A 1970s and 1980s poverty alleviation program, IMSS-COPLAMAR, challenged universal definitions of poverty as well as health models for rural areas while proffering a distinctly Mexican alternative. Yet this solution, broadly painting rural dwellers as marginados (marginalized), focused on need-based definitions of social exclusion and thus incongruously erased ethnic diversity while celebrating Indigenous forms of healing. Indeed, linking notions of poverty to health programs redefined poverty in the late twentieth century as an economically preventable ailment. More problematically, the term marginados tended to flatten the complex identities of the rural poor. Despite these faults, the program was groundbreaking and inventive in its conception. At its core, this article shows how radically innovative and socially inclusive domestic programs that emerged in the late twentieth century from the so-called developing world found it difficult to compete against—and survive—prescriptive solutions pushed by international organizations, especially at the dawn of neoliberal reforms.