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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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.

For example, the SUS provided access to health services for tens of millions of previously excluded citizens 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.

How to cite this article. This ideology is still hegemonic, accepted not only by physicians and kaurell healthcare personnel but also by politicians and even the general population.

The challenge is apparently to create another culture of health, built step by step and with sustained social participation. Salud Colect ; 6: 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. 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.

Por el derecho universal a la salud. In the former, it has proven impossible to replace the preexisting public institutionality with another, market-centered and private system without encountering serious problems. SUS is intended to guarantee the universal right to health as a duty of the state.


Asa Cristina Laurell – Wikipedia, la enciclopedia libre

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 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. It is based on the original English model of the National Health Service: June 23, ; Accepted: It has various negative results, unnecessarily increasing the cost of medical care, destroying clinical procedures, alienating physicians, and causing iatrogenic outcomes.

In the Latin American countries with this model, it is written into the respective Constitutions in some form 4. Consejo Latinoamericano de Ciencias Sociales; Mapeo de la APS en Brasil. Int J Health Serv ; Social policy priorities vary from country to country, depending on their particular issues and the available resources. Cuadernos del Doctorado, These forces have additionally helped underfinance the public system by capturing tax resources directly or via tax exemptions.

La Segunda Reforma de Salud: 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. 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.

There is also a sustained effort lautell building a public system focused on comprehensive, integrated primary care. March 18, ; Revised: This idea segments the health system and increases inequality in access to the required crustina.

The scenario in countries with neoliberal governments is quite different. It favors lajrell interests and profits of the medical-industrial complex that promotes it by all means possible. 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.


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. The main objective of such governments is to make social and health policies another field for commodification and generation of profit for capital.

The right to health: Social policy in these ass is targeted and minimalist, generally conducted through income transfer programs conditioned on the adoption of prescribed behaviors.

Asa Cristina Laurell

Besides, insurance coverage does not guarantee access to the required services, for two reasons. Fidelis de Almeida P. The three most well-known national cases of this model are Chile, Colombia, and Mexico, which nevertheless have some differences 3. The content of the packages of services varies according to the premium, and public funds are often used to subsidize the market.

This is an open-access article distributed under the terms of the Creative Commons Attribution License. Even the public social insurance institutions have frequently and successfully opposed joining the SUS. The Mexican Popular Health Insurance: The reasons are varied and complex, of an economic, political, institutional, and ideological order, or rather a mixture of the above.

Telelboin C, Laurell AC, editores. Banco Interamericano de Desarrollo; In Venezuela, the Chavista government likewise expanded services to 17 million previously excluded Venezuelans 9. Instituto Suramericano de Gobierno en Salud; 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.

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. Services on Demand Journal.