Abstract：
Health systems are complex entities. The Mexican health system includes the private and public sectors, and subsystems that target different populations based on corporatist criteria. Lack of unity and its consequences can be better understood using two concepts, segmentation and fragmentation. These reveal mechanisms and strategies that impede progress toward universality and equity in Mexico and other low- and middle-income countries. Segmentation refers to separation of the population by position in the labour market. Fragmentation refers to institutions, and to financial aspects, health care levels, states\' systems of care, and organizational models. These elements explain inequitable allocation of resources and packages of health services offered by each institution to its population. Overcoming segmentation will require a shift from employment to citizenship as the basis for eligibility for public health care. Shortcomings of fragmentation can be avoided by establishing a common package of guaranteed benefits. Mexico illustrates how these two concepts characterize a common reality in low- and middle-income countries.
摘要：
卫生系统是复杂的实体。墨西哥的卫生系统包括私营和公共部门，以及基于社团主义标准针对不同人群的子系统。使用两个概念可以更好地理解缺乏统一及其后果，分割和碎片化。这些揭示了阻碍墨西哥和其他低收入和中等收入国家在实现普遍性和公平性方面取得进展的机制和战略。分割是指按劳动力市场中的职位划分的人口分离。碎片化是指机构，在财务方面，卫生保健水平,陈述了护理系统，和组织模式。这些因素解释了每个机构向其人口提供的资源分配和一揽子保健服务的不公平。克服分割将需要从就业转变为公民身份，以此作为获得公共医疗保健资格的基础。通过建立一个共同的保证利益包，可以避免碎片化的缺点。墨西哥说明了这两个概念如何表征低收入和中等收入国家的共同现实。
