A Review of Social Policy Expansion in Latin America

Social Policy Expansion in Latin America by Candelaria Garay New York: Cambridge University Press, 2016, 393 pp.

The welfare state emerged in middle-income countries in Latin America during the first half of the 20th century when health care services and pensions were granted to workers with formal sector jobs. However, for most of the 20th century, workers who were hired outside the formal market and their dependents did not have access to social protection. This was all too common in a region characterized by massive labor informality, segmented labor markets and relatively high unemployment.

In the last decade of the 20th century and the first decade of the 21st century, a stunning transformation took place—several Latin American democracies extended social protection to these citizens in the informal and rural sectors (often referred to as “outsiders”). Indeed, by 2010, Argentina and Brazil were providing universal health coverage to their populations, pensions were granted to between 80 and 100 percent of adults aged 65 and older in low-income households, and income-support transfers were provided to school-age children on a massive scale. While coverage rates were considerably lower in Mexico and Chile, about half of all senior adults in low-income households were also covered by pension support programs.

In Social Policy Expansion in Latin America, Harvard Kennedy School Associate Professor of Public Policy Candelaria Garay seeks to explain the factors that have driven this dramatic inclusion of these informal and rural workers and their dependents in Argentina, Brazil, Chile and Mexico. Garay theorizes that large-scale non-discretionary social policy expansion is driven by two factors: partisan competition for low-income voters in elections and large-scale grassroots social mobilization. Universal or nearly universal and more generous benefits, termed inclusive social policy design by the author, are more likely to be provided in cases in which social movements and labor allies are actively engaged in pushing for social policy reform. In the absence of social mobilization, social policies will be more restrictive and will be provided to a smaller pool of “outsiders” in a more state-centric welfare system design.

Using comparative policy analysis and process tracing since the establishment of benefits for insiders in the first half of the 20th century, Garay tests her theory with empirical rigor based on original data from multiple sources. Looking for possible explanations, she selects four countries that vary in their level of the institutionalization of the party system, the presence of social movement coalitions, and the size of the outsider population (with Argentina and Chile having relatively smaller outsider populations compared to Mexico and Brazil). Garay argues that increased electoral competition drives incumbents to advance nondiscretionary social programs as policymakers consider that these programs make them less vulnerable to accusations of engaging in politically-motivated policies to secure electoral support and as opposition parties in Congress are more likely to support social policies that have a less discretionary character. She concludes that electoral competition combined with powerful social movement coalitions in Brazil and Argentina, contributed to the adoption of broad-reaching benefits. However, Garay shows that these social movement coalitions operated in different ways. In the case of Argentina, social movements primarily relied on pressuring the government through protests whereas, in Brazil, social movements worked through institutional channels. In contrast, social movements were mostly absent in the cases of Mexico and Chile, and as a result, powerful conservative parties negotiated with opponents in Congress to produce more restrictive benefits.

In addition to the chapters detailing the book’s theoretical framework and a final chapter exploring the broader implications beyond the book’s case studies, the author’s seminal contribution is the four chapters devoted to in-depth case studies for each country. Garay shows that inclusive social policy expansion took place during very distinct democratization stages in Argentina and Brazil. In the case of Brazil, Garay traces the two major expansions to incorporate outsiders that took place underscoring the gradual character of the process which led to the incorporation of deeply excluded populations. The first expansion, and arguably the most comprehensive, coincided with the return to democracy in the late 1980s and early 1990s and resulted in the creation of a universal public health system and pension reforms to incorporate rural workers. These reforms were primarily driven by social movements that successfully lobbied for social service delivery to include community participation in councils in order to promote accountability and responsiveness. The second expansion centered on income-support programs for households (Bolsa Escola and Bolsa Família). Of the two, Garay argues that the increasing need for parties to secure the votes of outsiders is most important in explaining this second policy expansion. Incumbent President Fernando Henrique Cardoso and the PSDB initiated a broad income transfer program targeting the poorest households in the year before the 2002 election, but his party still lost to Luiz “Lula” da Silva of the Worker’s Party (PT). This income subsidy program was subsequently expanded starting in 2004 even though the Lula administration had initially sought to prioritize an anti-hunger program as its key social policy. Garay argues that is because a policy coalition made up of PT politicians who had implemented cash transfers subnationally was more effective in lobbying for a more straightforward top-down program in the context of electoral competition.

In the case of Argentina, Garay contends that the dramatic turnaround to extend social policy coverage was preceded by heightened electoral competition for low-income voters in the 1999 election (fifteen years after the return to democracy in 1983) and increased social mobilization of the unemployed and informal poor workers who subsequently forged alliances with unions. Faced with mounting protests and social upheaval in the late 1990s and early 2000s, programs to strengthen the primary health system, provide income assistance and subsidize prescription drugs were successfully introduced during the Duhalde interim presidency in 2002. Similar to Brazil, inclusive social policy expansion also took place in two waves in Argentina with the second and later wave under the Nestor Kirchner administration between 2003 and 2007 being the more comprehensive one. In this wave, social movements including the unemployed workers’ organization and their union allies successfully agitated for the universalization of contributory pensions to provide high benefit levels comparable to those of low-income formal workers to non-contributory seniors with coverage increasing to incorporate 97% of seniors formerly excluded from the pension system.

In the two cases with more limited social policy expansion, Garay contends that social movements played a more limited role and as result, benefits were restricted in scope and level of benefit. In the case of Mexico, social policy innovations only began in the early years of the democratic transition following the end of 71 years of rule by the Partido Revolucionario Institucional (PRI).

The Vicente Fox administration expanded the conditional cash transfer program started under Ernesto Zedillo, and introduced a health insurance program that provided full coverage to the extremely poor, but charged insurance premiums proportional to household income to the rest of households. Following the 2006 election of Felipe Calderón and fueled by alternative policies advanced by opposition parties, nondiscretionary social policies were once again expanded by the Partido de Acción Nacional (PAN), a conservative party ruling as a minority government.

In the case of Chile, social policy expansion only occurred sixteen years after the transition to democracy as the center-left Concentración party began to experience a constant and more credible challenge to its dominance of the presidency from the UDI and RN conservative opposition parties. However, health reforms were meager and limited to providing services for indigent and low-income outsiders. Most of the most social policies enacted in Chile were directed at increasing the percentage of noncontributory pension coverage while there was a moderate expansion in conditional cash transfers for school-age children from low-income households.

Garay’s volume makes a seminal contribution to scholarship on redistributive politics in developing democracies. It draws attention to a neglected and major transformation that has taken place in Latin America—the dramatic expansion of nondiscretionary social policies in the last decade of the 20th century and the first decade of the 21st century. Garay provides extensive and in-depth empirical evidence to trace the political dynamics that explain why welfare coverage advanced more significantly in some middle-income countries more than others in Latin America. The book is particularly noteworthy because it contradicts the predominant view in contemporary political science that emphasizes patronage and clientelism as the key determinants for understanding social policy provision in Latin America. Future scholars seeking to understand social policies and their effects in Latin America will have to reconcile their theories and results with the powerful arguments advanced in this volume by having to consider how the transition to democracy influences welfare state developments differently depending on political context.