Breilh, J. La medicina comunitaria: ¿Una nueva policía médica?[Community medicine. A new medical police?] Revista Mexicana de CienciasPolíticas y Sociales (Mexico, DF) 1976:84:57-82.

English Version: Breilh, Jaime. Community medicine under imperialism: A newmedical police? In: Navarro, Vicente (Editor). Imperialism, health, andmedicine. Farmingdale: Baywood Publishing Co., 1981, p. 149-168.

Objectives: To analyze the essential elements of the community medicine model that developed in Latin America during the 1960s and 1970s, and to compare this model with its European (especially German) counterpart of the 18th and 19th centuries, commonly known as the medical police model.

Methodology: Analytical-interpretive.

Results: The author demonstrates the similarities between the political or ideological objectives of the medical police system of the European absolutist states and those underlying Latin American community medicine. Both systems employed strategies designed to enhance state power and ideology. The model introduced by John Peter Frank in 1779 became widely accepted throughout Europe through the middle of the 19th century. In the less advanced European countries, a more paternalistic version took hold, whereas the more industrialized countries emphasized the application of work force health management measures. In Latin America, the crisis of the Flexnerian medical model reflected the larger socioeconomic crisis of the 1960s. As the state contained expenditures on health, it increased its degree of control over citizens.

This situation led to the appearance of the “community medicine model,” which, apart from its community service goals, became a strategic instrument of political control and social repression, geared to strengthening state power. The author elucidates the various mechanisms through which community medicine served the political and economic interests of the state. These included stimulation and rationalization of productivity, social and political coercion, and creation of low cost alternatives to the provision of integrated health services.

Conclusions: Although the two systems arose at different historical junctures and responded to different forms of state organization, the strategic parallel between the classic medical police model of Europe and the community medicine programs in Latin America is apparent. In both cases, the functions of state control, normalization, and legitimization are paramount.

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