Health care in Mexico

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Central offices of ISSSTE in Mexico City.

Health care in Mexico is provided via public institutions, private entities, or private physicians. Health care delivered through private health care organizations operates entirely on the free-market system, i.e., it is available to those who can afford it. This is also the case of health care obtained from private physicians at their private office or clinic. Public health care delivery, on the other hand, is accomplished via an elaborate provisioning and delivery system put in place by the Mexican Federal Government. In 2012, Mexico achieved universal healthcare.[1]

History[edit]

Health care in Mexico dates to at least 1791, when the Hospicio Cabañas in Guadalajara, Jalisco, Mexico, was founded. The institution, still functioning, is now a World Heritage Site. It is one of the oldest and largest hospital complexes in Latin America. The complex was founded by the Bishop of Guadalajara to combine the functions of a workhouse, hospital, orphanage, and almshouse.

The ubiquitous Mexican health care program IMSS was founded in 1943.[2] In the early 1990s, Mexico showed clear signs of having entered a transitional stage in the health of its population. When compared with 1940 or even 1970, Mexico in the 1990s exhibited mortality patterns that more closely approximated those found in developed societies.[3] By 2009, during the notorious swine flu pandemic, the World Health Organization director said that Mexico "gave the world a model of rapid and transparent reporting, aggressive control measures, and generous sharing of data and samples". The CDC's flu director Nancy Cox, added that Mexico's response "impressed the entire world".[4]

Public health care delivery[edit]

The Instituto Nacional de Cancerología

Public Health care delivery is accomplished via an elaborate provisioning and delivery system instituted by the Mexican Federal Government. Public health care is provided to all Mexican citizens as guaranteed via Article 4 of the Constitution. Public care is either fully or partially subsidized by the federal government, depending on the person's (Spanish: derechohabiente's) employment status. All Mexican citizens are eligible for subsidized health care regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaria de Salubridad y Asistencia, or SSA) agency.

Employed citizens and their dependents, however, are further eligible to use the health care program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (English: Mexican Social Security Institute). The IMSS health care program is a tripartite system funded equally by the employee, its private employer, and the federal government.

The IMSS does not provide service to employees of the public sector. Employees in the public sector are serviced by the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (English: Institute for Social Security and Services for State Workers), which attends to the health and social care needs of government employees. This includes local, state, and federal government employees.

The government of the states in Mexico also provide health services independently of those services provided by the federal government programs. In most states, the state government has established free or subsidized healthcare to all their citizens.[5]

Health statistics[edit]

Aggregate health statistics for Mexico have improved greatly since the 1970s. However, Mexico lags well behind other OECD countries in health status and health care availability.[6]

Total health care spending accounted for 6.4 percent of gross domestic product (GDP) in 2005; per capita spending on health care was US$675 (adjusted for purchasing power parity)—about a quarter of the OECD average.[6]

During 2005, 45.5 percent of health spending was paid from public sources—comparable to the share of public spending in the United States but significantly below the OECD average. Private financing in Mexico is almost entirely in the form of out-of-pocket payments, as only 3.1 percent of total expenditures on health are funded through private health insurance.[6] Consistent with every other major industrialized country (except the U.S.), government healthcare in Mexico is universal, making private programs' health insurance unnecessary except for use in private hospitals.

Some authorities have noted that while Mexico has some 3000 private hospitals, some private “hospitals” could hardly be considered hospitals at all, since they have no laboratories, radiography equipment, or even nurses.[7] The remaining 1000 or so public hospitals account for the majority of hospital beds and, in fact, the bulk of private hospitals are institutions with less than 20 beds.

In 2005, Mexico had 1.8 doctors and 2.2 nurses per 1,000 population, a significant increase in health care personnel over the previous decade but again below the OECD averages for these indicators. The mortality rate for children younger than five years was 17 per 1,000 live births in 2005, and Mexico has shown a faster acceleration to lower mortality rates than the U.S., Cuba, and Canada in the last 10 years. Ninety-seven percent of the population had direct access to potable water and 80 percent to sanitation. Also in 2005 the incidence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) among persons aged 15 to 49 was 0.3 percent.[6] At 11,000 deaths/year vs. 22,000/year in the U.S., this represents a 44% higher per capita death rate than the United States.[8]

Affordability[edit]

The IMSS La Raza Medical Center, a typical public hospital in Mexico

According to the site www.internationalliving.com, health care in Mexico is described as very good to excellent while being highly affordable, with every medium to large city in Mexico having at least one first-rate hospital. In fact, some California insurers sell health insurance policies that require members to go to Mexico for health care where costs are 40% lower.[9] Some of Mexico's top-rate hospitals are internationally accredited.[10] Residents of USA, particularly those living near the Mexican border, now routinely cross the border into Mexico for medical care.[11] Popular specialties include dentistry and plastic surgery. Mexican dentists often charge 20 to 25 percent of US prices,[12] while other procedures typically cost a third what they would cost in the US.[11] The www.internationalliving.com site states that on average, an office visit with a doctor—specialists included—will cost about US$25, an overnight stay in a private hospital room costs about $35, and a visit to a dentist for teeth cleaning costs about $20. Some 40,000 to 80,000 American seniors spend their retirement years in Mexico with a considerable number receiving nursing home and health care.[13]

