José Alarcón
Partner and Lead Health Services
PwC
/
View from the Top

Strikes and Budget Cuts Could Prove Benefical

Wed, 09/07/2016 - 14:30

Q: Considering the recent dual budget cuts in the healthcare sector, what challenges do you expect the industry will have?

A: You can see it in an optimistic or pessimistic way. Pessimistically, you can say that healthcare is cut and it is frozen, in which the only way to move forward is with pressure from organized society, the private sector, or even international organizations from the outside. Optimistically, considering the intellingence of our government leaders, such as Mikel Arriola at IMSS and José Narro, Minister of Health, we may now be more united and integrated. Using an integrated view, you can use the pressure originated by the budget cuts as an opportunity to change things for the better, meaning being more efficient. If politicians and leaders in the public sector share this view these cuts can be used as leverage for improvement. New models can be introduced using public-private cooperation such as pay for results, risk-sharing agreements and developing strategic demand linked to consolidated purchases.

Q: We have seen the beginnings of a universal healthcare reform this year along with doctor strikes. What do you think is the significance of this first step?

A: Fortunately, these strikes have not been as broad as in other countries. While they did not have a major impact on our health service provisions they are still not a good sign because it means we could reach a crisis. We should understand them as a call to action and comprehend that the process from student to practicing physician needs to change. We must tread carefully as strikes should not be used as a political weapon. As long as their demands are focused on genuine improvement of physicians’ quality of life then I think they are positive. On the other hand, no matter the amount of strikes we must be careful not to stop changes that must really happen.

Q: Are pharmacy doctors an appropriate alternative to delayed services in public hospitals?

A: I think it has been a good alternative for society, however, by taking that alternative the population is not receiving access to public healthcare as is their right. It is positive as long as the public sector sees it as a sign for improvement. As for private spending, it is too much out-of-pocket.

The public sector does not have the resources to comply with everything and an alternative is to shift to an innovative public-private partnership, which would lead us to negotiations with insurance companies. Only 8.2 million people are privately insured, which leaves plenty of space for collaboration.

Q: What do you foresee for the furure of Mexican healthcare?

A: In the near future, I do not think there will be anything revolutionary, just evolutionary things to maintain the status quo and maybe some relevant steps focused on efficiency on the public sector side. In the private sector, I see a more united voice pushing to have it seen as a competitiveness tool for the government and the country as a whole, which is the right way to see it, and hopefully driving the big reform in the early years of the next administration.

After the next eight years, I think reform will be implemented and the focus will shift to trying to stabilize a united national health system until 2030. Most of this will be employed through Public Private Partnerships (PPPs) since resources will be scarce on either side of the spectrum. Afterwards by 2034, a better healthcare system may be a reality with some room for improvement. Another way to view it is in terms of supply and demand. To avoid a crisis, the supply must be increased by being more efficient and the demand must be lowered with the help of innovations. We must get the reform right so the gap between supply and demand does not become a predicament.