Laurell Asa Cristina
Centro de Análisis y Estudios sobre Seguridad Social, Coyoacán.
Cien Saude Colet. 2011 Jun;16(6):2795-806. doi: 10.1590/s1413-81232011000600018.
The Mexican health system is comprised of the Department of Health, state labor social security and the private sector. It is undergoing a reform process initiated in 1995 to achieve universal coverage and separate the regulation, financing and service functions; a reform that after fifteen years is incomplete and problematic. The scope of this paper is to assess the problems that underlie the successive reforms. Special emphasis is given to the last reform stage with the introduction of the "Insurance of the People" aimed at the population without labor social security. In the analysis, health reform is seen as part of the Reform of the State in the context of neoliberal reorganization of society. Unlike other Latin American countries, this process did not include a new Constitution. The study is based on official documents and a systematic review of the process of the implementation of the System of Social Health Protection and its impact on coverage and access to health services. The analysis concludes that it is unlikely that universal population coverage will be accomplished much less universal access to services. However, reforms are leading to the commodification of the health system even in the context of a weak private sector.
墨西哥卫生系统由卫生部、州劳工社会保障部门和私营部门组成。它正在进行一项始于1995年的改革进程，以实现全民覆盖并分离监管、融资和服务职能；然而，经过十五年，这项改革仍未完成且存在问题。本文的范围是评估 successive 改革背后的问题。特别强调了最后一个改革阶段，即引入针对无劳工社会保障人群的“人民保险”。在分析中，卫生改革被视为在社会新自由主义重组背景下国家改革的一部分。与其他拉丁美洲国家不同，这一进程不包括一部新宪法。该研究基于官方文件以及对社会健康保护体系实施过程及其对医疗服务覆盖范围和可及性影响的系统综述。分析得出结论，全民覆盖不太可能实现，更不用说普遍获得服务了。然而，即使在私营部门薄弱的情况下，改革也在导致卫生系统的商品化。
