It is referred to as the open system. The facilities of both the open and premium-based health care systems are classified as primary care, second level or third level. Each system offers services throughout all 31 states and the Federal District. In a few of the more remote and less populated areas, second and third level facilities may not be available. The National Health Care System is based on an extensive infrastructure of more than 15,000 medical centers, of which about 13,000 are primary care facilities.
Organization providing health services have heterogeneous structures.
There is diversity in the range of services and the quality of the services offered by both private and public sectors among the geographic regions. The greatest challenge of public health has been equitable access to adequate health and social services. However, conditions in the country after the economic crisis in 1982, after two decade of constant growth, undermined the achievement of these objectives and increased the demands of the population. In fact, the future of public health system today remains unclear. Reforms are needed in order to increase coverage and equity, but also to contain costs.