National and Subnational Governments in the Argentine Health Sector. Institutional Changes and Effects on Intergovernmental Relations

Abstract

This paper aims to analyze the trajectory of relations between national and subnational governments regarding the provision, financing, and regulation of health services in Argentina. Intergovernmental relations are examined from the beginning of the 20th century to the present.

When the Constitution was ratified from 1853 to 1860, responsibilities regarding health were not delegated to the central government and remained under the control of the provinces. This was a decisive factor in the distribution of responsibilities and competencies. Then, the 1994 Constitutional Reform granted the national state responsibilities as guarantor of the right to health.

The article explores the dynamics and changes in intergovernmental relations in the health sector, based on policies promoting centralization and decentralization. The analysis does not address social welfare or the pension system.