Background facts on the National Health Service. A tale of debate and contradictions. Chile 1932-1952

Abstract

I present the outcomes of a piece of historiographical research concerning the genesis of the Chilean National Health Service in the national political, social and health context of the period 1932 - 1952. The peculiar timing of the health and social security system developments which began during the twenties and culminated in the passing of the 1952 NHS Law is here explained, along with the problems which were taking place among the political actors of thet period, particularly within the Frente Popular. The contradictions arising then around the conceptualization of health allow us to understand their strong and durable consequences in the government decisions concerning socialized versus liberal medicine. The latter was introduced even when a State health care system existed. My analysis focuses on the latency interval between 1941 and 1952. I find that it was the intervention of the Chilean Workers’ Confederation that forced the initiation of the debate around the NHS Bill. It is obvious that the changes in the health care system arose out of complex negotiations under the control of the existing powers and under the influence of the Cold War, and that the resulting agreements were always far from perfect. I conclude that the Chilean political regime of that time was not ripe for profound changes, but only for gradual reform, under the dominance of the conservative sectors.