Frenk Julio
Minister of Health of Mexico, Secretaría de Salud, Lieja 7, 06696 Mexico, Distrito Federal, Mexico.
Lancet. 2006 Sep 9;368(9539):954-61. doi: 10.1016/S0140-6736(06)69376-8.
During the past 6 years, Mexico has undergone a large-scale transformation of its health system. This paper provides an overview of the main features of the Mexican reform experience. Because of its high degree of social inequality, Mexico is a microcosm of the range of problems that affect countries at all levels of development. Its health system had not kept up with the pressures of the double burden of disease, whereby malnutrition, common infections, and reproductive health problems coexist with non-communicable disease and injury. With half of its population uninsured, Mexico was facing an unacceptable paradox: whereas health is a key factor in the fight against poverty, a large number of families became impoverished by expenditures in health care and drugs. The reform was designed to correct this paradox by introducing a new scheme called Popular Health Insurance (Seguro Popular). This innovative initiative is gradually protecting the 50 million Mexicans, most of them poor, who had until now been excluded from formal social insurance. This paper reports encouraging results in the achievement of the ultimate objective of the reform: universal access to high-quality services with social protection for all.
在过去六年里，墨西哥对其卫生系统进行了大规模改革。本文概述了墨西哥改革历程的主要特点。由于社会不平等程度高，墨西哥是一个反映影响各个发展水平国家的一系列问题的缩影。其卫生系统未能跟上疾病双重负担带来的压力，在这种情况下，营养不良、常见感染和生殖健康问题与非传染性疾病及伤害并存。墨西哥一半人口没有医保，正面临一个难以接受的矛盾：健康是消除贫困斗争的关键因素，然而大量家庭却因医疗保健和药品支出而陷入贫困。此次改革旨在通过引入一项名为“大众健康保险”（Seguro Popular）的新计划来纠正这一矛盾。这一创新举措正逐步惠及5000万墨西哥人，其中大多数是贫困人口，他们此前一直被排除在正规社会保险之外。本文报告了在实现改革最终目标方面取得的令人鼓舞的成果：全民均可获得高质量服务并享有社会保护。
