José Alarcon
Associate Professor Leadership in Healthcare Institutions
Anáhuac University

The Six Faces of Healthcare

Thu, 02/21/2019 - 13:45

The Ministry of Health wants to compensate the lack of health coverage at public institutions and provide healthcare access to those not affiliated with an existing program. However, in analyzing the government’s proposal, José Alarcón, Associate Professor Leadership in Healthcare Institutions at Anáhuac University, sees two main problems that could complicate the success of the initiative.
“Currently, around 20 million people have no access to health services. So, the first challenge for this government is to locate these people and then discover what is the best way to affiliate them with its new program,” says Alarcón. The second challenge is the health budget, which appears to be insufficient to cover the cost of adding 20 million new affiliates to the system. “Today, 49 percent of the affiliates consume more than 60 percent of the health budget, so adding more people could become financially critical,” says Alarcón. If IMSS’ per capita expenditure of MX$5,860 (US$307) is multiplied by 20 million new affiliates, it would result in an extra budget requirement of about MX$120 billion (US$6.3 billion). This is added to the cost to cover existing affiliates, which totals more than MX$397 billion (US$20.8 billion), while the current budget for healthcare services is MX$602 billion (US$31.5 billion).
Alarcón emphasizes the importance of combining qualitative and quantitative indicators to understand how healthcare services are performing among the population by applying the innovative Online Analytical Processing (OLAP) cube, which performs complex multidimensional analysis of data. In this case, it would be a Cube of Health. “The idea is to use the Cube of Health to understand the six dimensions that affect healthcare in Mexico and how the public sector can reach its goal of universal healthcare.
The cube shows and explains how the health system is a multidimensional matter that requires various solutions from different angles,” he says. The Cube of Health could help the government and the industry understand the issues that are challenging the health sector. In this analysis, the way the government sets its objectives and how it measures them will be key to ensure the health system’s success. “Qualitative objectives are as important as quantitative objectives because these show how long people are living and what their quality of life is like during those years,” he says.
President López Obrador’s National Health Plan establishes a series of objectives to contemplate the health of Mexicans in a more comprehensive manner, establishing a preventive approach and considering indicators such as socioeconomic deficiencies, nutrition and physical activity, which would be in line with the proposed Cube of Health analysis. “It is a more integral health model than before,” says Alarcón.
In addition to having indicators to measure objectives and being aware of the challenges ahead, Alarcón believes it is important for the government to follow certain steps and take care of its processes to ensure success. “The first step is to have transparency and a clear idea of the current state of the infrastructure and conditions in public health,” he says. “The next part of the process is to create a public-private network of healthcare providers to maximize coverage in Mexico. If successful, people would be able to go to any public health institution two or three years after the network’s implementation.”
Once the healthcare network is open to the entire population, the government’s focus could move from infrastructure to healthcare provision. “The immediate objectives would be to increase healthcare quality and coverage, while implementing a patient-centric approach to make sure Mexicans have an integral model of attention. If the government understands that the health system is a multidimensional matter, as illustrated by the Cube of Health analysis, then it will achieve or at least move toward universal access to healthcare,” Alarcón says. “A holistic approach to healthcare can provide multiple and integral solutions that will eventually lead Mexico to achieve a system like that in most developed countries.”