JOSÉ LAGUNA OCTAVIO CASTILLO Y LÓPEZ JOSÉ DE JESÓS VILLAPANDO-CASAS
The National Health System of Mexico contains three main components: (1) the social security subsystem covering workers and employees, their families, and retired personnel; (2) the public welfare subsystem (i.e., federal and state institutions providing health services to people not covered by a social security institution--mainly rural and marginal urban populations); and (3) entities of the social and private sectors, which usually have the financial means to provide medical care of good quality.
Persons affiliated with the social security subsystem enjoy a stable labor situation, reside in urban localities, and have access to other basic needs such as education, housing, and transportation. People in the public welfare subsystem lack steady employment: they are frequently peasants who work only part of the year and have limited access to other health resources, medical or non medical (clean water, nutrition, etc.); moreover, they live in marginal socioeconomic and cultural conditions. In any of the subsystems it is possible to identify two schemes for health care delivery: one oriented to individual-based medicine and the other to the provision of "community-oriented primary care." The first model prevails in all subsystems.
The Ministry of Health plays a most important role in the national health system, as it is responsible for the definition and operation of national policy in matters of medical care, social welfare, and public health. Specific activities include the sanitary control of goods and services (pharmaceuticals, cosmetics, etc.), as well as the coordination of health care service programs in the states and the Federal District. The Ministry of Health also coordinates the subsystem derived from the National Institutes of Health, which provide tertiary level medical care, advanced education, and training, and a setting for basic, applied, and clinical research in medical specialties, including cardiology, nutrition,