Adaptable Solutions for Common Well-BeingBy Miriam Bello | Fri, 04/24/2020 - 16:49
Q: How successful is the government’s coverage initiative to address epidemiological and demographic growth rates?
A: At the present time, the public health sector’s plans are focused on finances, not on service provision. The universalization of healthcare services is appropriate and necessary for the country, but the way INSABI was implemented generated doubts and challenges, such as medicine shortages. However, the INSABI model is viable and necessary as a breaking point that breathes life into the public healthcare system, which I think will be good for the population. That being said, the system lacks the PPPs that would greatly benefit the sector and could lead to a true improvement. I do see more PPPs happening soon but not in the way we have seen them, which has been almost exclusively in infrastructure projects.
The universalization of primary care is what the country needs most. This would lead to an increase in the number of affiliates to the public health system, which would demand the participation of the private sector to maintain and enhance services.
Q: Have you experienced or noticed growth in demand for insurance services?
A: We have not seen growth at all. In fact, the public sector and the insurance sector are practically divorced. The problem is that private insurance only focuses on accidents and major medical expenses but not on primary conditions. Meanwhile, the private insurance sector does not have the policies to cover the low-income segment of the population because there would not be enough budget to bear this cost burden. Moreover, if we are looking to promote preventive medicine, which is also the focus of social security.
The Mexican population needs new healthcare coverage packages. MASZ, as an Health Administrator, has accepted the task of creating new private healthcare coverage. This has led us to develop policies for minor medical expenses, indemnity policies and dental programs, among others, to ensure that we cover the population’s basic needs. We thought about these solutions at the public and private level. We see this as a great contribution to the sector and as a way to comply with the national healthcare plan and the efforts to improve the sector.
In terms of specific afflictions, we have participated on developing coverage products for infarction, cancer and diabetes. MASZ is constantly working on developing new coverage products to address the common needs of the population under our personalized coverage perspective. We are breaking the mold in coverage services for cancer and diabetes, basing our products on preventive healthcare. For example, with cancer patients, we evaluate their case and the status of their disease to offer a certain level of coverage. When the patient starts showing recovery, this sum increases. If someone has a case of severe diabetes, their coverage sum is going to be very low, but when the patient starts leveling their glucose levels and getting better, coverage goes up. This is an innovative and unique solution for the Mexican population.
The reception has been very positive but we are still learning how to position it and how to raise awareness in the sector about this innovative insurance product. The sector is so used to selling traditional coverage policies that they struggle when wanting to incorporate something new.
Q: What challenges has the insurance market faced in terms of regulation?
A: Twenty years after its implementation, we have found the insurance law to be limited, economically speaking. When we do an actuarial calculation for a healthcare insurance product according to current regulations, the outcome is a very high price that is impossible to pay.
MASZ is designing services that combine aspects from a major medical expenses policy with actions that promote preventive medicine. With our providers, we have searched for schemes that allow for this synergy to support people who face healthcare complications. MASZ’s role is to promote its use and prove its profitability. With all the numbers and data that we gather, we will be able to demonstrate our products’ workability in financial and healthcare terms. We need to work on changing the predetermined mindset on the subject. It is no secret that Mexico has one of the highest healthcare expenditures globally because of the amount of services paid out of pocket. All of this is the result of the lack of appropriate insurance coverage.
Q: How are you addressing the changing needs of the population?
A: MASZ is creating personalized services as a result of demographic changes. The current insurance offering is not enough and it does not cover the evolving needs of new generations. The lifestyle of the current population has changed drastically and new coverage structures are needed to fulfill these new needs. MASZ offers consultancy services for companies to adapt their policies to their workers, considering their lifestyle and leaving room for unexpected situations.
Updates are needed in the public and private sector, society has changed demographically and epidemiologically speaking and we face complications such as diabetes and obesity. However, we are now experiencing mental health issues that are as strong and dangerous, but there is still no proper care for such conditions. Treatments are going to be rendered ineffective if we keep ignoring these changing factors. Costs will also rise as a result. MASZ is trying to prepare for these situations with integral solutions using state-of-the-art technology to promote and showcase its products. We have developed an app of telemedicine that is available 24/7 to attend to patients, which helps to promote health, education and new habits.
MASZ was created by health insurance and consulting specialists. It aims to offer third-party medical service systems through design and implementation of prevention and health-promotion models