The Politics of Universal Health Coverage: Mechanisms in the Process of Healthcare Reform in Bolivia

Abstract

AbstractThis chapter explores the mechanisms shaping the progress towards universal health coverage in Bolivia. By investigating this process, unfolding in the context of a health care system characterised by fragmentation, segmentation and low coverage; increasingly challenged as democratisation and popular mobilisation brings the demands of previously excluded groups onto the political agenda; the study casts light on mechanisms that are also of broader relevance for the comparative literature on the politics of social protection in the Global South. The analyses highlight expert theorisation, class-based mobilisation, social movement–state interaction, alarmed middle classes, provider resistance and professional autonomy as the main mechanisms responsible for driving, impeding and shaping the progress towards universal social protection.