|The Nutrition and Health Transition of Democratic Costa Rica (INFDC, 1995, 228 p.)|
|5. Socioeconomic factors for the understanding of health policy during the 1970s|
During the 1970s, the Costa Rican development strategy, which had achieved such impressive gains, underwent a crisis due to international events and events in the Central American Common Market, and the persistence of high levels of poverty. The crisis in the Central American Common Market was the result of a breakdown (precipitated by the war between Honduras and El Salvador) in the intergovernmental arrangements that had been established. In Costa Rica, the industry that had been developed showed limitations in its ability to create jobs, expand markets, integrate the productive process, and be less dependent on foreign raw materials, machinery, technology, and patents. It also did not prevent a further concentration of wealth.
In the agricultural sector, increased mechanization and consolidation generated unemployment and under employment. Poverty not only did not diminish but actually became worse among the most disadvantaged. In light of this situation, Figueres, who was reelected President in 1970, ran for office with the slogan "fight against extreme poverty" and strengthened the participation of government in the economy.
The governments of the 1970s, in particular the 1974-1978 administration of Daniel Oduber Quirthe main promoter of entrepreneurial government, modified several aspects of the development strategy in a direction that was conducive to a strengthening of the social government that had been developing since the 1950s. The control of the government apparatus and of the so-called entrepreneurial government provided the government of the 1970s with more control over the rest of society and a stronger influence in the social arena. In the following section we will discuss the characteristics of this new entrepreneurial government and its impact on the development of stronger social policies.
The Entrepreneurial Government as a Response to the Crisis
To confront the above crisis, a stronger government interventionist policy was proposed to compensate for the weak national economic resources. This is why during the early 1970s several measures were taken that led to the entrepreneurial government of the period 1974-1978.
The formation of the entrepreneurial government was possible because of the support of owners of industry, whose development depended heavily on government, and of public employees, who were themselves part of the government apparatus. Daniel Oduber, who was the main ideological and political leader of this model, stated:
"It was necessary to nationalize many things to launch a more integrated and, thereby, more democratic Costa Rican socialism."
The issue was to create in Costa Rica an institution able to develop large and new industries that later would be owned by Costa Rican shareholders to avoid having transnational firms guiding industrial development on a large scale in Costa Rica. This applied to cement, aluminum, fisheries, navigation, etc. (UCID, 1981, pp. 9-10)
During the government of Figueres between 1970 and 1974, some important measures that led to the entrepreneurial government were approved, but it was not until Oduber's term that this new style of government was fully established. The Figueres administration took measures such as the nationalization of the oil company, but it was the Oduber administration that established the Corporation for the Development of Costa Rica (CODESA) with the intention of creating enterprises that would take advantage of the natural resources of the country, become modernized, and thrive in an international market. CODESA acquired many enterprises but by also supporting and channeling resources to the private sector, it assumed some banking functions as well.
The development of productive activities by the government with the purpose of generating profits did not imply the disappearance of other activities that had been carried out since the 1950s, such as developing private enterprises, transportation, physical infrastructure, and markets; fostering exports; and improving training and productivity.
During the 1970s, the government worked in favor of internal markets through the strengthening of the National Production Council (CNP), which was created in 1948 for the purpose of stabilizing prices. During the 1970s, CNP participated in sales, establishment of prices, and purchasing of industries for processing rice. This trend of the entrepreneurial government was supported by the international financial organizations, which at the time preferred to deal directly with governments rather than with private enterprises.
In conclusion, during the 1970s, the most important change influencing development was the emergence of an entrepreneurial government, which carried out activities for the purpose of generating profits and competing with the private sector. At the same time, actions were taken to foster exports and to strengthen internal markets, mainly those associated with the consumption of basic products, always taking into account the international trends that were prevalent in those days.
The Strengthening of Social Policy
The changes in government participation that took place during the 1970s resulted in some institutional transformations that allowed a stronger social role of the government. Forty-seven percent of the institutions created between 1950 and 1980 were formed during the 1970s (Valverde et al., 1990). It should be noted that these transformations did not mean a break in the central characteristics of the development strategy that prevailed in the country during the 1950s and 1960s. Furthermore, the social government that is required to meet the need of expanded markets and the government style that tries to avoid conflict by taking social measures not only continued but became stronger during the 1970s.
The combination of factors that led to the strengthening of the social policy, to the point where the results reached a level comparable with the industrialized countries included previous experience with social measures that formed a basis for their broadening, the social measures taken, and a reconciliatory government style; the international crisis and the Central American integration crisis; continued poverty levels, unemployment, and social inequity that led to discontent; and lastly, the entrepreneurial government, which represented a strong and decisive government willing to intervene in different social spheres where the private sector could not or would not intervene.
