One Third of the Population Does Not Have Health Services

The population affiliated with public healthcare institutions decreased by 14.4 percent between 2018 and 2020, while out-of-pocket expenditure in health increased by 40 percent, according to the newest report by the Economic Investigation Center (CIEP).

A sustainable and well financed health system is important for every country to keep its population safe but COVID-19 exposed deficiencies in Mexico’s healthcare system. The international recommendation is to have an 80/20 composition between public spending and private spending, according to WHO. In 2018, public expenditure in healthcare represented 51 percent of the total health spending in Mexico, with the remaining 49 percent being financed private parties.

Last year there were 87.4 million Mexicans affiliated to at least one public health institution (IMSS, ISSSTE, Pemex or IMSS Bienestar, among others), less than the 102 million affiliated in 2018. “People that didn’t report themselves as affiliated to any health subsystem went from 22.4 million to 38.8 million, 30.6 percent of the population,” CIEP pointed.

Besides the 14.6 million people affiliated to public health system lessen, the actual users also decreased by 8.5 million, with 57.5 percent of them treated at private hospitals.

Out-of-pocket Expenses Increased

In this same two-year period, out-of-pocket expenses in health matters increased from MX$2,358 (US$118) to MX$3,299 (US$165) per quarter. This phenomenon also affected those affiliated to healthcare institutions, especially Pemex affiliates, who suffered an 85.3 percent increase. “The importance of a correct public spending in health is that it creates lower out-of-pocket expenses for people,” CIEP insisted.

While WHO recommends countries to assign at least 6 percentage points of their GDP to health matters, Mexico has been lowering its budget during the past few years. In 2013, the government had assigned 2.87 percentage points of the GDP to the public health system, but this number decreased every year until 2019, which was “the lowest budget in ten years, MX$624 billion (US$31 billion), 2.55 percent of the GDP”.

Poor administration and low budgets left the Mexican public health system in a difficult position to face COVID-19 in 2020, playing an important role in the 241,000 deaths recorded by the government so far.

Less Money, Less Personnel

Countries that allocate less money to their health system will usually have less doctors and nurses. With 0.55 doctors and 1.14 nurses for every thousand people, Mexico “is far from reaching the average levels of the OECD.” Mexico would have to increase the number of doctors it has nowadays 6.4 times and the number of nurses 7.7 times, according to CIEP.