[Fragmentation, heterogeneity, and challenges facing the Argentine healthcare system in the context of emerging ultraliberal reforms].

Abstract

This study analyzed the characteristics of fragmentation in the Argentine health system and its implications for inequalities in health outcomes. The study covers the period from 1994, the year in which the last constitutional reform was carried out and a process of decentralization and deregulation of health care was promoted, to 2024, marked by a government that proposes to reorganize the health system implementing ultra-liberal measures that could further exacerbate problems of access and equity in the system. The research was conducted based on the following dimensions: (1) political and economic context in Argentina; and (2) characteristics of the fragmentation of the Argentine health system. Secondary sources were analyzed, including scientific articles, official documents and databases, and gray literature. The results indicate that the trajectory of fragmentation of the Argentine health system is characterized by three phases. The first phase (1994-2002) was marked by fragmentation through deregulation and decentralization of functions in the health system, with a loss of national coordination capacity. The second phase (2002-2015) shows the intention to reduce fragmentation and inequalities in health provision through regulation and programs aimed at the most vulnerable population. It was an important period, but the lack of structural changes contributed to the third phase (2015-2024) being characterized by deepening fragmentation, the reduction of the role of the State and ultra-liberal reforms from 2023 onwards. The analysis shows that the Argentine health system needs to be reorganized to prioritize universalization and equitable access.