The election of self-proclaimed anarcho-capitalist Javier Milei as president of Argentina on 19 November has raised questions over the future of South America’s second largest economy and one of the continent’s strongest healthcare systems.
Much of the discussion over Milei’s victory centred on the 53 year old’s eccentric personal life, which includes a stint as a frontman in a Rolling Stones tribute band, and his radical economic plans.
The libertarian hopes to adopt the American dollar, eliminate the central bank, and cut back state expenditure to mend the country’s economy.
At a rally in the city of La Plata the president-to-be wielded a chainsaw—a gesture symbolic of the deep cuts he hopes to make to the Argentine state.
“The changes our country needs are drastic. There is no room for gradualism,” he told jubilant crowds waving flags in Buenos Aires on the eve of his victory.
The economist is most recognised for his work as a TV pundit where he vehemently criticised the country’s economic mismanagement, but was unknown to most Argentinians just a few years ago.1
His campaign platform and manifesto suggest he will try to slash state spending to tame runaway inflation of more than 140%.
“El Loco,” as Milei is nicknamed, has won support from Donald Trump, Jair Bolsonaro, and Elon Musk among other outspoken libertarians for rallying against Argentina’s political class.
Milei has made outlandish comments, including that he wants to legalise the sale of human organs, but his health plans are not yet entirely clear.
“According to what Milei stands for, it implies a dramatic reduction of public money, including the healthcare budget,” former Argentinian health minister Adolfo Rubinstein told The BMJ.
Milei wants to shift all Argentinians to a full prepaid health insurance system, though it remains unclear how this will work for people who cannot afford a plan. Around half of Argentinians rely on healthcare provided through a trade union health system where part of their salary goes to the unions to manage members healthcare plans. A further 30% get their health costs covered by free national or local hospitals and 20% have private health insurance.2
Though there are concerns for the impact of the possible cuts to the quality of Argentinian healthcare, some of Milei’s ideas have the backing of experts. “Some of the circulating ideas are generic concepts that would be supported by most of the public health community,” Rubinstein said.
Among his more sober proposals is consolidating Argentina’s more than 300 social health insurance funds, Rubinstein said. “Argentina’s healthcare system performs well on several key indicators compared with other South American countries. Outcomes lag the country’s potential, however, given that it is one of the leaders in the region with respect to healthcare spending per capita and human development,” added Rubinstein.
Argentina spends nearly 10% of its gross domestic product (GDP) on healthcare.
Rubinstein said, “Many of Argentina’s healthcare shortcomings arise from its pluralistic and fragmented system which is divided into three large sectors—the public, social security, and private sectors—as found in many Latin American countries. “
Milei also wants to revamp PAMI, the social health fund for the elderly, which “takes 1% of the GDP and is a source of political misuse,” Rubinstein said.
Milei’s policy will become clearer as he appoints a team and takes office in December. What the far right economist can achieve will be limited by the fact his party controls only 38 of 257 seats in Argentina’s lower house and eight of 72 in the senate.
Abortion advocates fear one of his first targets will be access to the procedure.
Argentina became a regional trailblazer in abortion access in 2020 when it legalised abortion and its implementation has already been a huge health success story, said Agustina Ramón Michel from the Buenos Aires based research centre, the Centre of State and Society Studies.
“The implementation of the abortion law contributed to the reduction of maternal mortality and fertility among girls and adolescents. In addition, the number of hospitals and public health centres that offer safe abortions doubled, and the state trained more than 500 health professionals to improve the quality of care, among other actions,” said Ramón Michel.
Milei and people close to him are staunchly anti-abortion and are expected to try and reverse the law.3
“This is a curious and rather strange combination. They want to bring modernisation to the country, but at the same time they bring proposals of social and cultural backsliding such as criminally threatening mothers to be,” said Ramón Michel.
