Ciência & Saúde Coletiva
Print version ISSN 1413-8123
LAURELL, Asa Cristina. Mexican health insurance: uncertain universal coverage. Ciênc. saúde coletiva [online]. 2011, vol.16, n.6, pp.2795-2806. ISSN 1413-8123. http://dx.doi.org/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.
Keywords : Health insurance; Commodification; Healthcare reform; Health policy; Mexico.