Cavagnaro examined Argentina’s health care system in the 1990s, outlining its structure, major public health challenges, and the quality of care, while also assessing medical education and public health initiatives of the period. How did the 1990s policies of privatization and decentralization affect the government's ability to manage public health, and what lasting effects did this have on the healthcare system today? The 1990s health reforms in Argentina, which aimed to improve efficiency by decentralizing the system and introducing market competition, had the unexpected side effect of fragmenting the system, making it much harder for the government to effectively manage public health. Cavagnaro noted that as a result the system became overly bureaucratic, with limited resources focused on preventive care. This fragmentation became even more evident during the 2001 economic crisis, when approximately 9% of the population lost their social health insurance, forcing two-thirds of those individuals to transition to the public health system (Cavagnero & Bilger, 2010). In recent years, ongoing hyperinflation has further strained the system; between December 2020 and January 2024, the median price of 360 essential drugs increased by 1051%, significantly outpacing the 849% cumulative inflation rate. This has made basic care unaffordable for many, as the cost of a routine cardiovascular drug regimen for a retiree on a minimum pension rose from 17.4% to 34.9% of their monthly income (Macchia et al., 2024). Ultimately, the policies of the 1990s created a fragmented inefficient system that proved vulnerable to economic crises, with lasting negative effects on the affordability and accessibility of care. How has Argentina’s health system shifted from a focus on curative medicine to preventive care, and what is the role of public education in this change? While Argentina’s healthcare system in the 1990s focused on curative medicine, it has since shifted more towards preventive care through specific initiatives. The Plan Nacer/Sumar program, launched in 2004, exemplifies this change. The program provides care for millions of uninsured people, particularly women and children, by using a results-based financing model that links government funding to health outcomes. This has led to measurable results, including a 74% reduction in neonatal mortality and a 22% reduction in infant mortality among beneficiaries (World Bank, 2013). Furthermore, Argentina's participation since 2022 in the WHO Special Initiative for Mental Health aims to expand access to mental health services for an additional 5.2 million people by integrating community-based care into the public health system (WHO, 2024). Public health education and proactive interventions are playing key roles in improving health outcomes despite financial and structural constraints, demonstrating the system's adaptability and resilience in navigating ongoing economic and social challenges. References Cavagnero, E., & Bilger, M. (2010). Equity during an economic crisis: Financing of the Argentine health system. Journal of Health Economics, 29(4), 479-488. Macchia, A., Mariani, J. A., & Tognon, G. (2024). Inflation, Economic Policy Changes, and Access to Essential Drugs by Retirees in Argentina. JAMA Network Open, 7(6), e2415929. World Bank. (2013, September 18). Argentina: Plan Nacer Improves Birth Outcomes and Decreases Neonatal Mortality among Beneficiaries. World Health Organization (WHO). (2024, April 26). WHO Special Initiative for Mental Health - Argentina. Retrospective by Vini Jaiswal ‘ 26, B.S Industrial and Systems Engineering December 2025 Argentina, Portugal, Peru Edition Martindale Retrospectives Martindale Center for the Study of Private Enterprise Lehigh University College of Business Rauch Business Center, 621 Taylor Street, Bethlehem, PA 18015-3117 Tel: +1.610.758.4771 | Fax: +1.610.758.6549 | www.lehigh.edu/martindale Retrospective on Chris Cavagnaro, “Health Concerns in Argentina” from The Changing Face of Argentina Perspectives on Business and Economics, Volume 13, 1995 Chris Cavagnaro ‘95 is now a doctor, Pediatric Emergency Medicine at Children's Hospital Colorado/ Associate Professor, University of Colorado.
