This paper highlights the institutions, actors and processes that have driven social policy provision and health care in Venezuela during distinct political periods. The historical detail contextualises a protracted struggle over the distribution of the country’s oil wealth. The paper concurs with the importance of democracy, political will and a favourable international context in driving public access to health care but emphasises that situations of institutional and political decomposition as inherited by President Hugo Chávez require researchers and policy makers to engage with non-traditional mechanisms for articulating and responding to health care needs, and the importance of avoiding the temptation of writing these off as crude ‘populist’ experiments. The case of Venezuela illustrates the significant challenge of peacefully addressing the political roots of social inequality and the obstacles that can be posed to improving access to health and social development by conservative opponents and vested interests, including in the trade union movement and nominally social democratic parties.
is Professor of Comparative Politics and Associate Dean for Academic Affairs and Programs, Central European University, and Venezuela in particular. She is specialist on politics, security and development in Latin America, and Venezuela in particular