A Southern European Country? Social Policy in Uruguay in the 2000s

From the onset, social policy in Uruguay shared many similarities with that in South Europe: it relied primarily on social insurance and covered a larger number of people than in many other Latin American countries. Yet higher levels of labor informality and a larger number of insurance funds led Uruguay to even higher segmentation in the generosity of services between different groups than in Greece, Portugal or Spain. During the 1980s and 1990s, Uruguay moved further away from South European countries. While the latter promoted universal reforms, Uruguay witnessed a retrenchment of state intervention in social affairs following Latin America´s debt crisis and the implementation of policies embedded in the Washington Consensus. In contrast, during the 2000s, the Southern European crisis coincided with an expansionary phase in Uruguay, which pushed the country towards universalism as reflected in the health care reform, the expansion of non-contributory pensions and the enactment of a national care system. This paper studies this last phase of expansion, showing how Uruguay has become the most successful Latin American country and the closest to South Europe. To do so, we explore changes in access, generosity and equity—the three dimensions of universalism (Martínez Franzoni and Sánchez-Ancochea, 2016)—in health care and pension, and the reforms behind these results. We argue that the two primary drivers of these changes were a commodity-driven economic boom and the arrival of the left to power. We conclude with reflections on future comparative work between Uruguay (and other South American countries) and Southern Europe.