Retrospective on Tina (Niedzwiecki) Peloquin, “The Reconciliation in Argentina: Is It Complete?” from The Changing Face of Argentina Perspectives on Business and Economics, Volume 13, 1995 Tina Peloquin ’95 is now a partner at Fragomen. Niedzwiecki Peloquin examines Argentina’s efforts to address human rights abuses from the 1976–1983 military dictatorship. She argues that while some accountability has been restored, reconciliation remains incomplete. How have Argentina’s past human rights abuses and subsequent trials shaped the country’s current approach to justice and accountability? Argentina’s experience of state-sponsored human rights abuses during the 1976–1983 military dictatorship, commonly referred to as the “Dirty War,” involved the forced disappearance, torture, and murder of tens of thousands of individuals. In response, the country implemented the “Trial of the Juntas” in 1985, prosecuting top military leaders for crimes against humanity and establishing an early precedent for transitional justice (Niedzwiecki, 1995). The subsequent introduction of amnesty laws temporarily halted broader prosecutions, yet their annulment in 2003 allowed the judicial system to resume accountability efforts, culminating in over 1,000 convictions by 2016. Ongoing investigations continue, including the 2023 identification of Francisco Tenório Cerqueira Júnior, a victim of enforced disappearance (Balcells et al., 2025; Human Rights Watch, 2025). These developments illustrate both the capacity of Argentina’s legal institutions to uphold human rights norms and the resilience of judicial mechanisms in the face of historical impunity. Nevertheless, the election of President Javier Milei in 2023 has generated concerns regarding the potential weakening of memory policies and accountability practices, highlighting the ongoing fragility of these gains and the need for continued vigilance (Chehtman, 2024). Overall, Argentina’s approach demonstrates a dynamic evolution of justice, shaped by both historical precedents and contemporary political pressures. How has civil society, particularly movements like the Mothers of the Plaza de Mayo, influenced the preservation of memory and ongoing human rights advocacy in Argentina? Civil society, particularly the Mothers of the Plaza de Mayo, has been instrumental in sustaining public awareness of the dictatorship’s atrocities and advancing human rights advocacy. Beginning in 1977, these women organized weekly marches demanding information about their disappeared children, gaining international attention and challenging state-sanctioned impunity (OpenSPACES, 2022). Their activism directly contributed to the creation of the Nunca Más report and the establishment of the National Commission on the Disappearance of Persons, embedding mechanisms for truthseeking and influencing international human rights law regarding enforced disappearances (Balcells et al., 2025). Contemporary challenges, including political shifts and reductions in support for memory initiatives, underscore the persistent obstacles civil society faces in preserving historical memory. Yet, the continued activism of the Mothers and related organizations demonstrates the enduring power of civic engagement in shaping public discourse, promoting accountability, and reinforcing institutional respect for human rights in Argentina (Human Rights Watch, 2025). The trajectory of these movements reflects both the progress achieved in embedding human rights awareness into society and the ongoing struggle to safeguard these advances amid evolving political contexts. References Niedzwiecki, T. R. (1995). The reconciliation in Argentina: Is it complete? Perspectives: Business & Economics, 13, 8 –14. https://doi.org/10.18275/pbe-v013-008 Balcells, L., Palanza, V., & Voytas, M. (2025). Fixing the past: The effects of human rights trials on political attitudes in Argentina. British Journal of Political Science. Human Rights Watch. (2025). The Argentine government’s failure to back trials of human rights violations. Chehtman, A. (2024). Re-constructing criminal accountability for human rights abuses. Criminal Law Review. OpenSPACES. (2022). The Mothers of the Plaza de Mayo of Argentina. Retrospective by Vini Jaiswal ‘ 26, B.S Industrial and Systems Engineering Martindale Retrospectives 2 December 2025
Retrospective on Catherine Withers, “Renewable Electricity: Lighting the Way or Casting a Shadow?” from Portugal: Navigating from Crisis to Growth Perspectives on Business and Economics, Volume 33, 2015 Catherine Withers ‘14, ‘15 is a senior sustainability strategy consultant with IBM. Withers analyzes Portugal’s electricity sector transformation, showing that while renewable generation grew rapidly from the mid-2000s and the country exceeded its electricity targets by 2013, the sector accumulated substantial debt on unpaid costs that were deferred rather than passed on to consumers. How did Portugal address the large financial debt created by its early renewable energy policies, and were expectations for resolving it achieved? In 2015, analysts believed Portugal's electricity sector debt—largely driven by guaranteed premium prices the government had promised to pay renewable energy producers—could be