Laurell A C, Ortega M E
Int J Health Serv. 1992;22(2):331-7. doi: 10.2190/V2XG-18V2-5UX1-QGKE.
This article presents a discussion of the probable implications for the Mexican health sector of the Free Trade Agreement (FTA) between the United States, Canada, and Mexico. The authors argue that the FTA should be seen as part of neoliberal policies adopted by the Mexican government in 1983 that are based on large-scale privatization and deregulation of labor relations. In this general context the health sector, which traditionally has been dominated by public institutions, is undergoing a deep restructuring. The main trends are the decapitalization of the public sector and a selective process of privatization that tends to constitute the private health sector in a field of capital accumulation. The FTA is likely to force a change in Mexican health legislation, which includes health services in the public social security system and recognizes the right to health, and to accelerate selective privatization. The U.S. insurance industry and hospital corporations are interested in promoting these changes in order to gain access to the Mexican market, estimated at 20 to 25 million persons. This would lead to further deterioration of the public institutions, increasing inequalities in health and strengthening the private sector. The historical trend toward the integration of a National Health Service in Mexico would be interrupted in favor of formation of a dual private-public system.
本文讨论了美国、加拿大和墨西哥之间的自由贸易协定(FTA)对墨西哥卫生部门可能产生的影响。作者认为,该自由贸易协定应被视为墨西哥政府1983年采取的新自由主义政策的一部分,这些政策基于大规模私有化和劳动关系放松管制。在这一总体背景下,传统上由公共机构主导的卫生部门正在经历深刻的结构调整。主要趋势是公共部门的资本削减和选择性私有化进程,这往往使私营卫生部门成为一个资本积累领域。自由贸易协定可能会迫使墨西哥卫生立法发生变化,墨西哥卫生立法涵盖公共社会保障系统中的卫生服务并承认健康权,同时还可能加速选择性私有化。美国保险业和医院企业有兴趣推动这些变革,以便进入估计有2000万至2500万人的墨西哥市场。这将导致公共机构进一步恶化,加剧健康方面的不平等,并加强私营部门。墨西哥建立国家卫生服务体系的历史趋势将被打断,转而形成公私二元体系。