A Call for Public Health Improvement

Right before López Obrador’s administration, the Mexican public healthcare system was about to collapse, according to a study made by IMCO. By now, it is well known that Mexico is one of the countries with the largest out-of-pocket expenditure and that the government still destines a small part of the budget on healthcare. Having a poor public healthcare system deprives people from access to health and an inadequate service pushed many to seek for private health, representing extra costs.

According to the OECD, out-of-pocket expenditure can cause families to fall into poverty. The problem is not with one-time surgery procedures but with treating chronic diseases. That, at least to the government, costs almost all the budget it destines for healthcare. Before COVID-19, Mexico had already fought for over a year with its very own pandemic of chronic diseases. According to data from INEGI, 8.6 million Mexicans suffer from diabetes and 75.2 percent of Mexican adults are obese. Deputy Minister of Health, Hugo López-Gatell has referred to this as a “failure on public policies to address the situation and to prioritize private interests over public ones.”

These diseases also represent the major causes of death in the country, being heart disease the most common. Former Minister of Health José Narro admitted at the time that this problem affects productivity, something that inevitably impacts economic growth.

A call for public health in Mexico is something that, if not fixed, according the IMCO report, could lead to out-of-pocket expenditure for health services to represent 1 percent of the country’s GDP by 2030. The current government had healthcare as a banner. In fact, its plan for increasing coverage began in mid-2019, having a considerable impact at the beginning of this year as actions include extending the coverage of IMSS. Its goal was also to promote a preventive healthcare culture and to integrate IMSS operations with other public entities in charge of public health, thus increasing the number of prevention, care and hospitalization units, especially in marginalized regions that the president toured alongside IMSS’ Zoé Robledo to detect needs and concerns from the population.

Promoting transparency of resources for public health was also in the list. Additionally, the government wanted to improve the quality, safety and effectiveness of the comprehensive public health system, generating interaction mechanisms between IMSS and other sectors or public institutions that promote culture and health education. Lastly, the banner of the administration was INSABI, the institute that guarantees healthcare for everyone without access to IMSS or ISSSTE.

At the moment, 5 million people do not have access to public health as they live in rural areas or isolated regions that overall lack services and infrastructure. According to CONEVAL, getting to a hospital can take some people 2hr. Rural zones represent the toughest challenge for the government, as 97 percent of the hospitals are on urban areas. From the 100 percent of hospitals in Mexico, 24.6 percent are IMSS or former Seguro Popular (INSABI since January 2020). Moreover, as an OECD report exposes, Mexico has the lowest bed numbers per person, something that will hopefully change after the COVID-19 pandemic forces hospitals to increase their hospital equipment. Aside from this, Mexico has a shortage on medical staff, not even having a general doctor per 1,000 people and having 0.71 specialist per 1,000 people. The current public healthcare system was overflown. The number of people per day wanting a consult exceeds the capacity of some hospitals, which causes a long waiting times for medical attention.

When COVID-19 started spreading in Mexico, these concerns started to arise as it was no secret that our public healthcare system was already insufficient to cover regular health. The government was very vocal about prevention and started to promote preventive efforts early as they could foresee a crisis that could escalate quickly due to the status of our system.

Access to health is a human right and COVID-19 was a watershed for the world regarding healthcare. For Mexico, the pandemic brought to light many lingering issues, as well as global problems still in need to be addressed like investment in research, equality in access to healthcare services, gender equality in medicine at al levels, mental health as a priority, malnutrition caused by poverty, safe abortion, male circumcision, cannabis regulation, vaccine promotion, dentalcare, vision health and coverage. The list goes on. Could COVID-19 be used to improve our healthcare services? Will Mexico make healthcare a priority as it has done with other sectors?