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MEXICO | Summary

OVERVIEW | HISTORY | HEALTH & HEALTH SYSTEM | HEALTH INDICATORS & DEMOGRAPHY

OVERVIEW


BEEP: $ 1.258 trillion 1
Health expenditure (% of GDP): 5.46% 5
population 3
  • Population: 129 million
  • Housing: 83.4% urban, 16.6% rural

HISTORY


In 1917, after the Mexican Revolution, the State of Mexico passed a constitution with a deep social focus on education, labor and health policies. For reasons deeply rooted in Mexico's history, an effective health system was not in place. The system has always been characterized by fragmentation and imbalances in financial resources and the populations it serves. In 1943 the President founded three important institutions that still regulate and administer the health system today. The Ministry of Health, the Mexican Social Insurance Institute (IMSS) and the Mexican Children's Hospital. The Department of Health covers the non-eligible populations through the IMSS, which covers private sector workers. The Children's Hospital was the first of currently 13 national health institutes in Mexico that usually offers highly specialized services, aims to expand knowledge through research and has a major impact both nationally and internationally. With the establishment of the Institute for Security and Social Services for State Employees (ISSSTE) in 1960, insurance coverage was then extended to public service employees.7A program was launched in the late 1930s to address health inequalities in rural areas. The then president chose to require that all medical students spend a period of time working and living among the poorest Indigenous Mexicans. Although the program presented some challenges such as language barriers, the introduction of Western medicine into the existing medical culture, and inadequate living conditions for the students, it was incorporated into the Mexican constitution. This raised awareness of rural health issues and made doctors more comprehensive by exposing them to drugs that were not included in their urban training.7 Another initiative to bridge the gap with rural areas was COPLAMAR, or the marginalized social protection program . It took a community-based approach to health services by training local people such as midwives and traditional healers to provide basic services to the local population. A critical aspect of the program's success has been the belief that each patient's culture, language, and beliefs about health and healing are respected.8In 1983 the Mexican constitution was reformed to make health a universal right and to require the government to coordinate the health system to ensure access to health for all citizens. It was not until 2003 that the General Health Act was changed to introduce National Health Insurance, or Seguro Popular. Its intent was to cover a wide sector of the Mexican population, including the poorest in the country, those without formal employment and who are not protected by IMSS or ISSSTE.7National health insurance was Mexico's approach to universal health insurance, but own expenses remained high. Within 10 years of the introduction of national health insurance, Mexicans affected by impoverishing health care costs dropped from 3.3% to 0.8% and expanded coverage to more than 50 million who were previously unprotected. Previous reports have shown high levels of satisfaction among health service users with national health insurance in the high 90s.9This health insurance program was replaced in January 2020 by the Institute of Health for Welfare as a decentralized body of the Ministry of Health.

HEALTH & HEALTH SYSTEM


Mexico has improved in many health aspects in recent years, but is still lagging behind other OECD countries. Mexico's infant mortality rate has fallen 11.5% since 2009, but remains the highest in the OECD. The OECD average for infant mortality is 3.8 and Mexico has a rate of 13 per 1,000 live births. Expenses in Mexico have fallen from 55% to 45% of health care spending, but they remain a burden on the population. High personal spending has created significant financial barriers to access to health care, especially for those on low incomes. He stressed the need to develop a strong and affordable health insurance system. The biggest health problem in Mexico is obesity. In Mexico, 32.4% of the population is obese, making it the country with the second highest prevalence of obesity after the US. The country also has the highest prevalence of diabetes in the OECD with 15.9% of the population with diabetes.4To tackle the obesity epidemic, Mexico has put in place policies such as taxing sugary beverages and high-calorie non-essential foods, mandatory front labeling of food, and regulating food advertising for children. Despite these efforts, the prevalence of obesity continues to rise, creating a health and economic burden across the country.13
Mexico has a fragmented health system with three main types of care providers. These facilities offer health services to different population groups. The first provider is for the working population. The Mexican Social Security Institute (IMSS) provides insurance protection for private sector employees and their families13. This health insurance plan covers over 57 million people in Mexico, making it one of the largest health insurance providers in the Western Hemisphere.fifteenThe insurance program is financed by the federal government and from employer and employee contributions. All employers must register with the IMSS, which provides full government medical care, including home care, inpatient care, maternity care, and disability and injury benefits.16The Mexican State Social Insurance and Services Institute (ISSSTE) provides health insurance to public employees and their families.14The program is financed by the federal government and employees and includes around 12 million beneficiaries.fifteenCountries within Mexico also offer their employees their own health and pension benefits. The second provider is the private sector with insurance companies and service providers that maintain their own clinics and hospitals. Private insurance is voluntary and the individual has to pay contributions to the private insurer.14Employers can offer their employees private insurance where premiums and fees are split between the two. The premiums are based on the individual risk profile and for a jointly agreed package of health services. The private health sector is better equipped to offer specialized procedures and better quality care overall.16
Government social programs are the third largest health care provider and are reserved for citizens who are not subject to any other health system. These programs are financed almost entirely by the federal government.14The best-known statutory health insurance system is the Institute of Health for Wellbeing (INSABI), which was founded in January 2020. Since this is a new program that has replaced the previous public health insurance, Seguro Popular, there are still many components to complete. In addition, there is very little data to measure the effectiveness of the INSABI. The head of INSABI defends the program, claiming that the shortcomings and uncertainties are the result of the opposition that the ambitious project faces as it affects economic interests. He also mentions that the budget allocated to INSABI is much higher than that of Seguro Popular. The former health minister responsible for creating the now-extinct Seguro Popular warns that one possible failure of the INSABI is the federal government's responsibility for medical care that was previously placed in the hands of local governments.17According to INSABI regulations, users receive free medical care and medication without any restrictions, as they no longer have to enroll or pay fees. The annual fees associated with Seguro Popular have been abolished, as has the requirement to be a Mexican citizen.18The requirements for supervision at INSABI are currently very relaxed, but the legislation may change due to the initial phase of the program. Another program called IMSS-Opportunities is intended to specifically cover vulnerable and marginalized population groups and is fully funded by the federal government.

