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For years, Mexicans have been assigned public health coverage according to their employer - one institute attends to private sector employees, while another serves government workers. But the system excluded labourers in Mexico’s bustling urban markets and agricultural areas, a vital part of the country’s extensive informal economy.
“Not having the right to this service was considered an element of inequality, of poverty, and of the loss of opportunities,” said Salomón Chertorivski Woldenberg, Mexico’s Secretary of Health.
In an effort to combat this perceived disparity, Seguro Popular was born in 2003. Since its inception when President Felipe Calderón took office six years ago, the state-provided insurance has grown at an incredible rate.
Back then, this fledgling system had just 15 million members. But today, more than 51 million people have access to its health care, equalling approximately 45 percent of the population.
Seguro Popular has finally allowed Mexico to achieve universal health care, which was initially declared a constitutional right in the early 1980s.
It was former Mexican Health Secretary Julio Frenk, now Dean of Faculty at the Harvard School of Public Health, who originally designed Seguro Popular. But Chertorivski Woldenberg has overseen the all-important phases of implementation and expansion.
However, Seguro Popular did present some immediate challenges. Many of its prospective members were poor and living in isolated, underserved rural areas.
There is also the issue of managing expectations for new members. Chertorivski Woldenberg asserts that the service addresses, “95 percent of the reasons for which Mexicans enter a hospital.”
But at this stage, it doesn’t cover some 20 percent of specialised medicine, although it is gradually extending its care. Early last year President Calderón announced that Seguro Popular would begin to treat strokes, heart attacks, haemophilia and lysosomal diseases.
Having set the ambitious goal of signing up roughly six million people a year through 2010, the Government needed to act fast to prepare facilities and accommodate the influx of new patients.
In less than a decade, the Mexican Government has built and renovated thousands of health centres throughout the country. In the case of Baja California, that translated into 38 new clinics and hospitals, and the remodelling of more than 20 existing health care facilities.
To keep up with growing demand, public health spending has experienced an 80 percent surge since 2007. Seguro Popular’s own budget nearly tripled from 18 billion pesos in 2006, to 52 billion pesos in 2010.
According to Chertorivski Woldenberg, the future looks bright for international investment. He declared that in a few years, “the model of health care in Mexico is going to be worth more than the energy market.” Foreign services and equipment providers have been granted the opportunity to participate in hospital construction projects through public private partnerships (PPPs).
The Secretary of Health advised investors to consider establishing specialised hospital services, an area that is expected to thrive. Private providers are already offering cataract procedures and bone marrow transplants in several private hospitals that carry out Seguro Popular treatments.
Furthermore, there are additional investment opportunities emerging in Mexico’s burgeoning medical tourism industry. In 2010, the Ministry of Tourism projected that Mexico could receive 450,000 foreign patients annually by 2015, and up to 650,000 patients by 2020.
“Mexico has 90 private hospitals that meet international standards, and are open to provide services to foreigners,” said Chertorivski Woldenberg. All-inclusive surgical packages are already offered in such booming cities as Tijuana, which cover hospital stay, procedural fees and airport transportation.
“Operating in Mexico comes out to half the price, with quality, with smiles and without risks of infections,” said Romeo Rodríguez Suárez, head of the Coordinating Committee of National Health Institutes and Specialised Hospitals.
Although a positive development for Mexico, this trend is a symptom of a more troubling global issue. With rising medical costs and economic instability, many countries are struggling to meet the health needs of aging populations, facing high incidences of hypertension, cancer, diabetes and other health issues.
But Chertorivski Woldenberg believes Mexico possesses a natural advantage in helping its citizens, in that, “we have a very young population.”
At present, just 9 percent of Mexican citizens are over 60 years of age. By 2050, that same age demographic will comprise 33 percent of the population.
Mexico still has time to learn from and amend the problems of earlier, antiquated universal health systems, including waiting lists, quality control, and patient care.
Meanwhile, Seguro Popular has become a model for international governments exploring options for comprehensive health coverage systems.
Chertorivski Woldenberg explained that countries such as the Philippines, India, Pakistan and China have all requested Mexico’s guidance. Mexican health officials have also collaborated with the World Health Organisation and the Organisation for Economic Co-operation and Development “to pass on the Mexican model.”
Chertorivski Woldenberg admired, “We can say with pride that Mexico is one of the few countries with a model to share and export with demonstrable results.” |