eliminated through reforms. These included adjusting how costs were distributed among ratepayers, reducing the fixed payments guaranteed to early renewable projects, and converting some of the debt into bonds to be paid over time. (European Commission, 2014). In practice, full elimination never occurred. Instead, the debt was managed through pooling various electricityrelated debts and selling rights to future cash flows to third party investors as debt securities, as well as through the CESE (Energy Sector Extraordinary Contribution) tax applied from 2014 to 2020 (Reuters, 2024). Structural liabilities remained, particularly from legacy CMEC (Contractos de Manutenção do Equilíbrio Contractual) contracts, which continued to require significant payments (European Commission, 2014). Competitive renewable energy auctions introduced around 2019 helped contain costs by reducing subsidies for new projects and improving financial discipline in the sector. By 2023–2024, renewable energy deployment continued: pumped-storage hydro capacity reached approximately 3,585 MW, total hydraulic capacity approached 8,216 MW (REN, 2024), and renewables supplied the majority of electricity consumption. Therefore, Portugal did not fully eliminate tariff debt but effectively managed and restructured it while sustaining renewable growth. To what extent did Portugal’s investment in hydropower and renewable energy lead to genuine energy indpendence? In 2015, hydropower was central to Portugal's pursuit of energy independence. Large dams such as Baixo Sabor and Foz Tua were expected to expand capacity and reduce reliance on imported fossil fuels, with nearcomplete electricity self-sufficiency anticipated. Over the following decade, hydropower expansion occurred but at a smaller scale than planned. The Tâmega hydroelectric complex, completed between 2022 and 2024, added 1,158 MW across three plants (Power-Technology, 2024). By 2023, total hydraulic capacity reached approximately 8,216 MW (REN, 2024), below the 9,000 MW target but up from 5,000 MW in 2014. Portugal's net electricity position shifted from net exporter in 2017 to net importer by 2023, with approximately 57% of the gap left by fossil fuel decline supplied via Spanish imports (IEEFA, 2024). Rapid solar and wind expansion diversified generation, with solar capacity growing 440% since 2017. In conclusion, hydropower investments enhanced storage and system flexibility but were insufficient for full energy independence. Portugal's energy strategy evolved toward resilience through regional integration, combining domestic renewables with cross-border trading rather than pursuing complete self-sufficiency. References European Commission. (2014). Electricity Tariff Deficit: Temporary or Permanent Problem in the EU? Economic Papers No. 534. Directorate-General for Economic and Financial Affairs. Brussels. IEEFA. (2024). Portugal needs more wind capacity to replace rising Spanish electricity imports. Institute for Energy Economics and Financial Analysis. Power-Technology. (2024). Hydropower Capacity in Portugal and major projects: data and insights. REN. (2024). Annual Electricity Statistics / Renewable generation reports. Redes Energéticas Nacionais. Reuters. (2024, May 8). Portuguese court declares levy on renewable utilities unconstitutional. Retrospective by Vini Jaiswal ‘ 26, B.S Industrial and Systems Engineering Martindale Retrospectives 3 December 2025
Retrospective on Shaan Gurnani, “The Financial Crisis in Portugal: Austerity in Perspective” from Portugal: Navigating from Crisis to Growth Perspectives on Business and Economics, Volume 33, 2015 Shaan Gurnani ‘16 is now CFO at Grammer Logistics. Gurnani examines the roots of Portugal's financial crisis and evaluates the austerity measures and structural reforms mandated by the 2011 IMF-EU bailout. The author argues that despite imposing significant short-term hardship, these policies were essential for economic stabilization and laid the foundation for sustained recovery. Did Portugal’s structural reforms deliver the long-term economic growth that justified the short-term pain of austerity? Portugal's 2011 IMF-EU bailout required strict austerity measures and structural reforms, including labor market liberalization, pension adjustments, and public sector wage cuts that achieved their primary stabilization goal by preventing sovereign default, maintaining eurozone membership, and restoring market confidence during a critical period when Portugal's economic survival was uncertain. However, the longterm growth trajectory proved more modest than reformers anticipated: while unemployment declined to approximately 6.7% by 2019 (Eurostat, 2019) and public debt fell from 134% of GDP in 2014 to around 97.7% in 2023 (FRED, 2023), productivity growth remained sluggish relative to EU averages, real wage growth remained constrained even as employment recovered, and GDP growth averaged only 1.8% annually from 2014–2019. The reforms successfully prevented economic collapse and restored fiscal stability, making the shortterm sacrifices arguably necessary and unavoidable, yet they failed to deliver the transformative productivity-driven growth initially projected by policymakers and international