HEALTH INDICATORS & DEMOGRAPHY


Health conditions also differ between social classes in urban areas, with poor and indigenous Mexicans experiencing higher morbidity from unsafe water supplies, infections, respiratory diseases and violence.10Mexico does a national census but does not collect any ethnicity information.elfRacial identity remains a powerful social construct in Mexico.10 Health indicators 3
  • Fertility rate: 2.1 live births per woman
  • Life expectancy (female, male): 78, 73
  • Infant mortality rate: 12.5 deaths per 1,000 live births
  • Child mortality rate: 14.5 per 1,000 live births
  • Maternal mortality rate: 33 deaths per 100,000 live births
  • Obesity prevalence: 32.4%
Racial / Ethnic Demographics 6
  • Mixed: 62%
  • Predominantly Indians: 21%
  • Indians: 7%
  • Other: 9%
  • knows European, Asian
  • Afro-Mexicans: 1%
age structure 12
  • 0-14 years: 26.6%
  • 15-24 years: 17.4%
  • 25-54 years: 40.9%
  • 55-64 years: 7.9%
  • 65 years and older: 7.3%

References

1. The World Bank. (2020). GDP (current US $) - Mexico. Data. https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=MX.

two. World Bank country and lending groups. (undated). Retrieved from https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups

3. Mexico demographics. (undated). Retrieved from https://www.worldometers.info/demographics/mexico-demographics/

Four. Health Policy in Mexico. (2016, February). Retrieved from https://www.oecd.org/health/health-systems/Health-Policy-in-Mexico-February-2016.pdf

5. Ríos, A. (2020, August 14). Health care spending as a percentage of GDP in Mexico 2019. Retrieved from https://www.statista.com/statistics/947944/mexico-health-expenditure-share-gdp/

an age cohort refers to

6. Geography now! Mexico. (2018, September). Retrieved from https://www.youtube.com/watch?v=Kxy74EAjAec

7. Health care system: Mexico. (undated). Retrieved February 2014 from https://www.researchgate.net/publication/279179706_Health_Care_Delivery_System_Mexico

8. Laveaga, D. (1970-01 Jan). Mexico's historical models for rural health care. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK316259/

9. Presentation of the 2016 Mexican Health System Review. (N.d.). Retrieved from https://www.oecd.org/health/presentation-of-the-review-of-the-mexican-health-system-2016.htm

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10. Meyer, M., & Cline, H. (2020, September 25). Health and wellbeing. Retrieved from https://www.itannica.com/place/Mexico/Health-and-welfare

elf. Muskato, C. (n.d.). Mexican Ethnic Groups: Percentages and Demographics. Retrieved from https://study.com/academy/lesson/ethnic-groups-in-mexico.html

12. Mexico Demographic Profile 2019. (n.d.). Retrieved from https://www.indexmundi.com/mexico/demographics_profile.html

13. Mexico Health Policy Letter. (2020, January). Retrieved from https://www.oecd.org/health/Policy-Brief-Mexico-Health-EN.pdf

14. Review of Public Procurement for the State Institute of Social Security and Services in Mexico. (undated). Retrieved from https://www.oecd.org/gov/ethics/ISSSTE%20Highlights%20English%20Merged.pdf

fifteen. Challenges and opportunities of the Mexican health system. (2015, January). Retrieved from https://www.manatt.com/uploadedFiles/Content/5_Insights/White_Papers/Mexican%20Healthcare%20System%20Challenges%20and%20Opportunities.pdf

16. Zavala, R. (2019 January 9). Health insurance for workers in Mexico. Retrieved from https://www.lexology.com/library/detail.aspx?g=fafb03d8-d08d-45d2-86ae-80d1f22aa765

17. Will Mexico Offer Universal Health Care? (2020, January 15). Retrieved from https://www.eluniversal.com.mx/english/will-mexico-offer-universal-health-care

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18. Paul, P. (2020 January 4). Mexico: A look at the health program that replaced Seguro Popular. Retrieved from https://qroo.us/2020/01/02/mexico-a-look-at-the-health-program-that-replaced-seguro-popular/

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