The North American Free Trade Agreement (NAFTA) may not imply changes in the immigration laws of its signatories, but it will make it easier for people to move freely among Canada, Mexico, and the United States. One of the concerns arising from NAFTA involves meeting the health care needs of people who move from one member country to another. The publication analyzes the legal implications of the access to health care by individuals from NAFTA countries who are temporarily working or residing in another member country. The book compares the health systems of Canada, the United States, and Mexico, focusing on their principles and objectives, legal framework, institutional structure, operational modalities, and outcomes. Detailing the similarities and differences among the systems of these three countries, this publication attempts to anticipate the treaty's potential benefit or detriment to access to health care services and examines the expectations and concerns that free trade generates in this respect.

?This academic but passionate and controversial work should be read by specialists on Mexico and Latin America, as well as by those interested in healthcare and social policy in general.??Carmelo Mesa-Lago, University of PittsburghHas Mexico, twenty years after beginning the process of decentralizing its health system, realized the anticipated benefits of increased community participation and improvements in efficiency and quality? Addressing this question, Decentralizing Health Services in Mexico presents a thorough historical and theoretical grounding, as well as representative case studies of decentralization at the state and local levels.The authors combine qualitative and quantitative data in their examination of the transfer of authority over fiscal, human, and physical resources in the health sector. The result is a major contribution to the ongoing debate over the advantages and disadvantages of decentralization in varying political, cultural, and economic contexts.Nuria Homedes is associate professor at the University of Texas School of Public Health-Houston. Antonio Ugalde is emeritus professor at the Department of Sociology, University of Texas at Austin. CONTENTS: Decentralization: Theory and History. Decentralization: The Long Road from Theory to Practice?the Editors. Decentralization of Health Services in Mexico: A Historical Review?the Editors. The First Attempt, 1983-1988. Decentralizing Health Services: Formulation, Implementaion, and Results?M. Gonzalez-Block, R. Leyva, O. Zapta, R. Loewe, and J. Alagon. Federalist Flirtations: The Politics and Execution of Health Services Decentralization for the Uninsured in Mexico, 1985-1995?A.-E. Birn. Trying Again, 1994-2004: Case Studies from Five States. ?Decentralized? in Quotes: Baja California Sur, 1996-2000?L. Olvera Santana. The Slow and Difficult Institutionalization of Health Care Reform in Sonora: 1982-2000?R. Abrantes Pego. Guanajuato: Invisible Results?S. Arjonilla Alday. Nuevo Leon and Tamaulipas: Opening and Closing a Window of Opportunity?the Editors. Decentralization at the Health District Level in Nuevo Leon?the Editors. Conclusions?the Editors.

A setenta años de su fundación, El Colegio de México publica esta serie de dieciséis volúmenes, titulada Los grandes problemas de México, en la que se analizan los mayores retos de la realidad mexicana contemporánea, con el fin de definir los desafíos que enfrentamos en el siglo XXI y proponer algunas posibles respuestas y estrategias para resolver nuestros problemas como nación. Serie: Los grandes problemas de México. Vol. XIII Políticas públicas, está dividido en cuatro partes, que abordan desde diversos ángulos la naturaleza y capacidad del Estado mexicano para formular e implementar las políticas públicas. La primera trata aspectos del marco institucional de las políticas públicas, como las relaciones entre el Ejecutivo y el Legislativo, la evolución del tamaño y naturaleza del Estado, la planeación y la evaluación. La segunda se enfoca en las políticas de modernización y el estado general de la administración pública federal centralizada. La tercera incluye capítulos sobre algunas organizaciones y políticas en ámbitos nacionales distintos a la burocracia central, esto es, la administración pública federal descentralizada y la sociedad civil. La cuarta y última se refiere al estado de la relación entre las esferas federal, estatal y local y su impacto en las políticas públicas.

This report helps policy makers better understand the issues and challenges around geographic variations in health care provision and considers the policy options.