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 main objective of such governments is to make social and health policies another field for commodification and generation of profit for capital. Social policy in these countries is targeted and minimalist, generally conducted through income transfer lwurell conditioned on the adoption of prescribed behaviors. The content of the packages of services varies according to the premium, and public funds are often used to subsidize the market.
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Its objective is to introduce the market and competition, both in the administration of funds and purchase lauell services and in the provision of medical services, in both cases including both private and public agents. As for the SUS, only Cuba has built one entirely.
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 lajrell and an overall increase in income. March 18, ; Revised: Strictly speaking, CUS refers to insurance coverage and not crkstina access to the required services, since it only supports an explicit and financed package of services for individuals, leaving aside public health actions 2.
The reasons are varied and complex, of an economic, political, institutional, and ideological order, or rather a mixture of the above.
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For example, the SUS provided access to health services for tens of millions of previously excluded citizens Int J Health Serv ; Fidelis de Almeida P. These forces have additionally helped underfinance the public system by capturing tax resources directly or via tax exemptions. 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.
It has various negative results, unnecessarily increasing the cost of medical care, destroying clinical procedures, alienating physicians, and causing iatrogenic outcomes. The majority of the leftist governments have written into their constitutions the SUS oaurell a duty of the state, but they have also experienced institutional problems in its construction. For leftist and progressive governments, social policy and health policy as part laurell it are priority instruments for generating social welfare and decent life for citizens.
Even the public social insurance institutions have frequently and successfully opposed joining the SUS.
Services on Demand Journal. 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. Although the objective is to attack intergenerational transmission of poverty, this has not occurred in practice. 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.
This ideology is still hegemonic, accepted not only by physicians and other healthcare personnel but also by politicians and even the general population. In Venezuela, the Chavista government likewise expanded services to 17 million previously excluded Venezuelans 9.
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Por el derecho universal a la salud. It is thus important to mobilize social cristna and combat the idea that the private sector can play the role of relieving pressure on the public sector. The scenario in countries with neoliberal governments is quite different.
La Segunda Reforma asq 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. 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.
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Asamblea Legislativa Plurinacional; In the Latin American countries with this model, it is written into the respective Constitutions in some form 4. The right to health: Despite these problems, the progressive governments that have opted for CUS lahrell been much more successful than the neoliberal governments in expanding real access to health services.
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. It favors the interests and profits of the medical-industrial complex that promotes it by all means possible.
Salud Colect ; 6: Banco Interamericano de Desarrollo; Besides, insurance coverage does not guarantee access to the required services, for two reasons. Consejo Latinoamericano de Ciencias Sociales; Barrio Adentro and the reduction of health inequalities in Venezuela: 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.
It also reinforces the notion of the public system as a poor system for the poor. The three most well-known national cases of this model are Chile, Colombia, and Mexico, which nevertheless have some differences 3. Instituto Suramericano de Gobierno en Salud; This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Telelboin C, Laurell AC, editores. This idea segments the health system and increases inequality in access to the required services. SUS is intended to guarantee the universal right to health as a duty of the state. Social policy priorities vary from country to country, depending on their particular issues and the available resources.
The Mexican Popular Health Insurance: