Panama at the Crossroads: Health for All or Profits for Few

Purpose:

Case study analysis of social and healthcare worker responses to a deteriorating public health system in a country with one of the best economic growth indexes of Latin America provides opportunity to look at how a paradigm shift might happen in a world immersed in constant struggle between public health and market commodity interests.

Methods:

Socio demographic, epidemiologic and economic data from credited sources provided the basis for this case study analysis. Triangulation of data from different sources, plus standard data processing, validation, analysis and interpretation, using a combination of quantitative and qualitative methods, provided the results presented here.

Findings:

Construction of mega tertiary health care infrastructure with gross overruns, where huge sums of public monies for health passed into private hands. Meanwhile, deterioration of existing infrastructure, and chaos in human resources planning and management, plus disruption and dysfunction of essential public health functions, created a sanitary crisis. This spurred large social mobilizations of health care workers and other sectors, putting health on the political agenda during a national election year. Most presidential candidates publicly signed formal commitments to rescue the country’s public health system, including the candidate who became President.

Conclusion:

Market forces continue exercising pressure, but there is political will to address the crisis of the public health system. The President has called for a national dialogue with health worker organizations whose mandate is to come up with a new public national health system. This is history in the making, whose outcome will transcend Panama’s borders.