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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Dr. Asa Cristina Laurell discusses impact of Seguro Popular in Mexico in new book

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

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. Int J Health Serv ; Banco Interamericano de Desarrollo; Consejo Latinoamericano de Ciencias Sociales; In the Latin American countries with this model, it is written into the respective Constitutions in some form 4.

These forces have additionally helped underfinance the public system by capturing tax resources directly or via tax exemptions. The scenario in countries with neoliberal governments is quite different. Barrio Adentro and the reduction of health inequalities in Venezuela: For example, the SUS provided access to health services for tens of millions of previously excluded citizens In Venezuela, the Chavista government likewise expanded services to 17 million previously excluded Venezuelans 9.

Dr. Asa Cristina Laurell discusses impact of Seguro Popular in Mexico in new book – ISAGS

Services on Demand Journal. Mapeo de la APS en Brasil.

Even the public social insurance institutions have frequently and successfully opposed joining the SUS. How to cite this article.


This idea segments the health system and increases inequality in access to the required services. 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. Nevertheless, not only laurel, 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.

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 laurell of employment and an overall increase in income.

Social policy priorities vary from country cristona country, depending on their particular issues and the available resources. Instituto Suramericano de Gobierno en Salud; La Segunda Reforma de Salud: Fidelis de Almeida P. For leftist and progressive governments, social policy and health policy as part of it are priority instruments for generating social welfare and crisrina life for citizens. This is an open-access article distributed under the terms of the Creative Commons Attribution License.

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Strictly speaking, CUS refers to insurance coverage and laursll universal access to the required services, since it cristona supports cristinaa explicit and financed package of services for individuals, leaving aside public health actions 2. Telelboin C, Laurell AC, editores. 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 content of the packages of services varies according to the premium, and public funds are often used to subsidize the market. It is thus important to mobilize social participation and combat the idea that the private sector can play the role of relieving pressure on the public sector.

June 23, ; Accepted: Besides, insurance coverage asw not guarantee access to the required services, for two reasons. 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 the former, it has proven impossible to replace the preexisting public institutionality with another, market-centered and private system without encountering serious problems.


Asa Cristina Laurell

It also reinforces the notion of the public system as a poor system for the poor. SUS is intended to guarantee the universal right to health as a duty of the state.

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 cfistina corresponding model of care with social participation, inter-sector collaboration, and health education and promotion at the center.

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

Meanwhile, clean slate attempts have led to the parallel development of another health subsystem built as a further obstacle to construction of the SUS. Social policy in these countries is targeted and minimalist, generally conducted through income transfer programs conditioned on the adoption of prescribed behaviors. Asamblea Legislativa Plurinacional; Cuadernos del Doctorado, There is also a sustained effort at building a public system focused on comprehensive, integrated primary care.

The challenge is apparently to create another culture of health, built step by step and with sustained social participation.

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.

The main objective of such governments is to make social and health policies another field for commodification and generation of profit for capital. This ideology is still hegemonic, accepted not only by physicians and other healthcare personnel but also by politicians and even the general population.