SALUD

Mexican Health System

SALUDMexico

•Health Protection is a constitutional right.•Nowadays health care services are available for 95 million Mexicans in 32states through social insurance and public decentralized services.•Universal coverage will be achived at the end of 2011, early 2012. 1

•Birth rate: 18 per 1,000 inhabitants. 2

•Life expectancy: 73/78 3

•Per capita GDP 2010: US$ 9,030.00 4

•Total expenditure on health as % of GDP (2009) 3: 6.5

Sources: 1. Comisión Nacional de Protección Social en Salud, CNPSS, 2010. Ministry of Health, Mexico; 2. Consejo Nacional de Población, CONAPO.Proyecciones de la población de México, 2005-2050. www.conapo.gob.mx; 3. Global Health Observatory, WHO, www.who.int/countries/mex/en;4. Instituto Nacional de Estadística y Geografía. INEGI. Encuesta Nacional de Ingreso y Gastos de los Hogares, 2008. México.

SALUD

Unemployment,Insecurity, Education,

Migration and Poverty

Proliferation of Vectors

Dyslipidemia

Incomplete Vaccination

Overcrowding

Under-utilization of Services

Insufficient coverage of services

Alcoholism and Tobacco

Consumption

Environmental pollution

Obesity

Sedentary behavior

and stress

Hipertensionand Diabetes

Malnutrition

No HealthyConducts

Accidents and Disability

Aging

Demographic and epidemiological transitions

SALUDChronic Diseases: Mortality in Mexico 1985-2010

Diabetes Mellitus

Ischemic Heart Disease

Brain vascular disease

Cirrhosis and other liver illnesses

Hypertension

Population Aging

0

2

4

6

8

10

12

14

16

2005 2010 2015 2020

Percentage of population consisting of senior adults, by age

60 a 64

65 a74

75 a84

85 o más

Source: ECLAC and CONAPO, updated with

2010 CENSUS

The Institute of Geriatrics was created in 2008

SALUDHealth Interventions

• NCDs: Obesity prevalence among adults has tripled since 1980. Health care forNCD s related to obesity costs 0.3% of GDP and 13% of total healthexpenditure (2008). National Agreement for Nutritional Health. Intersectoralinterventions.

• Maternal & Infant Mortality. Maternal mortality rate has dropped 40.8% from1990 to 2010 (90.41 to 53.5 deaths per 100 thousand living).

• Influenza AH1/N1.Byproduct of the epidemic, the national surveillance systemwas strengthened. Mexico is better prepared to deal with global epidemics.

• Tobacco and Alcohol Consumption.

• IMESEVI. Mexican Initiative for Road Safety.

• HIV/AIDS Prevention. 35,000 patients without social security receive freetreatment through Seguro Popular’s Catastrophic Protection Fund.

SALUD

Benefits Package

Population

Financing

Management

Users

Service provision

SS IMSS

Formal workers in the private sector

Public Sector

General taxes States

Population without social security, to be

affiliated

ISSSTE Private insurance

Medicines

Doctors

Hospitals

Without social security and with no interest to be affiliated

Formal workers in the private sector

Public Sector

Population without social security, to be

affiliated

Without social security and with no interest to be affiliated

Social contribution

Workers’ and employers’ contributions

SESASFPGC

•Maternity and illness insurance•Health Benefits Package•universal 266•catastrophic 49•New generation 128

Mexican Health System Today

Social contribution Social contribution

Workers’ and employers’ contributions

SALUD

• System Fragmentation

• Duplicities and inefficiencies

• Offer of differentiated services

• Variability of medical attention

• Heterogeneity in the funding and administration

NEED TO HOMOLOGATESERVICES

• Right to health protection

• Descentralization of services to federal entities

• Health equity

• Creation of the Social Protection System in Health

REFORMSFEDERALISM AND UNIVERSALIZATION

Opportunities and Huge Challenges

SALUDMexican Health Reform with SeguroPopular

2003: 49 millions ; 2011: 96 millions of total public health coverage

2006

2008

2011

Population

Interventions

Popular Health Insurance including:- All primary-care and child interventions- Universal access to medical drugs for chronic diseasesand Universal coverage for cancer in pediatric and woman’s (breast and cervical)

45,0

46,0

47,0

48,0

49,0

50,0

51,0

52,0

2005 2006 2007 2008 2009

51,7 51,3

50,9

49,3

47,7

Out of Pocked Expense as a % of Total Health Expenditure 2005-2009

%

Source: Ministry of Health, Dirección General de Información en Salud. Sistema de Cuentas en Salud a NivelFederal y Estatal (SICUENTAS), México 2010. 10

SALUDPaving the way for the future: Functional

Integration

Population covered Others

Health Benefits Package

Single financial source

Benefits Package

Population

Financing

Management

Users

Service provision

Private insurance

Medicines

Doctors

Hospitals

Population coveredOthers

SALUD

Enriched by experience, strengthening prevention and health promotion.

Universal coverage

Preventive- early detection of risks and damages

Integral

Focused in risk groups

Community and family focused

Strengthened health promotion and the educative process. Modify behaviors

Use of multiple medicines (efficiency)

Interdisciplinary teams

Paving the way for the future: A New Model

Strategy 2007-2012

• National health registry of covered population

• Electronic file network

• Standardized medical attention

• Systematic service exchange among public institutions

• Sectorial use of resources

• Consolidated buying of medicines

• Human Resource Formation

Improve availability and use of resources to cope with challenges

Towards Functional Integration

SALUD

Thank you