This paper analyzes health sector reform as a political process by examining the Mexican experience. The analysis is based mostly on qualitative methods (interviews, official documents and newspapers). Figures and trends of health outcomes and access complement it. The analysis is divided in three parts. First, it traces the political and economic forces that have historically shaped the segmented configuration of the health system and that set the political context to analyze both the 1980s and the current processes of health sector reform. Both processes have led to increasing health inequalities. Second, it focuses on the 1980s reform experience by analyzing the role of the most important groups that influenced both the policy making process and the outcome of this effort of reform, as well as to assess the state weakness and little capacity to implement it. Then it builds on the analysis of both the historical and the 1980s policy making process to help evaluate the feasibility of the current health sector reform. Analyzing the political dimensions of health care reform in Mexico helps to explain why the efforts to integrate the segmented structure of the health system have failed because the power of the Mexican Institute of Social Security (IMSS) has managed to successfully oppose the changes that threaten its hegemony in the Mexican health sector. These findings suggest that political analysis provides important insights to better understand the inequalites behind health care reform processes.
Key words: Health care reform, Policy making process, Political analysis, Mexico.
Learning Objectives: 1. Assess the role of politics in health care reform by examining the Mexican experience 2. Identify the factors that have led to health care inequalities in Mexico 3. Recognize why integration as a health care reform strategy is politically difficult
Keywords: Health Care Reform, Politics
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.