RESUMO
In this paper the authors stated the performance of the National System of Charges for Medical Services of the Mexican Ministry of Health. The study focus the analysis on 1,776 charges on hospitals at a secondary level of attention. It includes a presentation of the background of the System, and it's regulations, major problems and irregularities. The main founding were: a) irregularities on the classification for payment of the patients according to social class. The 67 per cent of users were classified in the upper class section; b) additional charges of 109 per cent on deconcentrated states; c) fees don't established on information on costs. The authors recommended: 1) Establishment of cost units on regional basis; 2) standarization of procedures of socioeconomic classification, exemption o payment and disminution of discretional procedures; 3) programmed adjustment on fees; 4) Monitoring of the system; 5) integration to the System of the third level of attention and the descentralized states and; 6) solution to budget problems.