The article discusses the health care reforms that have been underway in Mexico since 1982. The process is examined as a socio-political phenomenon whose dynamics and nature are the products of past and present conflicts regarding technical and social-work projects, which constitute reflections of certain views of the future. The text first looks at the government-engendered power structure that has dominated the health care sector and that has benefited certain social groups, encouraged their development, and incorporated them into its power structures while simultaneously marginalizing or repressing others. The article next offers an empirical reconstruction of the "social history" of this reform, that is, of the dynamics of interests and conflicts surrounding the question of how the health care sector might best be shaped.
health care services; structural reform; health care in Mexico; government action Introducción