The crisis and economic adjustment policies of the 1980s added a dramatically high social cost to an accumulation of unresolved social problems. Data from international organizations reveal that close to half of all Mexicans now live in poverty, and of those, some 17 to 20 million are officially classified as living in extreme poverty, i.e., they are unable to afford even the minimum essential diet.(1)
Although the severe depression of wages and growing underemployment and unemployment (Gutierrez, 1989) explain a good deal of the deterioration in the social conditions of working people, another contributing factor is the reorientation of social policy and the 27% decrease in social spending between 1981 and 1989 (Poder Ejecutivo Federal, 1989a). The most relevant consequences of this situation are, on the one hand, a decreasing satisfaction of health care and educational needs, and, on the other hand, a marked deterioration of the public and quasi-state institutions that supplies these services.
The magnitude of the social problems contrasts with the lack of emphasis they are given in official proposals and measures taken to resolve the crisis. This is clearly related to the government's neoliberal approach, which emphasizes the fiscal crisis and the excessive size of the state. Thus, the strategy outlined in the 1989-1994 National Development Plan (Poder Ejecutivo Federal, 1989b) -- which is essentially a continuation and deepening of the neoliberal-neocorporatist project of the previous administration -- claims that social welfare will be achieved through economic growth based on private investment; state action as a solution to social problems is only emphasized in reference to aiding the most impoverished groups, particularly through Pronasol (the Mexican government's poverty program). However, a social policy with these characteristics represents a political problem for the government, which finds it necessary to present economic and social policies as though they were conceptually separate. This is expressed in the ideological formulation regarding how the state-as-property-owner is incompatible with the social state.(2)
Nevertheless, a growing number of social and political organizations are attempting to project alternate solutions to the crisis by giving maximum priority to social democracy. That is, they propose as the goal of their projects an economic recovery directed toward guaranteeing the fulfillment of the population's social rights. The existence of abroad current representing this perspective highlights the need to promote debate about the alternatives available to social policy as a state tool for addressing unresolved social problems and guaranteeing social rights.
This article attempts to contribute to this process by analyzing a specific area of social policy, specifically, the production of health and education services. The first section assesses the principal changes since 1983, recognizing the continuity of policies since that date and the current problems in this area. Then the article delineates the strategic axes of an alternate policy that (1) makes the strengthening and the democratic transformation of the public institutions that produce the services priorities, (2) favors the redistribution of social wealth toward the working classes, and (3) paves the way for eventually removing the obstacles to the integration of single systems of health and education with universal access. This allows us to clearly present the option implicit in the government's project and contrast it with the option delineated here. Only in this way can we generate an informed public debate, which is a necessary condition for democratic participation in the resolution of social and political problems.
II. A Diagnosis
As a point of reference to characterize social policy, one can distinguish, in broad terms, between two general models that are based on the character and importance of the state's role in regulating, producing, and financing activities designed to guarantee the welfare of the population. …