Mexico’s health system: in longstanding pursuit of universal coverage and integration

Abstract

Mexico's system is dominated by corporatist, social insurance organizations governed by employer and employee trade unions in close relationship to the federal government, supplemented with government services for the uninsured, and a thriving private sector. Social insurance covers about half the population, although coverage for most is sporadic. Furthermore, these organizations have divergent service, financing, and governance structures, posing inequities and barriers in responding to beneficiary needs. Profiting from a growing capacity gap, the private sector now provides almost half of total outpatient consultations. Major public health challenges include obesity and diabetes, and social and health inequalities. Fiscal policy and improved preventive programs across institutions have had some effect on reducing health risks. Health policy has aimed towards universal coverage through coordinating government providers and strengthened public health programs. Since 2004 Seguro Popular had made progress toward universal health coverage, protecting about 85% of the population, reducing catastrophic expenses, and increasing coverage of high-cost interventions. However, to address health care package limits, attain universal financial protection and respond to corruption, President Lopez Obrador's administration canceled Seguro Popular from 2020 and established the National Health Institute for Wellbeing (INSABI). INSABI aims to equalize benefits across the insured and uninsured and re-centralize health authority by establishing the federal government as sole funder and provider of coverage for the uninsured. The separation of funding and provision, a hallmark of Seguro Popular, was replaced with supply-side funding, following the social insurance model. While these policies have challenges, they could facilitate integrating social insurance and tax funding into a single-payer capable of increasing efficiency and continuity of care as well as achieving greater equity.

The Experiences of Strategic Purchasing of Healthcare in Nine Middle-Income Countries: A Systematic Qualitative Review

“… 102 The REPSS were designed to exist outside of the state health agencies, in order to separate financing from provision, as a mechanism to improve the efficiency and quality of service delivery. 102 However, recent reforms have eliminated REPSS, effectively (re)centralising purchasing to a national level under INSABI 91 , 102 ( Table 2 ).…”

State-of-the-Art and Opportunities for Bioactive Pentacyclic Triterpenes from Native Mexican Plants

“…In the same way, this behavior is related in part to the equipment deficiencies mentioned previously but also with an abandonment of this research line at a national level and more closely to the current national pharmaceutical policy (regulation and centralization). This last aspect is exemplified with the reported 29% acceptance rate of new drug applications in 2018 by social security institutions [57]. An alternative for encouraging drug delivery development in the future may be the search for synergies with the local industry, public health institutions, and government.…”

Impact of surgical resection on the survival in Mexican patients with gastric cancer: A meta-analysis and systematic review

“…Besides, the Mexican health system still faces many challenges, such as health inequity and the implementation of an adequate reporting system for cancer patients. [10] There is scarce nationwide data regarding the number of surgical resections performed and the overall outcomes in GC patients in Mexico. Therefore, we hypothesize that surgical resection is associated with longer survival.…”