MEXICO’S HEALTH SYSTEM IS IN DECLINE...
FEWER HAVE ACCESS
There are many reasons why investing in and donating to a non-profit organization for children in poor conditions with medical needs in Mexico is more than a good idea.
Let’s consider the narrative of Mexico’s public health system for a second. The public health system in modern Mexico achieved its institutionalization breakthrough in the 1940's. The 1917 Constitution introduced access to health services for workers as one of its labor rights. Thus, for a little more than 355,000 workers, Social Security became a reality with the creation of IMSS (Mexican Institute for Social Security) on January 19th, 1943. The first steps to try to increase its coverage were taken in 1973, when the Social Security Law was reformed to enable the IMSS to extend its benefits beyond salaried workers and reach groups of the population with no contributive capacity. As a result of this reform, in 1974 the “Social Solidarity’s National Program through Community Cooperation” was implemented, and on May 25th, 1979, a collaboration agreement was signed between COPLAMAR (General Coordination Office for the National Plan of Depressed Areas and Marginalized Groups) and the IMSS.
On February 3rd, 1983, a decree to add the right to health protection for all people was published in the DOF (Official Federation Journal). With this initiative, the Mexican State became the access protection guarantor, under equal conditions, to health services. Thus, on February 7th, 1984, the general health bill (LGS-Ley General de Salud) was created, regulating the right to health protection for all Mexicans, establishing the bases and modalities for access to health services and the participation of the FEDERATION and its 32 STATES in health matters. Considering the promised support of the World Bank (WB) and the International Monetary Fund (IMF) to decentralize the financial burden of health care to each state government, by 1987 administrative responsibilities were transferred only to 14 states. It wasn’t until 1997 that all state governments signed the agreements of the “National Agreement for the Decentralization of Health Services” to the general population.
More than three decades after the initial health reform and due to the lack of co-responsibility in health financing among the branches of government and other economic factors, the Mexican National Health System was still unable to guarantee health services to the non-rightful claimants. For this reason, on May 15th, 2003, a decree reforming and adding to the General Health Bill (LGS) was published in the Official Federation Journal (DOF), formalizing the creation of the Social Health Protection System, specifically aimed at the general population, which includes health promotion, prevention, diagnosis, treatment and rehabilitation. Thus, in 2004, operations began under the name of Popular Insurance (El Seguro Popular). In 2020, the Mexican Federal Government reformed article 4 of the Constitution which created the “Health System for Well-being” (SSB-Sistema de Salud para el Bienestar), whose purpose is to "guarantee the progressive expansion (both quantitative and qualitative), of health services for the integral and cost-free health care for people who did not have access to social security".
Let’s consider the narrative of Mexico’s public health system for a second. The public health system in modern Mexico achieved its institutionalization breakthrough in the 1940's. The 1917 Constitution introduced access to health services for workers as one of its labor rights. Thus, for a little more than 355,000 workers, Social Security became a reality with the creation of IMSS (Mexican Institute for Social Security) on January 19th, 1943. The first steps to try to increase its coverage were taken in 1973, when the Social Security Law was reformed to enable the IMSS to extend its benefits beyond salaried workers and reach groups of the population with no contributive capacity. As a result of this reform, in 1974 the “Social Solidarity’s National Program through Community Cooperation” was implemented, and on May 25th, 1979, a collaboration agreement was signed between COPLAMAR (General Coordination Office for the National Plan of Depressed Areas and Marginalized Groups) and the IMSS.
On February 3rd, 1983, a decree to add the right to health protection for all people was published in the DOF (Official Federation Journal). With this initiative, the Mexican State became the access protection guarantor, under equal conditions, to health services. Thus, on February 7th, 1984, the general health bill (LGS-Ley General de Salud) was created, regulating the right to health protection for all Mexicans, establishing the bases and modalities for access to health services and the participation of the FEDERATION and its 32 STATES in health matters. Considering the promised support of the World Bank (WB) and the International Monetary Fund (IMF) to decentralize the financial burden of health care to each state government, by 1987 administrative responsibilities were transferred only to 14 states. It wasn’t until 1997 that all state governments signed the agreements of the “National Agreement for the Decentralization of Health Services” to the general population.
