The front-runner heading into Argentina’s presidential vote on Oct. 22[1] is prone to wielding a chain saw – both physically and metaphorically.
Javier Milei[2], a right-wing libertarian whose brash demagoguery has drawn comparisons to Donald Trump[3] and Brazil’s former President Jair Bolsonaro[4], likes to brandish the power tool at campaign events[5] as a symbol of what he intends to do if elected: cut back on government.
Milei has promised to take his chain saw to the ministries of education, environment and women’s rights[6], to name but a few, and to ax funding for scientific research[7]. The country’s central bank would also cease to exist[8], if Milei fulfills his pledge to “dollarize[9]” Argentina’s economy – that is, to scrap the country’s peso and replace it with the U.S. currency.
Milei promises a radical change to Argentina’s current trajectory. And his attacks on science and education[10] form part of a troubling anti-intellectual, right-wing populism[11] that threatens liberal democracies worldwide.
However, as an expert on the history of public health in Argentina[12], I believe Milei could face stiff resistance if he tries to undo a long-standing consensus on the need for the government to provide universal health care and other social services.
A shock to the political system
A former economics professor[13], Milei is a relative political newcomer, having served just one term in the national congress. As with other right-wing populists, he casts himself as a political outsider.
When it comes to public spending, Milei styles himself as an “anarcho-capitalist[14].” His plans include eliminating both the Ministry of Health and Conicet[15], the agency that funds most academic research in Argentina, and folding them into a new Ministry of Human Capital[16], with a fraction of their current budget and personnel.
Milei’s rhetoric taps into a deep well of discontent[17] among Argentinians with the current government led by Alberto Fernandez, a member of the Peronist party[18], which has held power for most of the past three decades.
Since assuming power in 2019, Fernandez has presided over runaway inflation[19], rising poverty[20] and accusations of official corruption[21].
The government’s handling of the COVID-19 pandemic saw an initial boost in public support for Fernandez[22]. But by the middle of 2021, frustration with the government was starting to boil over – due in part to accusations of preferential priority[23] for COVID-19 vaccinations for Peronist officials and their friends and families.
Meanwhile, for Milei, the pandemic proved to be a catalyst for his rise to political fame[24]. Fanning the flames of public discontent, he appeared frequently on television and in social media to call out a “political caste” for imposing what he deemed unnecessary and economically damaging pandemic restrictions. His popularity has since skyrocketed among young people in Argentina[25], attuned to “anti-progressive” messaging online and exhausted by economic crisis and political corruption. Milei polls much better among men[26], in part because many women are alarmed by his intention to reverse the country’s 2021 legalization of abortion[27].
Health as a social right
Evidently, Milei has tapped into a thirst for sweeping political change[28].
But there is reason to believe that his proposals to reduce the government’s role in the health sector would run into strong headwinds, given the longer-term pattern in Argentina and across the Latin America region.
Today, there is a broad public acceptance[29] of a strong role for government in guaranteeing and protecting the right to health care, along with other “social rights” like education and gender equality.
As I explain in my new book, “In Pursuit of Health Equity[30],” a hemispheric “social medicine” movement has, over the past century, played a key role in the construction of welfare state institutions in many Latin American countries. Led by progressive doctors, left-wing academics and health activists, social medicine – which sees health as being intrinsically tied to socio-economic factors – has sought to build robust health systems as part of a strong social safety net[31]. Social medicine advocates see health as a right rather than a commodity.
In Argentina, Juan Domingo Perón[32], the founder of the populist Peronist movement that Milei now hopes to dislodge from power, understood social medicine. To make Argentina’s population healthier and more productive, in the 1940s Perón expanded the government’s role in health care while advancing policies to improve labor conditions, nutrition and housing[33]