Introduction
The National Development Plan (NDP) 2025-2030, approved on April 10 by the morenista majority and accompanying parties (Labor Party and Green Ecology Party of Mexico), was presented as the roadmap for the “Second Floor of Transformation.” It aims to establish a universal and free healthcare system along with dignified social security for all Mexicans. However, a rigorous technical analysis and evidence-based evaluation of its goals, strategies, and commitments reveal a document filled with good intentions but lacking substance, clear direction, or transformative ambition in health and social security matters.
Health Goals: Mediocrity as the Horizon
Examining the key indicators from the NDP itself, the level of mediocrity in its health commitments becomes evident. The plan’s primary goal is to reduce healthcare access disparity from 39% in 2022 to 22% by 2030. In essence, it aspires to return to the 2020 level, disregarding the severe decline following the Seguro Popular’s disappearance and the failed implementation of INSABI and subsequently IMSS-Bienestar. More alarmingly, the government explicitly renounces its international commitment to achieve Universal Health Coverage by 2030, as outlined in the UN’s Agenda 2030 and Mexico’s own Article 4 Constitution.
The second significant goal is to increase complete prescription fulfillment from 65% in 2022 to 80% by 2030. This means the NDP acknowledges, in practice, that one out of every five Mexicans will still lack access to all prescribed medications in the public system even after six years. This is a tacit admission of the government’s weakness in medicine and supply chain management, as well as its inability to ensure basic supplies in clinics and hospitals.
The NDP lacks concrete targets for reducing maternal mortality, improving chronic disease care, strengthening hospital infrastructure, or ensuring sufficient medical and nursing personnel. It also omits any quantifiable commitments regarding mental health, preventing non-communicable diseases, or attending to vulnerable populations like indigenous people, individuals with disabilities, or the elderly.
Contradictions Between Rhetoric and Budgetary Reality
The official discourse emphasizes the consolidation of IMSS-Bienestar, the creation of “Farmacias para el Bienestar,” and hospital modernization. However, the NDP fails to specify investment amounts, funding sources, or detailed infrastructure plans. Worse, the 2025 health budget suffers an 113 million pesos cut. How can universal and free healthcare be achieved with fewer resources, personnel, and medications?
The medicine shortage crisis, acknowledged even by President Sheinbaum during recent tours, remains unsolved in the NDP. The document avoids detailing solutions for supply chain issues, distribution strengthening, or efficient inventory purchasing. The reality is that millions of Mexicans will continue without access to their treatments while the government merely promises hollow assurances and modest targets.
Social Security: Lack of Integral Vision and Financial Sustainability
Regarding social security, the NDP boasts about consolidating IMSS-Bienestar and integrating social programs. Yet, it neglects the regular IMSS regimen, historically the backbone of the system. It also fails to address fragmentation between IMSS, ISSSTE, IMSS-Bienestar, and state services. The financial sustainability of IMSS is questionable: without unifying tax databases and combating tax evasion, the institute’s finances will remain fragile.
The plan does not address the urgency of strengthening health personnel formation and retention or propose strategies to improve care quality. It merely mentions creating a National Care System and home care for the elderly without specifying resources, logistics, or verifiable goals.
Superficial Diagnosis, Absence of Indicators, and Lack of Transparency
The NDP fails to meet the requirements set by the Planning Law: it lacks a thorough diagnosis of the current health system, does not establish clear and measurable goals beyond the two mentioned indicators, and does not project necessary resources to achieve its stated objectives. This contradicts Articles 21 and 21Bis of the law, which demand precision and transparency in national planning.
The absence of an integral vision translates to the lack of proposals for improving coordination between subsystems, digitizing clinical files, ensuring transparent resource use, or evaluating the real impact of public policies. In summary, the NDP is a catalog of good intentions without operational, financial, or technical backing.
Comparison with International Evidence and Experience
While other regional countries advance towards universal coverage and effective guarantee of health rights, Mexico settles for regressive goals and openly admits its inability to fully supply prescriptions. The official ideology, boasting of “sufficiency” in medicines and supplies, clashes with daily evidence of shortages, gaps, and delays in care.
The contrast is stark: while proclaiming a robust and sufficient system, the NDP resigns to 80% prescription fulfillment by 2030.
Conclusion
As a legislator, medical professional, and representative of León, Guanajuato’s District 05 residents, I maintain that the NDP 2025-2030 is a missed opportunity to transform Mexicans’ lives in health and social security matters. Grandiose promises clash with the reality of reduced budgets, mediocre goals, and the complete absence of concrete, viable strategies.
I call on the federal government to reconsider the budget cut and present a coherent, detailed, and financially viable health plan. Mexicans’ health should not be held hostage by unattainable promises or inconsistent policies. We need genuine commitment, backed by sufficient resources and evidence-based strategies. Only then can we move towards a truly universal, equitable, and high-quality health system. Health cannot wait. Mexicans deserve more than empty promises and mediocre goals.
*The author (www.ectorjaime.mx) is a general surgery specialist, certified in public health, and holds doctorates in health sciences and public administration. He is a legislator and advocate for Mexico’s public health, reelected PAN group member in the LXVI Legislature.
