Departamento de Conservación de la Biodiversidad, El Colegio de la Frontera Sur, Carretera Panamericana & Av. Periférico Sur S/N, 29290, San Cristóbal de Las Casas, Chiapas, Mexico.
Network GRAAL (Research Groups for America and Africa Latins), San Cristóbal de Las Casas, Chiapas, Mexico.
Int J Equity Health. 2019 Feb 7;18(1):30. doi: 10.1186/s12939-019-0929-y.
Adopting key mechanisms to restructure public policy in developing countries is a crucial political task. The strengthening of infrastructure of health services, care quality, monitoring and population health; all might contribute to assuring the functionality of a national system for health monitoring and care. Over the last decades, the Mexican government has launched wide-ranging political reforms aiming to overcome socioeconomic and environmental problems, namely health, education, finances, energy and pension. The proposed (but yet not implemented) health reform in Mexico during E. Peña Nieto's administration (2012-2018) pretended an adjustment in Article 4 of the Mexican Constitution to compact medical care and reduce the State's responsibility to a provision of minimum health packages for the population. Here we use a simple analytical model to describe and interprete the concepts of context, process, actors and content and the outcome of three of the most important resulting components of this intended reform i.e. universality, basic packages, and 'outsourcing'. In light of the start of the Mexico's new federal administration, we argue that, if not properly defined by all actors, the implementation of such structural health reform in Mexico would precipitate a model of private/public association exacerbating a crisis of political representation, human rights, justice and governance.
在发展中国家采用关键机制来重构公共政策是一项至关重要的政治任务。加强卫生服务、护理质量、监测和人口健康的基础设施建设，都有助于确保国家卫生监测和护理系统的功能。在过去几十年中，墨西哥政府发起了广泛的政治改革，旨在克服社会经济和环境问题，特别是卫生、教育、财政、能源和养老金问题。在埃切维里亚·佩尼亚·涅托（E. Peña Nieto）政府（2012-2018 年）期间，墨西哥提出了（但尚未实施）的医疗改革，旨在对《墨西哥宪法》第 4 条进行调整，以压缩医疗保健服务并减少国家对人口提供最低医疗保健套餐的责任。在这里，我们使用一个简单的分析模型来描述和解释背景、过程、行为体和内容的概念，以及这一预期改革的三个最重要结果组件的结果，即普遍性、基本套餐和“外包”。鉴于墨西哥新联邦政府的开始，我们认为，如果没有所有行为体的适当界定，墨西哥实施这种结构性卫生改革将加剧政治代表性、人权、正义和治理危机的私人/公共协会模式。
