Rough Start for The Well-Intentioned INSABI

2020 marked the beginning of many new challenges for the healthcare sector. In Mexico, this year welcomed the new Health Institute for Welfare (INSABI) with the goal of achieving universal healthcare by offering social security to people that were outside IMSS’ and ISSSTE’s coverage, which is around 69 million Mexicans. INSABI offers primary and secondary levels of attention and it is contemplating to scale up to third-level attention.

Regarding primary care services, INSABI covers the following:

• Preventive healthcare
• Health promotion
• Disease prevention
• Outpatient care for the most common illnesses provided by general practitioners and nurses

In the secondary level, the institute covers:

• Basic specialties at general or specialty hospitals
• Laboratory and imaging diagnosis
• General surgery, gynecology, obstetrics, internal medicine and pediatrics

At the beginning of 2020, the Institute explained that for third level coverage attention, INSABI would initially charge a moderate fee expecting that by December of this year it would no longer need to charge for its services. People affiliated to INSABI can go to public medical facilities, such as health centers, health centers with extended services (CESSA), IMSS Bienestar medical units, medical specialties units (UNEMES) and rural, community and general hospitals.

Has INSABI worked so far? The institute has faced many challenges since its introduction, the most vocal one being medicine shortages for cancer patients. These situations evidenced INSABI’s inexperience. While this initiative has been seen as a well-intentioned effort, it has also attracted severe critics. “(INSABI is) viable and necessary as a breaking point that breathes life into the healthcare system, which I think will be good for the population” said Alejandro Sancen, Director General on MASZ, during an interview with MBN. “(However,) the way INSABI was implemented generated doubts and challenges, such as medicine shortages.”

From a logistics point of view, MBN spoke with Javier Calero, Commercial Vice President of GNK logistics, who explained that “the arrival of INSABI created an operational gap that has hindered talks with the government as authorities themselves do not have the functioning rules to know which funds can support a project like ours.”

For the pharmaceutical industry, the story has been complicated as President López Obrador accused pharmaceutical companies for the medicine shortages. “There has been a lack of clarity on who is responsible for medication purchases. Before, these were handled by the Administrative Office, while now they are the responsibility of INSABI. However, INSABI has not really taken the reigns and there are still discussions on which dependency should be responsible for this” Cecilia Bravo, President of ANAFAM, told MBN.

How can the government put INSABI on track to achieve its true goal, which is universal healthcare coverage for all Mexicans? During an interview with MBN, Vinicio Orea, Deputy Director of Health and IT Business Unit at Grupo Altavista, reflected on the subject. “The current steps that the government is taking to improve healthcare with INSABI are good but very ambitious. When the government realizes that the burden cannot be tackled alone, it will start looking to the private sector.”