Healthcare a fundamental human right
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Healthcare a fundamental human right

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Oliva López - Health of Mexico City


Q: How is your vision of a comprehensive healthcare system shaping Mexico City Ministry of Health’s (SEDESA) policies?
A: Focusing on the population’s right to healthcare services forces us to go beyond medical treatment. Health does not equal the absence of disease and should not be the responsibility of healthcare providers only. It is a much broader concept. Guaranteeing the population’s right to access healthcare services requires an analysis of the social determinants or conditions that generate well-being and allow people to have a fulfilling and fruitful life as individuals, families and societies.
Our scope for healthcare is broad because it tackles every step between health determinants to provide medical attention when necessary, including medical care, rehabilitation and companionship during the last stages of life through palliative care and support for a dignified death. The healthcare system involves many players but the state is responsible for guaranteeing healthcare for its citizens. The government should provide access to healthcare services to all, no matter their personal beliefs, socioeconomic status, living conditions or ethnicity. While some question whether we should provide healthcare to immigrants, healthcare is a fundamental right and we have to provide it to everyone.
Q: How is the ministry ensuring proper access to healthcare?
A: We are developing a plan to connect the capabilities of all federal ministries in charge of providing access to other health determinants, including access to a job, drinkable water, food, a place to live and a peaceful environment. All these determinants are necessary for a person’s well-being.
To bring everything together, we are introducing a system called Salud en tu Vida (Health in Your Life) that will provide a holistic service for primary care. This system strives for social transformation through the use of state resources to provide healthcare. The system will be based on a network of service providers that will adapt their actions to individual regions. Salud en tu Vida will offer specialized services for individuals in different stages of life. It includes home visits from doctors, especially to seniors, terminal or handicapped patients, under the program called Salud en tu Casa (Health at Your Home). Another project, Salud en tu Escuela (Health at Your School), focuses on enforcing existing regulations that limit the advertising of junk food and sugary drinks at schools and encourages the use of fresh, non-processed foods for students. Our model will continue to provide care to those who need it but at its core, the model aims to promote preventive measures from an early age to reduce the number of people who need medical attention for a preventable disease.
SEDESA handles many different responsibilities, including monitoring infectious outbreaks and organizing vaccination campaigns. We have also developed specific programs for homeless people, inmates and immigrants. Our priorities in the short term include the timely supply of medicines and doctor availability. We must also ensure quality in healthcare services and that individuals participate in all stages of the process, from prevention to palliative care. We are also spearheading sanitary regulation at a local level. Our model for primary attention ensures it is universal, integral, cost-free, intercultural and decentralized. Our network comprises 210 health centers, 17 specialty clinics and 32 hospitals. This year, our budget is close to MX$10.6 billion (US$556 million) and we manage about 30,000 employees.
Q: What role will the private sector and doctors at points of sale play in the future of the healthcare system?
A: Doctors at the point of sale address an existing need. Mexico City has many private hospitals and clinics but those services are not economically accessible for most of the population. Healthcare is a fundamental human right so it cannot be subject to economic capabilities. However, we can create synergies in some cases. For instance, we are developing an agreement with a private hospital with extremely specialized capabilities that are not available in the public sector. This agreement will allow our patients to receive the care they need.

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