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Structure of the Health Care System

Unlike any of the other countries de- scribed in this chapter, Mexico has a three-part system for health care: (1) private health care and health insurance for the wealthiest, (2) a government-provided insurance program for salaried workers (Social Security), and (3) a separate gov- ernment-provided insurance program for everyone else (Seguro Popular). This three-tiered system is a product of Mexico’s unique history in which revolutionary fervor and conservative sentiments have always counterbal- anced each other and in which the social and economic division between indige- nous people (who now make up less than 10% of the population) and others (who are primarily a mix of Spanish and indigenous people) has remained important.

Over the centuries, Mexico has experienced several revolutions—some vio- lent and some at the ballot box. Throughout the 20th century, these revolutions resulted in gradual improvements in the health care available to Mexico’s citizens. In 1917, Mexico’s new constitution first gave the federal government responsibil- ity for health care. The government soon began providing funds for rural clinics staffed by health aides and, by the 1930s, began requiring all new physicians to work for a year in a rural community.

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