Laurell, A.C., “Work and health in Mexico” Int. J. Health Serv. 9(4): (Reeditado en: V. Navarro (ed) Health and work under capitalism, Baywood. Neoliberalism has been implemented in Latin America for about three decades. This article reviews Mexico’s neoliberal trajectory to illustrate the political, ec. Dr. Asa Cristina Laurell, recognized as one of the most representative researchers of current Latin American social medicine, in her new book discusses the.

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The three most well-known national cases of this model are Chile, Colombia, and Mexico, which nevertheless have some differences 3.

Int J Health Serv ; How to cite this article. Meanwhile, clean slate attempts have led to the parallel development of another health subsystem built as a further obstacle to construction of the SUS. This idea segments the health system and increases inequality in access to the required services. The solution proposed by the Colombian government, to condition the right to health on sufficient budget resources, was defeated through a broad mobilization of different sectors of the population in which health workers played an important role 7.

For leftist and progressive governments, social policy and health policy as part of it are priority instruments for generating social welfare and decent life for citizens.

The content of the packages of services varies according to the premium, and public funds are often used to subsidize the market. Rightist or neoliberal governments view such policies as an area they cannot overlook without losing legitimacy, and as a terrain for patronage and corporate population control.

Por el derecho universal a la salud.

In Venezuela, the Chavista government likewise expanded services to 17 asw previously excluded Venezuelans 9. As for the SUS, only Cuba has built one entirely. Strictly speaking, CUS refers to insurance coverage and not universal access to the required services, since it only supports an explicit and financed package of services for individuals, leaving aside public health actions 2. Besides, insurance coverage does not guarantee access to the required services, for two reasons. There is also a sustained effort at building a public system focused on comprehensive, cdistina primary care.


The reasons are varied and complex, of an economic, political, institutional, and ideological order, or rather a mixture of the above.

It has various negative results, unnecessarily increasing the cost of medical care, destroying clinical procedures, alienating physicians, and causing iatrogenic outcomes. Nevertheless, not only the neoliberal governments or states, minimal or modernized, but also social welfare, leftist, or progressive governments have experienced problems in implementing their respective health policies that apparently would correspond to their political ideology.

SUS is intended to guarantee the universal right to health as a duty of the state.

Banco Interamericano de Desarrollo; Despite these problems, the progressive governments that have opted for Cgistina have been much more successful than the neoliberal governments in expanding real access to health services. Its objective is to introduce the market and competition, both in the administration of funds and purchase of services and in the provision of medical services, in both cases including both private and public agents.

The existence of institutions with their own history and structures cannot be overlooked particularly when asq from one form of the state to another, as is the case both in the construction of the neoliberal state and that of the laufell democratic state of law. La Segunda Reforma de Salud: Social policy in these countries is targeted and minimalist, generally conducted through income transfer programs conditioned on the adoption of prescribed behaviors.

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Although the objective is to attack intergenerational transmission of poverty, this has not occurred in practice. The challenge is apparently to create another culture of health, built step by step and with sustained social participation. As is thus important to mobilize social participation and combat as idea that the private sector can play the role of relieving pressure on the public sector.


Instituto Suramericano de Gobierno en Salud; June 23, ; Accepted: For example, the SUS provided access to health services for tens of millions of previously excluded citizens These forces have additionally helped underfinance the public system by capturing tax resources directly or via tax exemptions.

Nevertheless, when such policies are insufficiently or incorrectly implemented, they not only fail to serve their purpose, but can become an important source of de-legitimation and popular discontent.

Fidelis de Almeida P. Even the public social insurance institutions have frequently and successfully opposed joining the SUS. Salud Colect ; 6: It is based on the original English model of the National Health Service: Meanwhile, in Colombia the denial of services has led to hundreds of thousands of court cases, and the Constitutional Court has declared unconstitutional the existence of distinct packages of services according to the payment made.

Social Medicine

This is an open-access article distributed under the terms of the Creative Commons Attribution License. The priority is an extensive social policy expressed as the inclusion of a number of diverse themes, especially featuring both public goods and services such as active generation of employment and an overall increase in income. In the Latin American countries with this model, it is written into the respective Constitutions in some form 4.