Vol 22, 2013 Annals of Health Law 381
UNIVERSAL HEALTH COVERAGE IN MEXICO
of Article 73 of this Constitution.37
A year later, the first General Health Law (Ley General de Salud) was
passed.38 This law replaced an old-fashioned sanitary code and regulated
the new right to the protection of health.
Most social critics praised the addition to Article 4 and the new law as
milestones but there were also calls to caution regarding their immediate
impact. Law texts made clear that constitutions like that of Mexico had
three types of provisions: positive, which generate rights and obligations;
organizational, which establish the arrangement of constitutional
institutions; and programmatic, which establish action advices for
constituted powers.39 The right to the protection of health was a
programmatic provision and, as such, only a guide for public action. The
declaratory character of programmatic norms implies that they cannot be
asserted in a trial, which means that the recipients of the new social right
could not force the State to comply with what was established in such a
This did not discourage those involved in the effort to reform the
Mexican health system. Francisco Ruiz-Massieu, lawyer and senior official
of the Ministry of Health, quoting Burdeau, stated the following in an
article published in 1983, a few months after the incorporation of the right
to the protection of health into the Mexican Constitution: “Those working
with legal norms know that the law is more than an instrument of coaction
[. . .] it is a representation of the future, a creator of the social future,
because it is the motor of political dynamics.”40
In closing that particular article, Ruiz-Massieu made a call to accelerate
change in the Mexican society in order to democratize it, creating, among
other things, the conditions for the effective exercise of social rights. Those
conditions were reached until the year 2000, when Vicente Fox was elected
President of Mexico. His term marked the end of a seventy year-old
authoritarian regime headed by the Institutional Revolutionary Party (PRI).
37. Constitucion Politica de los Estados Unidos Mexicanos [ C.P], as amended en 2009,
Diario Oficial de la Federacion [DO], 5 de Febrero de 2013 (Mex.).
38. Ley General de Salud, El Diario Oficial de la Federación [DO], 7 de febrero de 1984
39. PAOLOBISCARETTIDIRUFFIA,INTRODUCCION ALDERECHOCONSTITUCIONAL
COMPARADO: LAW FORMAS DE ESTADO Y LAS FORMAS DE GOBIERNO, LAS CONSTITUCIONES
MODERNAS 321-22 (Fondo de Cultura Economica, Fondo de Cultura Economica 1975).
40. Jose Francisco Ruiz-Massieu, El Contenido Programático de la Constitución y el
Nuevo Derecho a La Protección de la Salud, 25 SALUD PUBLICA MEX. 353, 353 (1983).