Quality[edit]

With many physicians from the U.S. having received their training in Mexico, and with many Mexican doctors having received at least part of their training in the United States, the quality of Mexican health care has been reported to be comparable to that in the United States: "in general, health care in Mexico is very good…and in many places it is excellent."[14] Lower medical costs than the U.S. have been found to bear no relationship to the quality of medical attention and knowledge about health care provided in Mexico.[2] Mexican hospitals are equipped to first world standards, use modern equipment and hygiene and many Mexican doctors received their training in the US.[15][16] When it comes to diagnosis and treatment, Americans receiving treatment in Mexico say it is just as good as in the United States – and sometimes better.[17]

Universal health care[edit]

Further information: Universal healthcare

On December 1, 2006, the Mexican government created the Health Insurance for a New Generation also known as "Life Insurance for Babies".[18][19][20] This was followed by a February 16, 2009, announcement by President Felipe Calderon where he stated that at the current rate of progress Mexico would receive Universal Health Coverage by 2011,[21] and a May 28, 2009, announcement in which his administration made public Universal Care Coverage for Pregnant Women.[22] In August 2012 Mexico installed a universal healthcare system.[1]

Social determinants[edit]

Social determinants of health in Mexico are factors that influence the status of health among certain populations in Mexico. These factors consist of circumstances in which people grow, live, work, and age, as well as the systems put in place to deal with illnesses. In Mexico, the health inequality among the population is influenced by such social factors. In the past decade, Mexico has witnessed immense progress within their health care system that has allowed for greater access to health care and a decrease in mortality rate, yet there are still various health inequalities caused by social factors.

References[edit]

  1. ^ a b "Mexico achieves universal health coverage, enrolls 52.6 million people in less than a decade". Harvard School of Public Health. 2012-08-15. Retrieved 2013-09-16. 
  2. ^ a b Mexico's health care lures Americans. Chris Hawley. USA Today. 9/1/2009. Retrieved 24 August 2012.
  3. ^ Health Care and Social Security. Tim L. Merrill and Ramón Miró, editors. Mexico: A Country Study. Washington: GPO for the Library of Congress, 1996. (Quoted as: "Source: U.S. Library of Congress.") Retrieved 24 August 2012.
  4. ^ Mexico Wins Praise for Swine Flu Response. Maria Cheng (London) and Vicente Panetta (Buenos Aires). Associated Press. Retrieved 4 July 2009.
  5. ^ Quienes Somos. Secretaria de Salud. Federal Government of Mexico. Retrieved 4 July 2009.
  6. ^ a b c d Country profile: Mexico. Library of Congress Federal Research Division (July 2008).
  7. ^ Health care quality improvement in Mexico: challenges, opportunities, and progress. Enrique Ruelas. Baylor University Medical Center Proceedings. (Proc (Bayl Univ Med Cent). 2002 July; 15(3): 319–322.) July 2002. [PMCID: PMC1276627] Retrieved 10 July 2009.
  8. ^ Country Comparison :: HIV/AIDS – deaths – Mexico. U.S. Central Intelligence Agency. World Fact Book. Retrieved 24 August 2012.
  9. ^ Insurers require insured to go to Mexico. National Nurses United. Retrieved 10 July 2009.
  10. ^ Some Hospitals are Internationally Accredited. Retrieved 10 July 2009.
  11. ^ a b Philip J. Hilts, Quality and Low Cost of Medical Care Lure Americans to Mexican Doctors, New York Times, November 23, 1992, accessed July 10, 2009
  12. ^ Manuel Roig-Franzia, Discount Dentistry, South of The Border, Washingtonpost.com, June 18, 2007, accessed October 15, 2008.
  13. ^ Medical Tourism Statistics and Facts. Health-Tourism. 2012. Retrieved 10 July 2009.
  14. ^ Health: Health in Mexico. Viento Ensenada. 2008. Retrieved 24 August 2012.
  15. ^ First Mexican Hospitals and Bariatric Surgeons Awarded Center of Excellence Designation. Alyssa Willard. Surgical Review Corporation. July 6, 2011. Retrieved 23 August 2012.
  16. ^ Doctor Visit USA vs Mexico. Karen McConnaughey. Focus on Mexico. 04-02-2010. Retrieved 23 August 2012.
  17. ^ Cheap Health Care, South of the Border. Kelly Cobiella. CBS News. 17 December 2009. Retrieved 23 August 2012.
  18. ^ Message to the Nation from the President of Mexico, Felipe Calderón Hinojosa, on the occasion of his first State of the Union Address. Mexican Federal Government. Office of the Presidency. 2006. Retrieved 4 July 2009.
  19. ^ President Calderón during First National Week of Affiliation to Medical Insurance for a New Generation. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.
  20. ^ President Calderón at Launching of Affiliation to Medical Insurance for a New Generation. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.
  21. ^ Mexico to Achieve Universal Health Coverage by 2011. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.
  22. ^ International Women's Day. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.