Introduction
The Mexican Social Security Institute (IMSS) recently unveiled the “2-30-100” program, boasting ambitious quantitative targets: performing 2 million surgeries, providing 30 million specialist consultations, and offering 100 million family medicine consultations by the end of 2025. However, beneath the eye-catching headlines and colorful graphics lies a troubling question: is this a genuine productivity drive or another attempt to disguise accumulated inefficiency?
Historical Context and Political Marketing
In the context of an institution burdened by historical shortcomings, the launch of this program seems more like a political marketing strategy than a serious, comprehensive, and evidence-based public policy. It’s a “macro-effort” that’s “micro-disintegrated,” potentially exacerbating structural problems instead of solving them.
Misinterpreting Productivity
The IMSS General Director appears to confuse productivity with mere numerical accumulation. In his narrative, reaching large figures automatically equates to institutional success. However, the reality is that robust health systems are evaluated by the health outcomes of their populations, not just the number of consultations or surgeries offered.
Potential Risks and Concerns
Implementing the program without adequate human, financial, or material resources risks further overwhelming the already exhausted healthcare personnel. Specialist doctors, many nearing burnout, face schedules that barely allow time between patients. The massive attempt to increase attention could lead to more medical errors, avoidable complications, and longer surgical waiting lists.
The “Surplus” Paradox
Ironically, the program is launched alongside the IMSS’s claim of a “surplus.” However, this surplus suggests institutional negligence rather than good management: if there’s money, why aren’t essential services being improved? Why are equipment renewals, staff hiring, and hospital infrastructure improvements still postponed?
Key Questions and Answers
- 1. How many preventive, family, and specialist consultations are currently scheduled based on the IMSS’s actual population structure?
- 2. How many specialists of what kind are needed to cover 30 million annual consultations? Assuming a reasonable standard of 20 consultations per day over 220 working days, is this even feasible?
- 3. What is the current shortage of specialist doctors? Does the announced 30% increase even meet the minimum required to meet international standards?
- 4. How many more family doctors are needed to meet the 100 million consultations annual goal?
- 5. What percentage of operating rooms and elevators are in optimal condition with up-to-date technology by specialty?
- 6. How many diagnostic equipment units have critical obsolescence that endangers patient lives?
- 7. What impact will the consultation overload have on the quality of care and the increase in iatrogenic events?
- 8. How does this additional burden align with the MAS-Bienestar model, which prioritizes prevention, continuity, and comprehensive care?
- 9. What percentage of medical units have interoperable electronic clinical records?
- 10. How will chronic disease control and patient satisfaction be evaluated under this scheme?
- 11. How will the persistent shortage of medications, especially for degenerative diseases, be addressed?
- 12. What will be the hidden cost of delayed diagnoses and prolonged hospital stays?
- 13. How will family medicine goals be related to effective chronic disease monitoring?
- 14. How will this plan be integrated with local strategies like “Salud Casa por Casa” in high-marginalization areas?
- 15. Is there any external audit planned, for example by the OECD, to validate the program and prevent operational risks?
Conclusion
Programs prioritizing volumetric goals without considering the system’s real capabilities often become political distractions rather than solutions. Simulated results do not replace structural improvement. Express consultations, lacking proper clinical history, without attention filters between levels, and with overloaded schedules, ultimately exclude those who need the system the most.
Instead of strengthening prevention, continuous care, and holistic approaches, a fragmented and reactive model is imposed that simulates care but doesn’t generate health. Mexico urgently needs a serious, articulated, and evaluable health policy. The “2-30-100” program may seem effective on paper, but without operational backing, untrained personnel, and infrastructure improvements, it could be another failed attempt to mask a critically worsening reality.
We cannot allow the official discourse to continue ignoring the daily experience of doctors, nurses, and patients. The IMSS doesn’t need more simulations or numerical promises; it needs a deep transformation that acknowledges its limitations, strengthens its capabilities, and most importantly, guarantees healthcare with quality, dignity, and opportunity.
