The Commodification of Health Services: an Alternative for the Marginalized Population of Mexico City / A mercantilização dos serviços de saúde: uma alternativa para a população marginalizada da Cidade do México

Abstract The Doctor's Office Adjacent to Pharmacies (DAP) model has grown exponentially in Mexico. Its proliferation is due to two factors. The first is the high cost of medical consultations in private hospitals, and the second is that public health services are insufficient. To gauge the importance this model has acquired, it is necessary to analyze the pattern of distribution and operation of this type of doctors' offices and determine whether they are responding to the unmet demand of a population that is socio-territorially marginalized from health infrastructure. A database was created with updated, geo-referenced information on the precise location of DAP throughout Mexico City and its metropolitan area. Information was obtained on the location, condition and type of franchise, and the infrastructure of each establishment. The analysis found that the distribution pattern of DAP satisfies an unmet need in areas with the highest demand for health services. This situation occurs particularly in areas inhabited by the most marginalized population.

Resumo No México, o modelo Consultório Médico Adjacente às Farmácias (DPA) cresceu exponencialmente. Sua proliferação se deve a dois fatores. A primeira é o alto custo das consultas médicas em hospitais privados e a segunda é que os serviços públicos de saúde são insuficientes. Para determinar a importância que este modelo adquiriu, é necessário analisar o padrão de distribuição e funcionamento deste tipo de consultórios e verificar se estão a responder à procura não satisfeita de uma população socioterritorialmente marginalizada da infraestrutura de saúde. Metodologicamente, foi criado um banco de dados com informações atualizadas e georregerenciadas sobre a localização precisa dos DAP em toda a Cidade do México e sua região metropolitana. Foram obtidas informações sobre a localização, condição e tipo de franquia, e a infraestrutura de cada estabelecimento. A análise constatou que o padrão de distribuição de DAP atende a uma necessidade não atendida em áreas com maior demanda por serviços de saúde. Esta situação ocorre particularmente coincide onde se encontra a população mais marginalizada.

Increasing insurance protection efforts and improving the fairness of health care services: A-nalysis on the convergence mechanism between New Rural Cooperative Medical Scheme and Healthcare Financial Assistance Program / 中国卫生政策研究

The goal of China's health care insurance system is to improve the fairness and accessibility of health care services for low-income people. In the past 10 years of practice, the insurance has made remarkable a-chievements and gained popularity among broad masses of people. With the support of World Bank and UK Depart-ment for International Development, China Rural Health Development Project ( hereinafter referred as Health XI Project) have used the advantages of unique funding, management and human resources to launched a series of pro-ject activities, with the main goal of achieving effective convergence between the New Rural Cooperative Medical Scheme (NRCMS) and Healthcare Financial Assistance Program (HCFAP) in order to explore the assistance system of catastrophic diseases. Some areas have achieved seamless convergence between NRCMS and HCFAP to explore the assis-tance program for catastrophic diseases in the context of confirming and optimizing the management of services covered by the project, especially conducting a series of exploration and practice activities in the aspects of increasing new funding channels to establish theCatastrophic Disease Assistance Fund, strengthening the related supporting regulations, etc. The results show that the utilization of services covered by HCFAP in the project has significantly improved, the protection level of health insurance has greatly improved, and the people satisfaction has significantly increased.

Analysis on the Countermeasures of Medical Aid to the Urban Poor Population / 中国医学伦理学

The World Health Organization points out that everyone has right to acquire basic health care service and social guarantee. The government should adopt proper and legal means to gradually realize everyone's health right with current resource.As the aggravation of poverty problem in the city,the problem of urban poor population will become one of the most important political events in the 21st century.Through analysing the problem of urban poor population in health care,this article discusses the mechanism of medical aid and the countermeasures to meet the basic medical demand of urban poor population,which will help to improve the health of poor population in the city,the medical service utilization and health fairness.