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AbstractMost Latin American countries have extensive social policies which absorb high levels of state spending. Despite this, Latin America continues to suffer from high levels of inequality in terms of income and access to basic services. This article explores this apparent paradox. It focuses on three aspects of social policy in the region: patterns of resource allocation, the distribution of welfare entitlements and differing capacities to take advantage of these entitlements. It applies this framework to study the distributional effects of education, health and social security policies, paying particular attention to recent changes and developments. The article shows that these three factors combine in various ways to benefit higher‐income groups and exclude the poor. Recent changes have marginally improved provision for low‐income groups, but the fundamentally inegalitarian nature of social policy in the region remains largely unchanged and unchallenged.

ABSTRACTDrawing on quantitative survey data and in‐depth interviews, this article seeks to map out the potential direct and indirect effects of simple cash transfers on households in impoverished rural and urban settings. Brazil is shown to have an extensive system of old age pensions, which affords almost universal coverage to households containing older people. These benefits have a significant impact on levels of poverty and vulnerability in recipient households. They also facilitate access to essential healthcare items, such as drugs, which are seldom freely available through the state health system. The in‐depth interviews reveal that pensions can have important effects on intra‐household relations, but these effects were not generalizable nor easily captured by quantitative survey tools. There was clear evidence that pensions reduced the propensity of older people to remain economically active, but this must be understood in a context of limited employment opportunities for all age groups and a high prevalence of disability. Overall, the article demonstrates the complex effects of a relatively simple cash transfer, which policy makers need to take into account.

Abstract Social health insurance (SHI) has gained popularity in recent years as a health‐care funding mechanism for developing countries in Latin America and beyond. This is reflected in a number of high‐profile conferences sponsored by international agencies, and a profusion of externally funded reform projects. This article assesses the potential of SHI to provide a sound model of health‐care financing, drawing on the experiences of Argentina and Mexico. It uses four criteria to assess the performance of SHI: coverage, equity, effectiveness and sustainability. The article begins by outlining key principles of SHI and comparing it to other models of health‐care financing. It then gives a comparative overview of four SHI programmes in Argentina and Mexico, before analysing their performance in greater detail. The article finishes by extracting lessons from this comparative analysis, both for the countries studied and for global debates on SHI.

The article examines the problems facing a programme to finance health care for pensioners in Argentina, known as PAMI. The programme is accumulating large deficits and many of its services are of doubtful quality. PAMI's problems and its resistance to reforms are put in the wider context of Argentina's liberalised health‐care system, neo‐liberal adjustment and flawed governance. The Argentine experience has relevance for other developing countries with weak state regulatory capacity, and points to the dangers of delegating health financing of older people to the private sector.

AbstractThis paper assesses the usefulness of Nussbaum's version of the capabilities approach for understanding the condition of older people in developing countries. It observes that ageing is a highly heterogeneous experience, but that policy debates take a polarized approach. The paper then summarizes key elements of Nussbaum's approach, relates these to older people, and identifies a key distinction between older people's internal capabilities and structural factors related to the environment they inhabit. The paper puts forward a new framework, which combines capabilities and life‐course perspectives. The policy implications of this framework are then explored. Copyright © 2002 John Wiley & Sons, Ltd.