The Mexican health care system has made great progress during the last decade – but the remaining challenges are daunting | WPN World People News

In the ten years since the introduction of Seguro Popular, some 50 million Mexicans previously at risk of unaffordable health care bills now have access to health insurance.

The OECD Review of Health Systems: Mexico 2016 finds that the share of the population exposed to unaffordable or impoverishing health care costs has fallen from 3.3% to 0.8% of the population in the past decade. Key indicators such as infant mortality, and deaths from heart attacks or stroke, as well as patient satisfaction rates, have improved as a result of a better access to affordable health care services. And ground-breaking efforts to keep Mexicans healthy – like the sugar tax, food labelling and regulations for adverts targeting children – are well-designed and internationally innovative policies.

But a number of daunting challenges remain. Rates of overweight or obesity within the adult population increased from 62% in 2000 to 71% in 2012, and one in three children is now overweight or obese in Mexico. More than 15% of adults have diabetes – more than double the OECD average of 6.9%. Deaths from heart disease have decreased by only 1% since 1990, in sharp contrast to the 48% reduction seen across other OECD countries. As a consequence, the gap in life expectancy between Mexico and other OECD countries has widened from about four years to almost six years over the past decade.

Public spending on health care increased from 2.4% to 3.2% of GDP between 2003 and 2013. But increased spending does not always translate into better health: the share of the Mexican health budget spent on administration (almost 10%) and individuals’ out-of-pocket spending on health (above 40%) are the highest in the OECD. These key indicators signal that the Mexican health system is not working as efficiently as it could.

A fundamental problem, according to OECD Review of Health Systems: Mexico 2016, is that health care is delivered through a number of disconnected social security institutes. Every year, around one third of individuals are forced to change doctor – simply because they change job.

“This disrupts continuity of care - a basic necessity of high quality health care, especially for people with chronic conditions” said OECD Secretary-General Angel Gurría. “It is also wasteful, given that the same individual needs to engage with multiple systems throughout his or her life or even for a single episode of care. As currently arranged, the Mexican health care system does not deliver value for money.”

In the report, the OECD recommends that Mexico makes further progress to build a more equitable, efficient and sustainable health care system through system-wide reforms including:

● Expansion of service-exchange agreements (or convenios) to let affiliates from one system use services from another. Critically, convenios must develop to cover chronic conditions managed in primary care, such as diabetes.

● Enforcement of information systems that monitor health care quality and that drive improvements across the health system. This is to ensure that the new convenios become living and active agreements, rather than remaining dormant and unused.

● Creation of a new Comisión to work across health insurance schemes and harmonise their care pathways, prices, information systems and administrative practices Without deliberate and carefully planned equalisation of the benefits offered by each insurance scheme, Mexico will not achieve the fairer and more efficient health care system that the country needs.

Source: Organization for Economic Co-operation and Development