Meanwhile South of The Border – The Mexican Healthcare Solution

The American solution to solving the uninsured problem was the Affordable Care Act. The Mexican solution is different.

Seguro Popular is Mexico’s solution to protect their uninsured population. It’s benefit structure is disease based. It’s cost basis is income based. No one is forced to participate and no one is penalized if they don’t.

Maybe we could learn something here as this seems to be a practical, common sense approach to universal healthcare.

Excepts from two sources (links below):

The Mexican health care system is formed by diverse public institutions that offer health care services to both the uninsured population (Ministry of Health Medical Services) and salaried workers from the tax-paying formal economy (Mexican Institute of Social Security (IMSS) and the Institute for Social Security and Services for State Workers (ISSSTE)).

In 2001, Seguro Popular (People’s Insurance) was created by the federal government as a major effort to protect the uninsured population against steep health care costs.

Enrolment in Seguro Popular is voluntary and is not dependent on health status or pre-existing illness. There is no co-payment and contributions are determined solely by ability to pay [15], with a predefined quote based on income deciles (the poorest 4 deciles of income without any payments and from the 5th to the top income deciles a quote of USD $152.00 to USD $834 per family per year) [21].

The rest of the population with purchasing power receives medical attention from the private sector.

In its last report from 2010, the Seguro Popular had already enrolled 43.5 millions of previously uninsured Mexicans reaching 88.5% of the final goal of universal coverage.

The program covers now more than 52 million people, includes over 250 types of medical procedures and over 500 pharmaceutical products. On top of that, almost 60 complex interventions are offered to affiliates, in case it is needed – this covers, for example, HIV antiretroviral trea

The insurance has grown over the years: it started with 78 types of treatments. Based on how frequently they were needed, cost – effectiveness and the opinion of scientists, among other things, the number of medical procedures covered by the insurance were expanded to the current 250.

The study also points out that the overall health system is fragmented – different health insurance schemes have different funding sources, insurance pools, provider networks, and administrative structures – and that results in inefficiencies and inequalities.

SOURCES:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599194/

https://www.worldbank.org/en/news/feature/2013/03/14/health-insurance-for-more-than-52-million-mexicans-without-social-security

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