Wellbeing, Health, and Welfare Regime: A Qualitative Analysis of Dealing with Health Problems Temuco, Chile and San Jose, Costa Rica.

Chile and Costa Rica have similar health indicators on the macro level, even though the health systems are organized by different welfare regimes: the liberal and social-democratic. We ask: To what extent do the logics of opportunities as shaped by welfare regimes (the interplay of markets, the state, communities and households) play out in everyday life for households and for their wellbeing? We analyze the way households practically deal with health issues, and what repercussions these have on their wellbeing and other life domains. We focus on households in precarious prosperity defined as a position of material wellbeing between secure prosperity and poverty. Such households usually belong to socially heterogeneous (lower) middle-income households, as economic growth has enabled some poor households to make their way out of poverty over the past decades, whilst changes in the way social security is organized linked to the abolishment of the Import Substitution Industrialization model has led other middle-income households to experience an increase in insecurity and downward mobility. We expect households in precarious prosperity to be particularly context-sensitive: Recent research has highlighted their socio-economic volatility; they do not have sufficient financial means to cushion unforeseen events, such as health problems, and are generally not target of social policies. They struggle to maintain or improve their level of wellbeing or avoid slipping into poverty. We analyze how health problems are dealt with by means of qualitative interviews with the same households in 2008/09, 2013 and 2016 in Temuco and San José. Results suggest that the interviewed households in Chile are constantly preoccupied with how to deal with health issues and the consequences. This furthers their anxieties and spills over into other life domains. In Costa Rica, the national health system of sufficient quality limits the spillover of worries into other life domains.