Introduction to Mexico’s Healthcare Landscape
Mexico’s medical services are provided by public, private, or social health institutions, along with professionals, technicians, and auxiliaries who freely engage in any activity related to these services. Over the past 25 years, public health institutions have undergone transformations.
Historical Context
Until 2019, the open population had access to services through the Seguro Popular, the Secretaría de Salud, state health services, and the IMSS-Oportunidades program. These institutions aimed to ensure comprehensive access to public health services without social, labor, or economic distinctions.
Government Interventions and Their Impact
Starting in 2019, the government distorted public health institutions’ organization, leading to the cancellation of the Seguro Popular and IMSS-Oportunidades. The Seguro Popular, which included a catastrophic expense protection fund for its beneficiaries, was dissolved in 2020 and replaced by the INSABI, which performed poorly and had management issues. Its functions were later taken over by IMSS-Bienestar in 2023.
Consequences of Erratic Measures
These erratic measures left nearly 45 million Mexicans (more than seven times Denmark’s population) without access to healthcare services, equivalent to 34% of the total population—more than double those without such services in 2018. The main reasons are declining public investment, poor administration, low-quality services, and shortages of personnel and medications.
Institutions Providing Healthcare Services
Security social institutions offering health services to their beneficiaries include the IMSS, ISSSTE, local security social institutions, and services provided by PEMEX, the Defense Secretariat, and the Navy to their employees.
The private sector offers health services to those with the capacity to pay.
The Need for Improved Mechanisms
Given the current circumstances, it’s crucial for the population to have mechanisms beyond protests and marches that safeguard their right to health protection and improve medical service quality and accessibility. This responsibility falls on CONAMED and state commissions, which have been largely absent but will be strengthened through reforms to the General Law of Health.
Common Conflicts in Mexico’s Healthcare System
As mentioned earlier, conflicts in the healthcare sector also affect insured individuals, primarily due to coverage rejection and delays in authorization from insurers. CONAMED currently lacks the authority to address these disputes, which typically involve policyholders who trust insurers but later discover their agents’ enthusiasm for selling policies contrasts with their stance on claims.
Key Questions and Answers
- What is the current state of Mexico’s healthcare system? The system faces significant challenges, including insufficient public investment, poor administration, low-quality services, and shortages of personnel and medications.
- Which institutions provide healthcare services in Mexico? Public institutions like IMSS, ISSSTE, and local security social institutions offer services to their beneficiaries. The private sector caters to those who can afford it, while PEMEX, the Defense Secretariat, and the Navy provide services to their employees.
- What role does CONAMED play in resolving healthcare disputes? CONAMED currently lacks the authority to address these disputes, but strengthened intervention in this area could benefit policyholders’ right to health protection.
