September 27, 2012
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Mexico establishes universal health care within 10 years

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More than 50 million previously uninsured people residing in Mexico have enrolled in a public medical health insurance scheme since 2004, enabling the country to achieve universal health care in less than 10 years, according to a report in The Lancet.

“The quest for universal health coverage in Mexico has produced remarkable progress and many valuable lessons,” Julio Frenk, MD, PhD, dean of the Harvard School of Public Health, former Minister of Health of Mexico and architect of the original reform, said in a press release. “It shows the value of sound evidence in fueling a virtuous upward spiral of policy formulation, implementation, evaluation and back to the formulation of new and improved policies on the basis of lessons learned. This experience is relevant to countries of both high and lower income.”

According to the report, prior to 2004, medical insurance in Mexico was only available to those who could receive it through their employers or afford expensive private insurance. But in 2003, the Mexican Congress approved reforms to Mexico’s health legislation, making way for the System of Social Protection of Health reforms. The reforms led to the implementation of Seguro Popular, a government-funded program that allowed all Mexican citizens — regardless of their income — access to adequate health care.

Although the authors of the report point out that it is too soon to say whether successes in Mexican health care are an effect of the implementation of the program, they say that health indicators have increased since the program’s implementation.

For example, antenatal care increased 14%, covering more than 81% of women. In addition, treatment of acute respiratory infection in children aged younger than 5 years increased almost 6%. Also, cervical cancer screening among women aged 25 to 64 years increased more than 7%, making more than half of the population covered.

There are still challenges, the authors said. They include disparities between the quality of health care in different states because of how funding is distributed, and ensuring access to health care for those in remote rural areas.

“Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health bills for the poor,” Felicia Knaul, PhD, director of the Harvard Global Equity Initiative and with the Mexican Health Foundation, said in the press release. “The Mexican experience is especially noteworthy for having continued despite and throughout economic downturn and periods of economic crisis. The challenge now for Seguro Popular and for the Mexican health system as a whole is to achieve more health for money.”

In an accompanying editorial, The Lancet commended the progress that Mexico has made toward reaching universal health coverage and stated that the experience provides several lessons for other countries that wish to implement universal health coverage, “notably the positioning of health reform within a legal framework to secure protection from future political interference.”

“Mexico has showed how universal health care, as well as being ethically the right thing to do, is the smart thing to do,” the authors wrote. “Health reform, done properly, boosts economic development.”

Reference:
  • Knaul F. Lancet. 2012;doi:10.1016S0140-6736(12)61068-X.