This article looks at the health sector in Chile between 1990 and 2000 to examine the obstacles that policymakers face in implementing reforms. Given that the health sector is highly politicized, it is important to pay attention not only to what kind of reforms are needed but even more to how the desired reforms may be implemented. The author identifies the key actors in the Chilean health sector and shows how the given politico-institutional context allowed them to obstruct reforms. As a result, the health sector came to be characterized by paralysis, despite widespread recognition that reforms were needed, and despite an awareness that large numbers of Chileans were more concerned about health than political issues.
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