Stratified Access to Health Systems: The Case of "Bolsa Familia" (Brazil) and "Oportunidades"(Mexico) Programs.

Throughout the twentieth century and up until the eighties, in some Latin American countries, a series of social policies that sought universalism but, however, remained primarily linked to the condition of being employed in the formal sector, were developed. Since the eighties, in countries like Brazil and Mexico, new archetypes of targeted social policy were established: the Conditional Cash Transfer (CCT), initially created to break the intergenerational cycle of poverty, with responsibilities aimed at developing human capital of the kids. The programs mentioned here are “Oportunidades” program (Mexico) and “Bolsa Familia” program (Brazil). These programs include an insertion package in health systems, characterized by precarious and different conditions compared to others types of insertion, for example, compared to workers with social security gained through formal employment. That is why this research focuses on the effects on access to health that have had Oportunidades and Bolsa Familia in beneficiary households. The data collection methods used were a survey of both a municipality of Mexico (Tonalá, Jalisco), and one of Brazil (Salvador de Bahía); and a series of in-depth interviews conducted in both countries. The results point to a residual improved access to health systems, with different access features that build a new step down the scale of stratification of health systems, making the program beneficiaries second-class citizens in terms of access to health.