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Monday 28th May 2018

Healthcare for all in Mexico

22nd January 2007

22112006_how_drugs_workQ.jpgHistoric reforms have been under way in the last six years in Mexico, which is undergoing a 'epidemiological transition', according to former Mexican health minister Julio Frenk.

Mexico's federal government has said it will provide healthcare for the country's 'other half', who currently lack health insurance. 

The country is moving from being one which struggles with communicable diseases and malnutrition to one dealing with chronic conditions and injury from violence.

Frenk, who also is founding director general of the National Institute for Public Health in Mexico, gave the Dean's Distinguished Lecture to the Harvard School of Public Health in December. He told them: "Four million households every year become impoverished by health expenses," adding that only half the population had health coverage-mainly employees of large private businesses or the government.

The poor, he said, suffer a "double burden" from both categories of illness and can be financially wiped out by a serious illness.

In 2000, Mexico spent just 5.6% of GNP on health care. Most health care consisted of private services purchased out-of-pocket. And the system was unbalanced-the country was spending three times more per capita on patients with insurance than those who lacked coverage.

In 2003 the government enacted a new programme, known as the Seguro Popular, which aimed to enrol the country's 50 million uninsured people by 2010. So far, about 22 million people have been provided with insurance, which is free to the poorest people and requires a small premium from those with more income. The government subsidy comes mainly from tax revenues.

The new legislation made an "ethical commitment" that access to high-quality health care is a fundamental human right, Frenk said. "The key step forward was that it is not enough to recognize the right to health care, but to make it so that every person in society can exercise that right."

The system covers about 250 medical interventions required under the law, including a drive to speed up the provision of free antiretroviral therapy for HIV/AIDS, he said.

Frenk added: "The government is investing heavily in telemedicine to bring health care to members of indigenous groups, many of whom live in remote areas." He said Consumers dissatisfied with the delivery of entitlement benefits can take the government to court. "This is a very powerful incentive for bureaucracies to do their job well," Frenk said.

Reforms include the setting up of a new public health agency regulating pharmaceuticals, food safety, and occupational and environmental health issues.

"What has happened in these past six years is that we began to rewrite the social contract for health, which is a social right that needs to be provided in an egalitarian and inclusive manner," Frenk said.

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