the political system
A former economics professor[13], Milei is a relative political newcomer, having served just one term in the national congress. As with other right-wing populists, he casts himself as a political outsider.
Milei’s rhetoric taps into a deep well of discontent[17] among Argentinians with the current government led by Alberto Fernandez, a member of the Peronist party[18], which has held power for most of the past three decades.
But there is reason to believe that his proposals to reduce the government’s role in the health sector would run into strong headwinds, given the longer-term pattern in Argentina and across the Latin America region.
Today, there is a broad public acceptance[29] of a strong role for government in guaranteeing and protecting the right to health care, along with other “social rights” like education and gender equality.
As I explain in my new book, “In Pursuit of Health Equity[30],” a hemispheric “social medicine” movement has, over the past century, played a key role in the construction of welfare state institutions in many Latin American countries. Led by progressive doctors, left-wing academics and health activists, social medicine – which sees health as being intrinsically tied to socio-economic factors – has sought to build robust health systems as part of a strong social safety net[31]. Social medicine advocates see health as a right rather than a commodity.
In Argentina, Juan Domingo Perón[32], the founder of the populist Peronist movement that Milei now hopes to dislodge from power, understood social medicine. To make Argentina’s population healthier and more productive, in the 1940s Perón expanded the government’s role in health care while advancing policies to improve labor conditions, nutrition and housing[33]
Later, politically active academics took on prominent roles in health planning in the leftist governments of Brazil, Argentina and Bolivia in the late 1990s and early 2000s, opposing market-based reforms and the incursion[35] of a U.S. health care model that critics say puts profit over people.
Healthy approval ratings
Milei’s popularity suggests another swing in the pendulum of Latin American politics, which has tended to oscillate between state-centered and free-market-oriented models.
Yet his more extreme proposals are likely to meet resistance.
As Argentinian scholar Maria Laura Cordero[38] and I found in our survey during the pandemic[39], Argentinians have mostly positive feelings toward public health institutions and the people who work in them, coupled with intense disdain for the political class. Around 67% of those we surveyed approved of the performance of the health sector, compared with 22% approval of political leadership during the pandemic.
There is broad consensus about a fundamental right to health care in Argentina, as elsewhere in Latin America[42]. And the public, by and large, understands that government intervention is necessary to make health care accessible to the poor and to respond to public health emergencies like the recent pandemic.
Health workers, deeply invested in the precepts of social medicine, are sure to resist Milei’s attempts at health reform. In response to Milei’s plans, the president of the Argentine Public Health Association stated that “solidarity and the building of the common good are present in the DNA[43]” of health personnel in Argentina. The public is also likely to worry at the prospect of increased fees and the lack of coverage for basic health care needs.
Research under attack
Milei hasn’t won anything yet, nor is there a clear rightward tilt in Latin American politics – in the past two years, leftist presidential candidates have prevailed in countries as varied as Brazil, Chile, Colombia and Guatemala. But even if he fails to push through his radical agenda, the rhetoric of his campaign could serve to undermine confidence in Argentina’s health and science institutions.
Such attacks on government support for scientific research, health care and education are consistent with a global right-wing ideology, typified by the likes of Viktor Orban of Hungary or Ron DeSantis[45], a Republican presidential candidate in the U.S.
Within the bottom-line mentality of neoliberalism – a political ideology that preaches free-market reforms over state involvement – such research is seldom viewed as profitable, nor does it tend to offer the possibility of new therapies or technologies produced by “hard” sciences and modern biomedicine.
But as the history of Latin American social medicine shows, social scientists can counter that, with time, their approach has helped build more just, free and healthy societies. And that legacy is now at stake as Argentinians head toward the polls.
However, as an expert on the history of public health in Argentina[12], I believe Milei could face stiff resistance if he tries to undo a long-standing consensus on the need for the government to provide universal health care and other social services.
A shock to the political system
A former economics professor[13], Milei is a relative political newcomer, having served just one term in the national congress. As with other right-wing populists, he casts himself as a political outsider.
Milei’s rhetoric taps into a deep well of discontent[17] among Argentinians with the current government led by Alberto Fernandez, a member of the Peronist party[18], which has held power for most of the past three decades.
But there is reason to believe that his proposals to reduce the government’s role in the health sector would run into strong headwinds, given the longer-term pattern in Argentina and across the Latin America region.
Today, there is a broad public acceptance[29] of a strong role for government in guaranteeing and protecting the right to health care, along with other “social rights” like education and gender equality.
As I explain in my new book, “In Pursuit of Health Equity[30],” a hemispheric “social medicine” movement has, over the past century, played a key role in the construction of welfare state institutions in many Latin American countries. Led by progressive doctors, left-wing academics and health activists, social medicine – which sees health as being intrinsically tied to socio-economic factors – has sought to build robust health systems as part of a strong social safety net[31]. Social medicine advocates see health as a right rather than a commodity.
In Argentina, Juan Domingo Perón[32], the founder of the populist Peronist movement that Milei now hopes to dislodge from power, understood social medicine. To make Argentina’s population healthier and more productive, in the 1940s Perón expanded the government’s role in health care while advancing policies to improve labor conditions, nutrition and housing[33]
Later, politically active academics took on prominent roles in health planning in the leftist governments of Brazil, Argentina and Bolivia in the late 1990s and early 2000s, opposing market-based reforms and the incursion[35] of a U.S. health care model that critics say puts profit over people.
Healthy approval ratings
Milei’s popularity suggests another swing in the pendulum of Latin American politics, which has tended to oscillate between state-centered and free-market-oriented models.
Yet his more extreme proposals are likely to meet resistance.
As Argentinian scholar Maria Laura Cordero[38] and I found in our survey during the pandemic[39], Argentinians have mostly positive feelings toward public health institutions and the people who work in them, coupled with intense disdain for the political class. Around 67% of those we surveyed approved of the performance of the health sector, compared with 22% approval of political leadership during the pandemic.
There is broad consensus about a fundamental right to health care in Argentina, as elsewhere in Latin America[42]. And the public, by and large, understands that government intervention is necessary to make health care accessible to the poor and to respond to public health emergencies like the recent pandemic.
Health workers, deeply invested in the precepts of social medicine, are sure to resist Milei’s attempts at health reform. In response to Milei’s plans, the president of the Argentine Public Health Association stated that “solidarity and the building of the common good are present in the DNA[43]” of health personnel in Argentina. The public is also likely to worry at the prospect of increased fees and the lack of coverage for basic health care needs.
Research under attack
Milei hasn’t won anything yet, nor is there a clear rightward tilt in Latin American politics – in the past two years, leftist presidential candidates have prevailed in countries as varied as Brazil, Chile, Colombia and Guatemala. But even if he fails to push through his radical agenda, the rhetoric of his campaign could serve to undermine confidence in Argentina’s health and science institutions.
Such attacks on government support for scientific research, health care and education are consistent with a global right-wing ideology, typified by the likes of Viktor Orban of Hungary or Ron DeSantis[45], a Republican presidential candidate in the U.S.
Within the bottom-line mentality of neoliberalism – a political ideology that preaches free-market reforms over state involvement – such research is seldom viewed as profitable, nor does it tend to offer the possibility of new therapies or technologies produced by “hard” sciences and modern biomedicine.
But as the history of Latin American social medicine shows, social scientists can counter that, with time, their approach has helped build more just, free and healthy societies. And that legacy is now at stake as Argentinians head toward the polls.
