[EQ] The democratization of health in Mexico: financial innovations for universal coverage

The democratization of health in Mexico:
financial innovations for universal coverage

Julio Frenk a, Octavio Gómez-Dantés b & Felicia Marie Knaul c
a. Harvard School of Public Health, Boston, MA, United States of America.
b. National Institute of Public Health, Cuernavaca, MO, Mexico.
c. Mexican Health Foundation, Mexico, DF, Mexico.
Bulletin of the World Health Organization Volume 87, Number 7, July 2009, 485-564

Available online as at: http://www.who.int/bulletin/volumes/87/7/08-053199/en/index.html

“……In Mexico, important strides have been made in increasing people’s access to comprehensive health care, thanks to a health reform that made health care a legal right, as prescribed by amendment to the Mexican Constitution in 1983. Through the new Seguro Popular, by 2010 high-quality health care will have been extended to everyone in Mexico. Thus, the democratization of health care – defined as the application of democratic norms and procedures to individuals deprived of the benefits and duties of citizenship, such as women, youngsters, ethnic minorities or workers of the informal sector of the economy²⁹ – will have been attained.

This paper has provided evidence that the financial innovations linked to the Sistema de Protección Social en Salud are improving insurance coverage, the availability of health infrastructure and basic health inputs, health-service utilization, effective health-care coverage, and the levels of financial protection enjoyed by the Mexican population, especially among the poor.

However, Mexico continues to face important challenges, mainly in connection with emerging diseases. Disease control efforts before the epidemiological transition yielded important improvements, but as immunization coverage increased and deaths from diarrhoea, acute respiratory infections and reproductive events dropped, non-communicable diseases began to take a proportionately larger toll. As a result, there is a critical need for additional public funding to extend access to costly interventions for non-communicable health conditions not yet covered by the FPGC, such as cardiovascular diseases, adult cancers and the complications of diabetes.

The benefits offered by the Seguro Popular in public outpatient clinics and general hospitals are very similar to those provided by comparable services in social security agencies. However, there is still a need to extend the coverage of costly interventions, which is still higher at IMSS, ISSSTE and other social security agencies……”

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