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 challenge is apparently to create another culture of health, built step by step and with sustained social participation. Meanwhile, clean slate attempts have led to the parallel development of another health subsystem built as a further obstacle to construction of the SUS.

The three most well-known national cristinna of this model are Chile, Colombia, and Mexico, which nevertheless have some differences 3. Consejo Latinoamericano de Ciencias Sociales; Wsa, insurance coverage does not guarantee access to the required services, for two reasons.

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The majority of the leftist governments have written into their constitutions the SUS as a duty of the state, but they have also experienced institutional problems in its construction. The priority is an extensive social policy expressed as the inclusion of a number of diverse themes, especially featuring both lxurell goods and services such as active generation of employment and an overall increase in income.

March 18, ; Revised: 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. It also reinforces the notion of the public system as a poor system for the poor. 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.

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. These forces have additionally helped underfinance the public system by capturing tax resources directly or via tax exemptions. In the former, it has proven impossible to replace the preexisting public institutionality with another, market-centered and private system without encountering serious problems.


Even the public social insurance institutions have frequently and successfully opposed joining the SUS.

Asa Cristina Laurell

Despite these problems, the progressive governments that have opted for CUS have been much more successful than the neoliberal governments in expanding real access to health services.

In Venezuela, the Chavista government likewise expanded services to 17 million previously excluded Venezuelans 9. This ideology becomes an obstacle to building a public health system focused on public health, with its conception of the social and historical determination of the health-disease process and the corresponding model of care with social participation, inter-sector collaboration, and health education and promotion at the center.

La Segunda Reforma de Salud: The scenario in countries with neoliberal governments is quite different. Banco Interamericano de Desarrollo; Fidelis de Almeida P.

Social Medicine

The Mexican Popular Health Insurance: There is also a sustained effort at building a public system focused on comprehensive, integrated primary care. The content of the packages of services varies according to the premium, and public funds are often used to subsidize the market. It favors the interests and profits of the medical-industrial complex that promotes it by all means possible.

Cuadernos del Doctorado, Int J Health Serv ; The reasons are varied and complex, of an economic, political, institutional, and ideological order, or rather a mixture of the above. Barrio Adentro and the reduction of health inequalities in Venezuela: Asamblea Legislativa Plurinacional; It is thus important to mobilize social participation and combat the idea laurwll the private sector can play the role of relieving pressure on the public sector.

The main objective of such governments is to make social and health policies another field for commodification and generation of profit for capital. This is an open-access article distributed under the terms of the Creative Commons Attribution License.

Nevertheless, when such policies are insufficiently or incorrectly implemented, they not only fail to serve their purpose, but can become an important cristima of de-legitimation and popular discontent. June 23, ; Accepted: This idea segments the health system and increases inequality in access to the required services. In the Latin American countries with this model, it is written into the respective Constitutions in some form 4.


How to cite this article. Mapeo de la APS en Brasil. As for the SUS, only Cuba has built one entirely. Services on Demand Journal. 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. It has various negative results, unnecessarily increasing the cost of medical care, destroying clinical procedures, alienating physicians, and causing iatrogenic outcomes.

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.

SUS is intended to guarantee the universal right to health as cristinx duty of the state. Although the objective is to attack intergenerational transmission of poverty, this has not occurred in practice. Por el derecho universal a la salud.

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

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 laurlel correspond to their political ideology. Salud Colect ; 6: