Primeros pasos de la administración médica en el IMSS / First steps of medical administration at the IMSS

La creación de una organización tan grande como el Instituto Mexicano del Seguro Social (IMSS) requirió de mucha planeación para lograr administrar todas las prestaciones que se brindan a la población. Siendo así una necesidad contar con personal de salud con conocimientos y experiencia en administración en servicios de salud. El presente manuscrito es un reconocimiento a los doctores Manuel Barquín Calderón, Antonio Ríos Vargas y Carlos Zamarripa Torres, pioneros y protagonistas reconocidos en la planeación y organización (administración) de los servicios médicos del IMSS entre 1945 y 1955, quienes además tuvieron iniciativas racionales y constructivas, cumpliendo con su deber. Por otro lado, el Instituto expuso y proyectó que las actividades médico-administrativas eran una tarea compleja, y que su práctica necesitaba conocimientos especializados que no podían dejarse al azahar, al empirismo, a la buena voluntad, a las creencias o a la imaginación no objetiva.

The creation of an institution as large as the Instituto Mexicano del Seguro Social (IMSS) required a lot of planning to manage all the benefits provided to the population. Thus, it is necessary to have health personnel with knowledge and experience in health services administration. This manuscript is an acknowledgment to doctors Manuel Barquín Calderón, Antonio Ríos Vargas and Carlos Zamarripa Torres, pioneers and recognized protagonists in the planning and organization (administration) of the IMSS medical services between 1945 and 1955, who also had rational initiatives and constructive, doing their duty. On the other hand, the Institute exposed and projected that medical-administrative activities were a complex task, and that its practice required specialized knowledge that could not be left to chance, empiricism, good will, beliefs or nonobjective imagination.

Universal health coverage as a global public health goal: the work of the International Labour Organisation, c.1925-2018.

We examine the efforts of the International Labour Organisation (ILO) to extend medical care under social security, through international conventions, advocacy and technical assistance. We consider the challenges faced by the ILO in advancing global health coverage through its labourist, social security model. The narrative begins in the interwar period, with the early conventions on sickness insurance, then discusses the rights-based universalistic vision expressed in the Philadelphia Declaration (1944). We characterize the ILO's postwar research and technical assistance as "progressive gradualism" then show how from the late-1970s the ILO became increasingly marginalized, though it retained an advisory role within the now dominant "co-operative pluralistic" model.

Universal health coverage as a global public health goal: the work of the International Labour Organisation, c. 1925-2018 / Cobertura universal como meta global de saúde pública: o trabalho da Organização Internacional do Trabalho, c. 1925-2018

Abstract We examine the efforts of the International Labour Organisation (ILO) to extend medical care under social security, through international conventions, advocacy and technical assistance. We consider the challenges faced by the ILO in advancing global health coverage through its labourist, social security model. The narrative begins in the interwar period, with the early conventions on sickness insurance, then discusses the rights-based universalistic vision expressed in the Philadelphia Declaration (1944). We characterize the ILO's postwar research and technical assistance as "progressive gradualism" then show how from the late-1970s the ILO became increasingly marginalized, though it retained an advisory role within the now dominant "co-operative pluralistic" model.

Resumo Analisamos os esforços da Organização Internacional do Trabalho (OIT) em ampliar o cuidado médico sob seguridade social, via convenções, amparo e assistência técnica internacionais. Consideramos os desafios da OIT no desenvolvimento da cobertura global de saúde por meio do modelo trabalhista e de seguridade social. A narrativa inicia no período entreguerras, com as primeiras convenções sobre seguro saúde, depois discute a visão universalista baseada em direitos da Declaração da Filadélfia (1944). Classificamos a pesquisa e a assistência da OIT no pós-guerra como "gradualismo progressivo" e mostramos como, a partir do final da década de 1970, a OIT foi marginalizada, embora mantivesse um papel de conselheira dentro do atual modelo "pluralista cooperativo" dominante.

Evolución de la Seguridad Social en México y su relación con el contexto socioeconómico nacional (1900-2020) / Evolution of Social Security in México and its relation with the national socioeconomic context (1900-2020)

La seguridad social es un derecho fundamental al que todos los miembros de una sociedad deberían tener acceso puesto que incluye un conjunto de beneficios vinculados a estabilidad económica, de salud y mejor calidad de vida, aunque aún es un reto para alcanzar la cobertura sanitaria universal. En el presente artículo se muestra una revisión de las condiciones socioeconómicas de México, asociadas a la seguridad social, en diversos procesos históricos: Porfiriato, Revolución Mexicana, Revolución pasiva, Proteccionismo, Neoliberalismo y Lopezobradorismo. En cada uno se identificaron aspectos políticos, financieros y sociales relacionados con la mejora o estancamiento de la seguridad social. Estos hallazgos reflejan la importancia de reflexionar de manera propositiva sobre las variables socioeconómicas para comprender el éxito o fracaso de las políticas públicas y los resultados negativos para la salud de la población

The social security is a fundamental right which all society members should have access because includes a set of benefits linked to economic and health stability and better quality of life, although it's still a challenge to achieving universal health coverage. This article presents a review of socioeconomic conditions from Mexico associated to social security in various historical processes: Porfiriato, Mexican Revolution, Passive revolution, Protectionism, Neoliberalism and Lopezobradorismo. Political, financial and social aspects were identified in each of these and that were associated to the improvement or stagnation of social security. These findings reflect the importance of analyzing proactively about the socioeconomic variables to understanding the success or failure of public politics and their negative results for the population health

Political Accommodations in Multipayer Health Care Systems: Implications for the United States.

Current interest in a single-payer approach to universal health care coverage in the United States has also triggered interest in alternative multipayer approaches to the same goal.An analysis of experiences in Germany, the Netherlands, Switzerland, and Israel shows how the founding of each system required a distinctive political settlement and how the subsequent timing, content, and course of the reforms were shaped by political circumstances and adjustments to the founding bargain in each nation.Although none of these systems is directly transferable to the United States, certain parallels with the American context suggest that a multipayer approach might offer a model for universal coverage that is more politically feasible than a single-payer scheme but also that issues associated with risk selection and other potential inequities would remain.

Medicina del Trabajo y Seguridad Social una mirada desde Latinoamérica / Occupational Medicine and Social Security: a view from Latin America

No disponible

Disability in Mexico: a comparative analysis between descriptive models and historical periods using a timeline.

Some interpretations frequently argue that three Disability Models (DM) (Charity, Medical/Rehabilitation, and Social) correspond to historical periods in terms of chronological succession. These views permeate a priori within major official documents on the subject in Mexico. This paper intends to test whether this association is plausible by applying a timeline method. A document search was made with inclusion and exclusion criteria in databases to select representative studies with which to depict milestones in the timelines for each period. The following is demonstrated: 1) models should be considered as categories of analysis and not as historical periods, in that the prevalence of elements of the three models is present to date, and 2) the association between disability models and historical periods results in teleological interpretations of the history of disability in Mexico.

Disability in Mexico: a comparative analysis between descriptive models and historical periods using a timeline / Discapacidad en México: un análisis comparativo entre modelos descriptivos y periodos históricos mediante una línea del tiempo

Abstract: Some interpretations frequently argue that three Disability Models (DM) (Charity, Medical/Rehabilitation, and Social) correspond to historical periods in terms of chronological succession. These views permeate a priori within major official documents on the subject in Mexico. This paper intends to test whether this association is plausible by applying a timeline method. A document search was made with inclusion and exclusion criteria in databases to select representative studies with which to depict milestones in the timelines for each period. The following is demonstrated: 1) models should be considered as categories of analysis and not as historical periods, in that the prevalence of elements of the three models is present to date, and 2) the association between disability models and historical periods results in teleological interpretations of the history of disability in Mexico.

Resumen: Se argumenta que tres modelos de discapacidad (de prescindencia, médico/rehabilitador y social) se corresponden con periodos históricos en sucesión cronológica. Esta visión a priori ha permeado dentro de los principales documentos oficiales sobre el tema en México. El presente trabajo se propone probar si esta asociación es plausible, mediante la aplicación de una metodología de línea temporal. Se diseñó una estrategia de búsqueda con criterios de inclusión y exclusión en bases de datos para seleccionar estudios representativos, con los cuales se retomaron hitos a representar en la línea temporal por cada periodo. Se muestra que los modelos deben plantearse como categorías de análisis y no como periodos históricos, dado que: 1) existe prevalencia de elementos de los tres modelos en la coyuntura actual y 2) la asociación entre modelos y periodos da lugar a interpretaciones teleológicas de la historia de la discapacidad en México.

Social Security Is Fair to All Generations: Demystifying the Trust Fund, Solvency, and the Promise to Younger Americans.

The Social Security system has come under attack for having illegitimately transferred wealth from younger generations to the Baby Boom generation. This attack is unfounded, because it fails to understand how the system was altered in order to force the Baby Boomers to finance their own benefits in retirement. Any challenges that Social Security now faces are not caused by the pay-as-you-go structure of the system but by Baby Boomers' other policy errors, especially the emergence of extreme economic inequality since 1980. Attempting to fix the wrong problem all but guarantees a solution that will make matters worse. Generational justice and distributive justice go hand in hand.

[Four stages in the history of the Centro Médico Nacional Siglo XXI of the IMSS]. / Cuatro etapas en la historia del Centro Médico Nacional Siglo XXI del IMSS.

This document presents four stages in the history of the Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century) of the Instituto Mexicano del Seguro Social. The first stage started at the end of the third decade of the twentieth century and ended in 1961, it corresponded to the conception, planning and construction of what was to be the Centro Médico del Distrito Federal (Centro Médico of the Distrito Federal) belonging to the Secretaría de Salubridad y Asistencia (Ministry of Health and Assistance). The second stage began when the Center was acquired by the Institute, then was known like Centro Médico Nacional (Centro Médico Nacional ), being put into full operation in 1963, more than twenty-two years later, in 1985, an earthquake virtually ended it, immediately began its reconstruction, finishing the second stage. In 1989 began the third stage, different and new buildings complemented or replaced the structures damaged or destroyed by the earthquake which formed the now Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century). In 2004 the fourth stage opened when the four hospitals of the Center were categorized like Unidades Médicas de Alta Especialidad (High Specialized Medical Units).

En este documento se presenta en cuatro etapas la historia del hoy Centro Médico Nacional Siglo XXI del IMSS. La primera etapa se inició a fines de los años treinta del siglo XX y terminó en 1961, correspondió a la concepción, planeación y construcción de lo que iba a ser el Centro Médico del Distrito Federal que pertenecía a la Secretaría de Salubridad y Asistencia. La segunda etapa inició cuando el Centro fue adquirido por el Instituto Mexicano del Seguro Social, conociéndose como Centro Médico Nacional, el cual fue puesto en funcionamiento completamente en 1963; más de veintidós años después, en 1985, un sismo prácticamente lo acabó, aunque de inmediato se inició su reconstrucción, la cual terminó en 1989, año en que comenzó la tercera etapa. Fue entonces cuando diferentes y nuevas construcciones complementaron o sustituyeron a las edificaciones dañadas o destruidas por el temblor, que son las que hasta el día de hoy conforman el Centro Médico Nacional Siglo XXI. En el año 2004 se abrió la cuarta etapa, al categorizarse a los cuatro hospitales que configuran el Centro Médico Nacional Siglo XXI como Unidades Médicas de Alta Especialidad (UMAE).

Social Security Policy and the Early Disability Movement--Expertise, Disability, and the Government, 1965-77.

In 1965, the Disablement Income Group launched its National Disability Income campaign to fight for equal treatment of disabled people in the British social security system. By 1977, a series of benefits were created to cover the general population. Yet, despite the obvious political significance of these developments, very little research has focused on the early pan-impairment disability non-governmental organization (NGO). Existing scholarship has come from one of two traditions: the 'poverty lobby' and NGO histories that focus on expert campaign groups; and disability studies which describes a teleological narrative of the development of disabled people's attempts to secure civil rights. This article contends that neither approach is satisfactory. The crossovers between these two historical approaches are necessary to understand how these groups operated and to appreciate their political significance. Using the archives of the Disablement Income Group, the Disability Alliance and the Royal Association for Disability and Rehabilitation, this article shows that the history of these NGOs is more nuanced than previously described. Similarly, the novelty and growing power of civil rights and poverty lobby campaigning should not be overstated. Through a specific analysis of the lobby in its social and political context, historians can find a clearer picture of how these groups operated and better analyse their significance.

La extension del seguro de salud en Iberoamérica: una estrategia de política exterior del franquismo en la inmediata posguerra (1942-1959) / The expansión of health insurance in Latin America: a foreign policy strategy of the franco regime in the post-civil war perior (1942-1959)

La dictadura franquista por motivos de estrategia política intentó influir en materia de seguros sociales, en especial en la cobertura de la enfermedad, en los países iberoamericanos durante las décadas de 1940 y 1950. Los resultados de esta colaboración resultaron mediocres en la práctica y produjeron pocos avances reales, al margen de la imitación de las instituciones de gestión y algunos cursos de formación actuarial y estadística. Este fracaso se debió en gran medida al propio atraso y debilidad del modelo de cobertura sanitaria de la dictadura franquista ahogado por un déficit financiero crónico y con graves limitaciones tanto en la cobertura de la población como en las prestaciones ofrecidas. A partir de la década de 1960, una vez superada la etapa de aislamiento y autarquía, las autoridades franquistas redujeron su interés en la estrategia iberoamericana y comenzaron a mirar a Europa (AU)

For reasons of political strategy, the Franco dictatorship sought to have an influence in matters of social insurance, especially sickness coverage, in Latin American countries during the 1940s and 1950s. The results of this collaboration were mediocre in practice and led to little real progress, apart from imitating management institutions and some actuarial and statistical training courses. This failure was due to a large extent to the backwardness and weakness of the Franco dictatorship’s own model of health care provision, stifled by a chronic financial deficit and with serious shortcomings in both coverage of the population and provisions offered. Beginning in the 1960s, once the stage of isolation and autarky was overcome, the Francoist authorities reduced their interest in the Latin American strategy and started to look towards Europe (AU)

Israel's Long-Term Care Social Insurance Scheme After a Quarter of a Century.

Long-term care social insurance schemes exist in a number of countries, while the introduction of such schemes enjoys some support in others. Israel's long-term care social insurance scheme has been operating since 1988. This article examines the emergence, goals, design, and impacts of this scheme and draws out some of the lessons that can be learned from Israel's quarter century experience of long-term care social insurance.