The social policy of the 1970s was a deeper and more effective continuation of previous social policy. This was possible due to the institutions that had already been created and the greater control of the government over social life. This greater control over society is manifested not only by the existence of government enterprises but also by a greater concentration of power in the executive. This was achieved through a series of measures taken to achieve control of public institutions. Among these measures were the law that allowed the party in power to name four of the seven directors of institutions, and the law that granted permission to the President of the Republic to name an executive director who would be the chief authority in each institution.
This process was also extended to social conflicts, where the government tried to achieve greater control of the popular movement. In agriculture, the government dealt with latifundism (the establishment of large estates with workers in a state of partial servitude) through the Land and Settlement Institute (ITCO), which attempted to avoid conflicts taking into account the interests of large owners, but demonstrating the illegal nature of latifundism, and avoiding any control of the left over popular agricultural movements. The ITCO ended up being a large owner that converted industrial workers into agricultural employees for the purpose of producing grains for the internal market and facilitating incorporation of Costa Rica into the international agroindustrial market (UCID, 1981, pp. 78-89).
It was during the 1970s that the National Community Development Department (DINADECO) took the previously described actions to attempt to control the community movement. With respect to labor unions, the Oduber government established a "tacit alliance" (UCID, 1981, p. 114) with the Communist Party of Costa Rica which controlled the principal popular organizations, although it simultaneously strongly repressed the more independent unions.
The most important social measures that were taken during this period were extended to other areas such as housing, education, health and nutrition, price control, culture and recreation, as well as the expansion of many other existing programs.
A housing deficit had been evident since the beginning of the decade, particularly among the low- and middle-income sectors. To face this problem, the government created or strengthened some institutions and programs. Two of these were devoted to the building of housing for low-income sectors: the Mixed Institute for Social Assistance (IMAS), which concentrated on the indigent, and the National Institute for Housing and Urban Planning (INVU), which concentrated more than ever before on programs targeting low-income segments of the population. Other institutions and programs targeted housing for the middle class through institutions such as the National Savings and Loans System, the National Insurance Institute (INS), the Costa Rican Social Security Institute (CCSS), public banks, and the Popular and Community Development Bank. These actions confirm that in the field of housing major resources were committed which increased the number of institutions dedicated to housing and expanded the programs (see Valverde et al., 1990, pp. 96-97).
In education, a study done in 1971 uncovered the deficiencies of elementary and high school education, providing the basis for the approval of the National Education Development Plan in 1971. The purpose of this plan was to modernize the education system and improve the average educational levels of the Costa Rican population. At the same time, diversified education began to be introduced in the technical colleges and institutions that young people attended after elementary school. The Technological Institute of Costa Rica was opened, and since the beginning it has had a strong linkage with industrial enterprises, The National University, and the State University, which absorbed students who had difficulties entering the National University of Costa Rica.
With regard to health and nutrition:
... the year 1970 marked the beginning of a National Health System that provided universal coverage and the control of common childhood infectious diseases and malnutrition. (Valverde et al., 1990, p. 82)
The National Health System achieved the integration of services in its field and developed primary health care in rural and marginalized urban areas. Furthermore, health coverage became universal and the National Health Plan was approved to increase health coverage.
Prices of products for basic consumption were controlled. The National Production Council, as described before, had the function of stabilizing prices, providing price guarantees for producers and consumers and opening retail stores with the intention of establishing ceiling prices that would not be surpassed by the other commercial outlets. The law for Consumer's Defense was also approved with the objective of protecting consumers against speculators.
During this decade, other public services that were already in place were expanded. These included electric power, which was extended to most of the country, as well as access roads, and water and sewage services, which also were also markedly increased.
The concept of social development was expanded to include culture and recreation. This involved extensive effort that created and strengthened entities such as the National Dance Company, the National Theater Company, the Youth Symphony Orchestra, the Ministry of Culture, Youth, and Sports, the La Sabana Recreation Park, and the National Park System.
To cover some needs of the most disadvantaged population by providing housing, food, and education, the Mixed Institute for Social Assistance was created at the beginning of the decade. Later, the Fund for Family Benefits was approved to
"provide assistance for nutrition, poor or disabled people without income, and education and welfare programs for the worker and his or her family." (Valverde et al., 1990, p. 133)
The funds of this program were channeled through several different social institutions and included health programs, food and nutrition, housing, productive activities and employment, training of professionals, and protection of minors and the elderly (see Valverde et al., 1990, pp. 133-151).
In conclusion, new elements were added to the social measures that had previously been approved. The new elements modified the social concept and tended to improve the training of workers and technicians; the quality of housing, health, and nutrition; access to culture and recreation; and the basic consumption of the most disadvantaged population. All this was done with the purpose of preparing and maintaining under adequate conditions the workers and technicians required for the development of the new forms of production. Another important objective was for the government to avoid the emergence of social conflicts that would threaten social peace, productivity, and the ability to compete at an international level.
Nevertheless, the 1970s ended with the deepening of a series of problems that affected both the economic and the social sectors. This situation cast doubts over the development strategy that had been followed since the middle of the century and that led the country into a crisis that it would attempt to solve through the process of structural adjustment.