INSABI's Troubled Legacy Could Spill Over to IMSS-Bienestar

Q: What are the potential challenges that you anticipate as a result of the elimination of INSABI?

A: The reform approved by the Chamber of Deputies on April 25 has not yet been published in the Official Gazette of the Federation, rendering it unofficial at present. If this reform is published, a 180-day period will be granted for INSABI to transfer resources to SS-IMSS-Bienestar. The manner in which the law was introduced is noteworthy due to the lack of transparency. On the same day it was presented, procedures were waived and there was no discussion. It was approved by the majority created by MORENA, PVEM and PT. This approval deviated from the normal legislative process. Mexico faces a significant health challenge given the complex and unique health issues across its more than 2,450 municipalities. INSABI proved to be disastrous and similar expectations loom over SS-IMSS-Bienestar. 

IMSS is financed through a combination of workers’ contributions based on their earnings, proportional contributions from employers and public taxes. Both IMSS and ISSSTE require increasing amounts of public resources due to the rising prevalence of chronic-degenerative diseases, which became evident during the pandemic when Mexico witnessed over 750,000 excess deaths. Furthermore, the measure restricting doctors to working in only one institution resulted in a shortage of medical professionals due to numerous unfilled positions.

The budget is dwindling as public financing has been significantly reduced by President Andrés Manuel López Obrador, PVEM and PT. This trend will further contribute to SS-IMSS-Bienestar’s disintegration, as it will have as little funding as INSABI had. Consequently, the population will continue to suffer from the same issues and endure a lack of quality medical care.

Q: What steps do you believe future administrations should take to rectify the current scenario?

A: The country has underinvested in healthcare and needs to double its budget, at least, to guarantee a basic package of high-quality primary care services. Then, a second-level package involving hospitalization should be implemented, followed by a third level for subspecialists. The sector needs to hire trained doctors and provide better financing. A campaign must be undertaken to encourage people to use these services. The government also no longer produces vaccines and needs to plan better in this regard. The system needs to be reconfigured and the population must be empowered regarding the management of their health. Patients should be placed at the center of the system and financing.

Q: What is your vision for the future of healthcare in Mexico and how do you plan to work toward that vision?

A: Firstly, I act within my closest circle, which is my family. Then, as a healthcare professional, I continuously strive to enhance my skills to provide optimal care to patients. Our parliamentary group introduces initiatives and ensures that healthcare issues align with PAN's doctrine. We also support initiatives from other parties that are beneficial for the country but if they are not, we vote against them. It is our responsibility to disseminate our work and keep working toward a better future. 

Éctor Jaime Ramírez is a Mexican politician affiliated with PAN. He serves as Deputy of the LXV Legislature of the Mexican Congress representing Guanajuato.