institutions. This raises the question of whether alternative policies, such as more gradual fiscal consolidation paired with targeted investment in human capital and innovation, could have achieved stabilization with less social cost and stronger long-term growth prospects. Did the eurozone address the systemic weaknesses that enabled financial contagion to trigger Portugal’s crisis? The European Stability Mechanism (ESM), established in 2012 with a €500 billion lending capacity (European Stability Mechanism, 2012), created a financial firewall, while ECB President Mario Draghi's July 2012 pledge to do "whatever it takes" to preserve the euro (European Central Bank, 2012) likely reduced sovereign stress transmission across member states by increasing policy credibility and providing liquidity backstops. The Banking Union further enhanced cross-border oversight, though the European Deposit Insurance Scheme remains incomplete. The COVID-19 pandemic provided a partial stress test through the EU's €750 billion NextGenerationEU fund, which allocated €16.6 billion to Portugal through coordinated mutual support (European Commission, 2021), demonstrating substantially improved crisis coordination compared to the fragmented 2011 response. Yet because COVID was primarily a demand and supply shock rather than a sovereign debt contagion crisis, it only indirectly tested the new architecture. While these reforms have likely reduced contagion risk compared to 2011, structural vulnerabilities persist: fiscal integration remains incomplete, banking reform continues unevenly, and political divisions constrain deeper integration. Full protection against future sovereign debt contagion would require deeper fiscal federation and more uniform banking standards, outcomes that remain politically challenging. References European Central Bank. (2012). Remarks by Mario Draghi. European Commission. (2021). Portugal’s recovery and resilience plan. European Stability Mechanism. (2012). About the ESM. Eurostat. (2019). Unemployment statistics – Portugal. FRED. (2023). Portugal general government gross debt (% of GDP). Retrospective by Vini Jaiswal ‘ 26, B.S Industrial and Systems Engineering Martindale Retrospectives 4 December 2025
Retrospective on David Danko, “Furthering Peru's Public Education in the Face of Financial Challenges” from Leveraging Peru's Economic Potential Perspectives on Business and Economics, Volume 35, 2017 David Danko’17 is now vice president at Newlight Partners. Danko examines Peru's education paradox: nearuniversal enrollment (94%) but severe learning deficits, with students ranking 64th of 70 on the 2015 PISA and stark rural-urban disparities. He attributes this to chronic underinvestment in teachers and infrastructure, proposing targeted reforms, accountability systems, merit-based hiring, increased compensation, and strategic investment, to improve outcomes within fiscal constraints. Did increased teacher accountability and professionalization actually improve educational quality in Peru? Danko identified teacher quality as the primary bottleneck in Peru's education system, arguing that declining real wages (reduced to one-third of 1975 levels), a devalued profession, and poor training programs had created a crisis of instructional capacity. To address this, Peru implemented the Ley de Reforma Magisterial (Teacher Reform Law) in 2012, establishing merit-based hiring, performance evaluations, and career advancement tied to professional standards (IIEP-UNESCO, 2020). Between 2014 and 2015, approximately 180,000 teachers underwent mandatory evaluation, with 55,000 promoted and receiving salary increases. Teacher compensation rose by approximately 40% between 2011 and 2015, with the government targeting 4,000 soles monthly by 2021 (Bobba et al…, 2021). However, when more than 238,000 teachers struck in 2017 for over 60 days, they demanded repeal of the reform law itself, indicating that accountability measures generated substantial resistance rather than consensus-driven improvement. Results have been modest. On the international standard PISA tests, Peru’s 2022 reading score of 408.2 represented an increase from 400.5 in 2018, a gain of only 7.7 points over four years (OECD, 2023). Between 2012 and 2022, the percentage of teachers fully certified declined by 17.7%, suggesting professionalization efforts did not meaningfully increase teacher quality at scale. While accountability mechanisms were structurally sound, implementation challenges and union resistance limited their effectiveness in transforming Peru's teaching workforce or producing significant learning gains. Did Peru’s infrastructure and spending gaps narrow, and did increased investment in education produce the expect improvements in rural and indigenous student achievement? Peru's education spending increased but fell short of ambitious targets. Public spending on education reached 4.24% of GDP in 2023, up from 3.83% in 2022, yet below the 6% target for 2021 and regional comparators (TheGlobalEconomy.com, 2024). Geographic inequality has proven remarkably persistent. In 2020, 83.7% of youth in urban areas had access to high school compared to 66.4% in rural areas (World Bank Group, 2019). A 2018 analysis of