the new approach granted a greater degree of administrative independence to states than under the first stage even though tight financial constraints were maintained through a system of earmarked federal transfers the states agreed to increase financing of health care from their own resources to reach of their budgets although this target was not always reached unlike the first wave of reforms the imssoportunidades system maintained its independence from state health services shs for the remaining states decentralised under the second wave while the general health law regulates all aspects of the health sector and draws on the universal right to health protection set out in the constitution it includes no comprehensive list or specific package of services covered beyond this generic entitlement to coverage a principal also indicated in the social security laws governing imss and issste