Julio Huato : "I was thinking that, using the knowledge and information you *already* have about Mexico's or about countries with similar conditions and problems, at that (perhaps high) level of generality or abstraction, you made your points. . . . Let me list issues in which information people on PEN-L already have may be useful: technology, the environment, foreign policy, international economic relations, dealing with the U.S., development, macro policy, finance, political organizing, etc."
Dear Julio: I have enjoyed your insights into the situation of a country I know little about. I am 'shy', but perhaps these simple thoughts might be of some small use. Health. 1) Stats inevitably place the primacy for health care outcome figures on overall environmental issues and socioeconomic determinants of health - not hospitals. Thus: Any national programme should stress sanitation, clean water, clean air (mindful of Mexico City), nutrition. Achieving equity in income is beyond the direct purview of this limited-reformist type of approach that is aimed at here. I think that is the idea anyway. (I obviously have some ideas as befits one who professes some Marxist ideology!) 2) There are available health care models from even the most capitalist states (to wit - India) that show the health care benefits of a midwife-infant health care giver non-physician based rural care. Hence: A regionalised non-physician care system with emphasis on infant and mother health care. These would focus on preventive health care starategies - appropriate free vacccinations; weight gain & free nutritional supplements; advice re breast feeding strategies; delivery assistance; maternal support vs paternal battering etc... 3) Mixed model systems show that listening to the community challenges power structures & improves health care outcomes. Hence: A detailed sampling (in a non-hostile environment) that explicitly evaluates community responses to the level and type of health care they are recieving. This feed-back must be responded to. 4) A national health care structure that starts with a model of the preventive health care model. Including the regular medical chek-up that endorses highest levels of evidence. Canada has such a programme. I must say that I am not a Canada-phile but if you have to live in a 'classic' capitalist country.... 5) A system like the NICE programme in the UK - that brings experts together to explicitly weighs competing hlat care burden-costs-benefits - & comes out with some evidence based recommendations. My issue with this is that it often kills Peter to save Pauline. However.... again, short of a fully socialist state... Anyway... if you have progressive health care docs-health care workers who want links to far better policy advice than I can proffer, I would be happy to put them in touch with some leading lights. With Best Regards, Hari Kumar
