In Search of the “Authentic” Universalism in Latin American Healthcare: A Comparison of Policy Architectures and Outputs in Chile and Mexico

Abstract The article analyses progress towards universal healthcare in Latin America by comparing the cases of Chile, where coverage was expanded and new benefits were added under a dual public-private model, and Mexico, where a voluntary public insurance programme was layered along existing social insurance schemes. The analysis adopts the framework of policy architectures. Both cases register significant equity gaps and segmentation of the population. Still, the Chilean system achieves higher coverage and generosity due to the unification of the public sector. In Mexico, the low quality of public schemes pushes families into unregulated private providers, triggering a process of implicit commodification.