standardized evaluations of Peruvian second grade students revealed a significant gap favoring urban areas by 63 points in mathematics, with 83% of this gap explained by differences in socioeconomic variables and school inputs (Rojas Apaza et al…,2024). Peru fell significantly short of targets and infrastructure investment failed to close the estimated $18 billion gap within the projected timeframe, leaving rural-urban disparities largely undiminished. References IIEP-UNESCO. (2020). Teacher career reforms in Peru. Bobba, M., Ederer, T., León-Ciliotta, G., Neilson, C., & Nieddu, M. G. (2021). Teacher compensation and structural inequality in Peru. NBER Working Paper No. 29068. OECD. (2023). PISA 2022 results: Peru. Rojas Apaza, R., Paz Paredes, R., Arpi, R., & Chura-Zea, E. (2024). Urban-rural gap in Peruvian education performance. Frontiers in Education, 9, 1394938. TheGlobalEconomy.com. (2024). Peru public spending on education. World Bank Group. (2019). Improving basic education in Peru. Retrospective by Vini Jaiswal ‘ 26, B.S Industrial and Systems Engineering Martindale Retrospectives 5 December 2025
Retrospective on Kathryn E. Bahner, “Peruvian Tax Reform: Increasing Government Revenues and Social Equality” from Leveraging Peru's Economic Potential Perspectives on Business and Economics, Volume 35, 2017 Kathryn E. Bahner ‘17 is now an auditor with KPMG, LLP. Bahner discussed that Peru’s tax system raised insufficient revenue due to widespread tax evasion and a large informal sector. She suggested that increasing corporate taxes, adjusting the VAT, and creating a higher income tax bracket for the wealthiest households could help. She predicted that these measures would boost government revenue and reduce social inequality. How effective have Peru’s recent efforts been in formalizing the informal sector and reducing income-tax and VAT evasion, and which policies or enforcement measures have actually driven changes in government revenue? Bahner argued that Peru’s large informal sector and low tax compliance limited the government’s revenueraising capacity, and she warned that over-reliance on enforcement could hurt poorer Peruvians. Since then, Peru increased its corporate income tax rate from 28 percent to 29.5 percent in 2017 (Oxford Business Group, 2017). However, structural issues persist: informality remains widespread, with more than 70 percent of workers in informal employment, according to the OECD (OECD, 2025). The OECD’s analysis also highlights that Peru’s tax system is fragmented, with multiple smallbusiness tax regimes that encourage firms to remain informal and contribute to weak compliance (OECD, 2023). Additionally, VAT non-compliance is estimated to cost Peru about 2.6 percent of GDP. And, lack of regulation, tax administration, and information systems has led to corporate tax evasion that deprives the government of around one-third of potential tax revenue, according to the OECD (OECD/GRADE, 2023). These persistent shortfalls suggest that Peru’s policy measures have only partially addressed the underlying issues Bahner highlighted. Enforcement initiatives have not produced major gains in formalization or compliance, and the state still faces structural barriers to expanding the tax base and increasing revenue. How have changes to Peru’s VAT, corporate tax, and personal income tax rates affected revenue generation and social equality, particularly for lower-and middle-income households, and have new measures targeting the wealthiest households achieved the predicted reduction in inequality? Bahner predicted that cutting VAT, increasing corporate tax, and introducing a new top income-tax bracket would increase revenue and reduce inequality, helping Peru make progress toward economic transition. In practice, although there was a proposal to cut the standard VAT rate from 18 percent to 17 percent in 2017, the measure was contingent on revenue targets and was not broadly implemented as a permanent cut (Oxford Business Group, 2017). Meanwhile, the corporate tax rate was raised to 29.5 percent (Oxford Business Group, 2017). On inequality, according to World Bank–OECD data Peru’s Gini coefficient fell from about 43.6 in 2016 to around 40.3 by 2022, indicating a more even distribution of income (OECD, 2024). Nonetheless, much of this reduction appears to stem not directly from tax reform but from economic growth and expanded social transfers (OECD, 2023). As such, while some of the tax changes Bahner anticipated were implemented, their redistributive effect appears limited; broader macroeconomic and social-policy dynamics have played a larger role in shaping inequality trends. References OECD. OECD Economic Surveys: Peru 2023. OECD Publishing, 2023. OECD. OECD Economic Surveys: Peru 2025. OECD Publishing, 2025. OECD/GRADE. Towards Universal Social Protection in Peru: Challenges and Possibilities, 2023. OECD. Latin American Economic Outlook 2024: Financing Sustainable Development. OECD Publishing, 2024. Oxford Business Group. “The government of Peru introduces new tax package,” Peru 2017. Retrospective by Vini Jaiswal ‘ 26, B.S Industrial and Systems Engineering Martindale Retrospectives 6 December 2025
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