this constitutes a real problem of inequitable access more deprived socioeconomic groups and more deprived states can expect to have access to much more limited services high outofpocket payments which make up a quite significant proportion of health spending risk being a significant financial burden for mexican citizens especially those least able to pay later codifications such as the general health law draw on this constitutional provision the ministry of health and assistance secretaria de salubridady asistencia ssa was formally established in by merging the ministry of public assistance and the public health department with a mandate to extend coverage to the poor and to set overall public health policy