1. Divided Economy - Divided Medicine An Introduction to the Mexican Health Care System Luis Alberto Avilés UCSD Center for Iberian and Latin American Studies

2. Traditional approach: Analyze medical statistics Population to be served: 95 million Health services indicators: 19911997 MDs /10,000 pop. 8.9 13.6 RNs / 10,000 pop. 15.8 18.1 Outpatient consultations:1415/1,000 pop. Dental consultations: 124/1,000 pop. Hospital occupancy rate: 69% Average length of stay: 4.1days

3. Better approach: Analyze society

4. Focus on social divisions

5. Analyze the elite and sources of power

6. Analyze the situation of the middle classes

7. Analyze the working classes and their social exclusion

8. How to analyze health care systems?  Consider the distribution of health and disease as a product of the way society is organized and stratified.  Consider the structure of the health care system as the result of historical, social, and political processes.

9. Visionaries of the Social Origins of Disease Friederick Engels: “The Conditions of the Working Class in England” Rudolf Virchow “Report on Typhus Epidemic in Upper Silessia” Salvador Allende “La Realidad Médico-Social Chilena”

10. Political Economy of Health “… a macroanalytic, critical and historical perspective for analyzing disease distribution and health services under a variety of economic systems, with particular emphasis on the stratified social, political, and economic relations within the world economic system.”