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 out-of-pocket 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 1984 General Health Law, draw' on this constitutional provision. The Ministry of Health and Assistance (Secretaria de Salubridady Asistencia, SSA) w'as formally established in 1943, 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.