Santiago, Chile - Crosswalk in long-exposure.

Chile’s New Constitution, the Right to Health, and Health System Reforms

By Marco Antonio Nuñez

During these months of the COVID-19 pandemic in Chile, the need to align the constitutional process with long-postponed structural reforms to the health system has become evident among public health experts.

Capitalizing on this moment might avoid the possibility of a constitutional right to health becoming a dead letter or being reduced only to the prosecution of particular cases, postponing again the aspirations of the majority of Chileans.

Although the Chilean Constitution promulgated under the dictatorship in 1980 and subsequently reformed in several of its chapters recognizes “The right to the protection of health,” it has been tainted by authoritarianism from its origin, and promotes a subsidiary role of the state in health.

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gavel and stethoscope on white background

The Right to Health in the Upcoming Constitutional Debate in Chile

By Veronica Vargas

At this unprecedented COVID moment, health has been revealed as one of our most precious possessions and protecting it has become imperative. The right to health was articulated by the WHO in the Declaration of Alma-Ata of 1978. The upcoming constitutional debate in Chile is an opportunity to re-examine this concept.

The Chilean constitution specifies the right to “free and egalitarian access” to health care. Simultaneously, the constitution guarantees that “each person has the right to choose the health system they wish to join, either public or private.”

These provisions have championed a prospering private health sector, with corporate clinics and a private insurance system that represents almost half of total health spending.

However, this private sector serves less than 20 percent of the population. Nearly 80 percent of the population utilizes public sector insurance. Although the public sector has been expanding its coverage of health services, and health indicators for those with public insurance have been improving, the public sector is chronically underfunded. Public sector health care spending represents only 4% of the GDP.

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Santiago, Chile.

Pragmatism and the Chilean Constitutional Moment

By Sebastián Soto

Chile is heading into a constitutional change.

After 40 years, the Chilean 1980 Constitution, enacted under Pinochet’s rule, but subsequently amended over fifty times, will probably be replaced. On October 25th, a referendum will decide whether or not to call a constitutional convention to change the Constitution.

If the referendum passes, in April 2021 the convention will be called and will have nine months (extendable for three more, if needed) to write a new constitution. If the convention reaches an agreement on a new constitution by 2/3 of its members, a new referendum to approve it will be called during the first semester of 2022.

Social rights are expected to be one of the most contested topics discussed during the process.

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Downtown Santiago, Chile.

The Novel Coronavirus and Civil Rights: An Update from Chile

By Lidia Casas Becerra

As the COVID-19 pandemic continues apace in Chile, a test of the country’s commitment to democracy and the rule of law looms close – in just over a month, a historic referendum will be held on the possibility to change the Constitution.

The plebiscite was a key political demand during the social mobilization after October 19, 2019. But since March 18, 2020, Chile has been under the state of constitutional catastrophe or calamity due to the COVID-19 pandemic, which will continue at least through September 24, 2020.

Due to the pandemic, the date of the plebiscite was moved from April to October 25th after a political agreement between Congress and the executive. Chile does not have a system allowing for either electronic voting or voting by mail.

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Political Map of South American Continent.

Regional Insights for Constitutionalizing the Right to Health in Chile

By Alicia Ely Yamin                                                    

Chile is one of the few countries in Latin America that has not amended its constitution post-dictatorship. That is set to change on October 25th when the country will hold a plebiscite on constitutional reform.

Any new Chilean Constitution may well follow the path of constitutional reform elsewhere in the region. These reforms, which occurred in the late 1980s and 1990s, and more recently in Mexico, expanded social rights through expanding enumerations and/or incorporation of international human rights law into the constitutional text through “constitutional blocs” (bloques de constiucionalidad).

In situating what is at stake, it is important to recall that the evolution of health rights in Latin America is closely linked to contestation over boundaries between private morality and public policy, between individual and social responsibility, and between the role of the state and markets.

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Santiago, Chile.

The Democratic Case for Social Rights in Chile’s Constitutional Moment

By Koldo Casla

We live an era of nationalistic, angry, and xenophobic challenges to human rights, a time in which the “will of the people” is maliciously presented as contrary to human rights. We have seen human rights backlashes consistent with this instrumentalization of the so-called popular will in India, Hungary, Poland, Turkey, the Philippines, the U.S., the U.K. — the list, sadly, could go on and on.

Chile, however, presents a test case for the opposite, an opportunity to refresh the democratic case for social rights, not due to natural or international law, but because human rights is what people demand.

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Santiago, Chile.

The Novel Coronavirus and Civil Rights: A Snapshot from Chile

By Lidia Casas Becerra

On March 18th, the Chilean government resolved, via an executive order, a state of constitutional catastrophe or calamity in response to the novel Coronavirus. Article 32, No. 5 of Chile’s constitution establishes the possibility to suspend certain civil rights based on exceptional circumstances.

Declaring a state of calamity allows the government to adopt a series of measures in the context of the pandemic which include, inter alia, restrictions to freedom of movement and freedom of assembly. The state of exception can last for up to 90 days and could be extended.

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