Francesca Colombo
Head of Health Division
View from the Top

Uniform System Would Spur Access, Better Health Management

Wed, 09/05/2018 - 09:06

Q: The OECD has recommended more structural changes for Mexico. How should the country approach health reform?

A: The OECD’s 2016 review of the Mexican health system suggested that the greatest challenge for the country is to create a more equitable, efficient and sustainable system because IMSS, Seguro Popular, PEMEX and ISSSTE provide the population with care of different quality, accessibility and results. Having a more uniform health system could help people have better access to medical care and help government better manage the health of its population.

Q: In the last Getting it Right report, the OECD highlighted several structural reforms the country has managed. How can the private sector get more involved?

A: Mexico’s spending on health is lower than most OECD countries as the 5.8 percent of GDP allocated to health is the third-lowest share across OECD countries, and much lower than the OECD average of 9 percent. From the point of view of health financing, the private share of health spending is also large – 41 percent of total health spending comes from out of pocket household expenditures, signaling low financial protection for individuals and the need for improved coverage arrangements. As to service provision, the private sector should not be seen from a negative point of view as it can play an important role in delivery of services to the population. The challenge for Mexico would be to improve the provision of services toward a model in which all providers cater to the needs of the population regardless of their affiliation to a particular institution.

Q: Mexico has the OECD’s highest rate of obesity and related disease. What further political action can be implemented to face this problem?

A: The only way to address obesity is through a comprehensive set of multisectoral policy interventions 

because the determinants of obesity are multifaceted and complex to tackle. Mexico already has an ambitious National Strategy for Prevention and Control of Obesity and Diabetes. This could be further strengthened, for instance, the national health program should include interpretative nutrition labels.

Q: Taxes on sugary drinks and foods have not yet proven to reduce their consumption. What is your view?

A: Taxes on food and drinks are used to encourage people to improve their attitude regarding certain consumption, but it is also important that these strategies are accompanied by other measures like education, school- based intervention, food labelling, regulation on advertising, primary-care interventions and so forth. A package of intervention is needed to tackle obesity. In addition, the Mexican government should take into account the specific objectives it wants to achieve in terms of public health.

Q: What measures would you suggest to improve healthcare access in Mexico?

A: Mexico has made many efforts to improve access to medical care but more interventions are still needed, especially in terms of structural inefficiencies and inequities of the system. One of the greatest challenges that Mexico faces is to improve the organization of the health sector to reduce its fragmentation. In addition, it is important to improve prevention and public health services. Prevention is everyone’s responsibility.

Q: How can technology help improve access to care, especially in hard-to-reach regions?

A: The role of technology is revolutionizing the health industry. Today it is possible to leverage Big Data to enhance disease surveillance, generate public health data, manage epidemics and improve the performance of health services. This offers the opportunity to elevate the power of treatments and to pull together solutions that have tremendous potential to improve the clinical management of health, reduce health risks, and make health systems more efficient. Technology is filling gaps and improving access to and implementation of health services.