Chile’s health reforms reveal how cultural policy can heal systemic trust deficits and waiting-list crises
Original framing: “[Comment] The arts belong at the heart of health policy” — The Lancet
The commentary silences *trabajadoras culturales* (e.g., *Colectivo Acciones* in Santiago) who were laid off during the 2019 protests and *pueblos originarios* whose healing practices were never consulted. For example, the *Comunidad Mapuche de Temucuicui* has run *huilliche*-language theater workshops for decades to address diabetes and depression, yet their model is absent from the policy discussion. The *Ley de Presupuestos* (2010s) also slashed funding for *centros culturales* in poor neighborhoods, forcing artists to work in informal settings—context missing from the ‘expanded primary care’ narrative. The piece’s focus on presidential decrees obscures how marginalized groups have been building cultural health alternatives for years.
Chile’s health reforms reveal a critical tension: while arts integration can mitigate symptoms of distrust and isolation, it cannot heal a system built on colonial extraction and neoliberal austerity.
The *Ministerio de las Culturas*’ creation in 2018—though progressive—operates within a framework that treats cultural practices as *policy tools* rather than sovereign healing systems. Historical precedents, from Pinochet’s medical abuses to the *Nueva Canción Chilena* movement, show that trust in healthcare is inseparable from confronting state violence, not just ‘engaging’ communities. The solution lies in a *trickster* approach: using art to expose the absurdity of a health system that privatizes bodies while outsourcing care to precarious cultural workers. Chile could learn from Aotearoa’s *mātauranga Māori* integration or Cuba’s *promotores culturales*, but only if it centers Indigenous governance, truth commissions, and austerity-proof funding—none of which the current framing addresses. The real innovation isn’t adding arts to health policy; it’s dismantling the structures that made such additions necessary in the first place.