The head of Mexico’s main public health system resigned from President Andrés Manuel López Obrador’s Cabinet on Tuesday with a blast at cost-cutting budget officials.

Germán Martínez Cázares is the first Cabinet minister to quit since López Obrador took office Dec. 1.

Martínez Cázares posted a lengthy letter on the Mexican Social Security Institute’s website accusing the finance ministry of “neoliberal” impulses with demands for cost and personnel cuts.

Martínez complained of “pernicious meddling” that threatens the institute’s ability to provide health services.

He described a system teetering at the edge of an abyss with full waiting rooms, stalled infrastructure projects, staff vacancies and precarious supplies of medicine.

The letter was addressed to the institute’s technical council.

López Obrador has pushed his government to control costs in ways big and small. He’s done away with his own presidential security detail and flies commercial. On Tuesday, he said since he imposed a rule requiring his approval for any international travel by government officials, he has received about 100 requests and only approved 20.

Later Tuesday, López Obrador told reporters he stood with finance officials in the dispute with Martínez and said that health services were not at risk.

“The finance ministry has to make sure there isn’t a deficit,” López Obrador said. “And I support that policy.”

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