{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:07:32Z","timestamp":1783166852778,"version":"3.54.6"},"reference-count":57,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2006,9,21]],"date-time":"2006-09-21T00:00:00Z","timestamp":1158796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2006,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Latin American national health systems were drastically overhauled by the health sector reforms the 1990s. Governments were urged by donors and by the international financial institutions to make major institutional changes, including the separation of purchaser and provider functions and privatization. This article first analyses a striking paradox of the far\u2010reaching reform measures: contrary to what is imposed on public health services, after privatization purchaser and provider functions are reunited. Then we compare two contrasting examples: Colombia, which is internationally promoted as a successful \u2013 and radical \u2013 example of \u2018market\u2010oriented\u2019 health care reform, and Cuba, which followed a highly \u2018conservative\u2019 path to adapt its public system to the new conditions since the 1990s, going against the model of the international institutions. The Colombian reform has not been able to materialize its promises of universality, improved equity, efficiency and better quality, while Cuban health care remains free, accessible for everybody and of good quality. Finally, we argue that the basic premises of the ongoing health sector reforms in Latin America are not based on the people's needs, but are strongly influenced by the needs of foreign \u2013 especially North American \u2013 corporations. However, an alternative model of health sector reform, such as the Cuban one, can probably not be pursued without fundamental changes in the economic and political foundations of Latin American societies.<\/jats:p><jats:p><jats:bold>Keywords<\/jats:bold> Latin America , Cuba , Colombia , health sector reform , privatization , national health system<\/jats:p>","DOI":"10.1111\/j.1365-3156.2006.01702.x","type":"journal-article","created":{"date-parts":[[2006,9,21]],"date-time":"2006-09-21T14:25:17Z","timestamp":1158848717000},"page":"1604-1612","source":"Crossref","is-referenced-by-count":27,"title":["Colombia and Cuba, contrasting models in Latin America's health sector reform"],"prefix":"10.1111","volume":"11","author":[{"given":"Pol De","family":"Vos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim De","family":"Ceukelaire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Van der","family":"Stuyft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,9,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2190\/70BE-TJ0Q-P7WJ-2ELU"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-311X2002000600032"},{"key":"e_1_2_8_4_1","unstructured":"BakerD&WeisbrotM(2002)The role of social security privatization in Argentina's economic crisis.http:\/\/www.union\u2010network.org\/uniindep.nsf\/0\/60561b99965fca53c1256b9f00245299?opendocument(accessed 12 March 2004)."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/13.1.59"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2190\/DB43-MWPL-2V12-WGXY"},{"key":"e_1_2_8_7_1","volume-title":"The Boom and the Bubble: The US in the World Economy","author":"Brenner R","year":"2002"},{"key":"e_1_2_8_8_1","first-page":"15","article-title":"The changing role and strategies of the IMF and the perspectives for the emerging countries","volume":"20","author":"Cardim de Carvalho FJ","year":"2000","journal-title":"Brazilian Journal of Political Economy"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1020-49892000000700020"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1020-49892000000700018"},{"key":"e_1_2_8_11_1","first-page":"110","article-title":"Desarrollo hist\u00f3rico de la salud p\u00fablica en Cuba","volume":"24","author":"Delgado G","year":"1998","journal-title":"Revista Cubana de Salud P\u00fablica"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2190\/PURT-1LY9-F0BG-RRUD"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2190\/M72R-DBKD-2XWV-HJWB"},{"key":"e_1_2_8_14_1","volume-title":"Cuba's Social Services: A Review of Education, Health and Sanitation","author":"Erikson D","year":"2002"},{"key":"e_1_2_8_15_1","volume-title":"Atenci\u00f3n gerenciada en Chile. 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