More than three decades after the initial health reform and due to the lack of co-responsibility in health financing among the branches of government and other economic factors, the Mexican National Health System was still unable to guarantee health services to the non-rightful claimants. For this reason, on May 15th, 2003, a decree reforming and adding to the General Health Bill (LGS) was published in the Official Federation Journal (DOF), formalizing the creation of the Social Health Protection System, specifically aimed at the general population, which includes health promotion, prevention, diagnosis, treatment and rehabilitation. Thus, in 2004, operations began under the name of Popular Insurance (El Seguro Popular). In 2020, the Mexican Federal Government reformed article 4 of the Constitution which created the “Health System for Well-being” (SSB-Sistema de Salud para el Bienestar), whose purpose is to "guarantee the progressive expansion (both quantitative and qualitative), of health services for the integral and cost-free health care for people who did not have access to social security".
In August 2022, Mexican Institute for Social Security and Well-being (IMSS-Bienestar) was created to "provide people without affiliation to social security institutions, free comprehensive medical and hospital care with medication and other associated supplies, universal and equality based, under conditions that allow them progressive, effective, timely, quality access and without discrimination of any kind". On September 7th, 2022, through an official communication in the Official Federation Journal (DOF), it was declared that “Popular Insurance (El Seguro Popular) did not achieve a substantial improvement in the basic health indicators of the population... considering the environmental and social determinants of health". Thus, on May 29th, 2023, the reform to the General Health Law (LGS) was published in the Official Federation Journal (DOF) to regulate the “Health System for Well-being” and return the authority to the Federation to; organize, operate, supervise, and evaluate the provision of services... from the states... seeking to reduce heterogeneity in the provision of health care to people without affiliation to social security.
Therefore, the President’s office analyzed the current state of the health services that serve the population without social security, and identified six major opportunity areas that formed the axis of attention of the current IMSS-BIENESTAR program:
1. The segmentation of health services,
2. The concentration of its efforts on healing and rehabilitation,
3. The deficit of human, financial, material and infrastructure resources,
4. The lack of effective communication channels between health professionals and users, as well as confidence erosion,
5. Economic restrictions due to catastrophic expenses in the economy of the individual and his/her family, the remoteness of services due to geographical conditions of those who live in highly marginalized areas and who must travel long distances to get to a health center and due to age, language or income discrimination.
6. The low quality and safety of health services when accessing ambulatory and hospital medical care.
SMA Missions and Trails for Christ maps to current IMSS-BIENESTAR opportunity areas on items 4 and 5:
Item 4
The Mexican government aligned with the Ottawa Charter for Health Promotion which delineates that health promotion should include the effective and concrete participation of the community in priority setting, and decision making to achieve a better level of health. In support of this opportunity area we provide counseling, and assistance to Mexican families to reorient health beliefs and healthy activities. This will provide a direct link to positive health behaviors, triggering similar behavior among other members of the community.
Item 5
Regarding availability of quality health services that are accessible to those who need them we will respond where the need exists including personnel availability, cultural relevance to health services, and practices, values and a realistic view of the population that requires needed services, whether indigenous, Afro-Mexican, or from another cultural origin without discrimination.
You can get involved by Supporting our Campaigns or Serving with Us or just by donating. There are seven (7) ways for you to get involved.
1. The segmentation of health services,
2. The concentration of its efforts on healing and rehabilitation,
3. The deficit of human, financial, material and infrastructure resources,
4. The lack of effective communication channels between health professionals and users, as well as confidence erosion,
5. Economic restrictions due to catastrophic expenses in the economy of the individual and his/her family, the remoteness of services due to geographical conditions of those who live in highly marginalized areas and who must travel long distances to get to a health center and due to age, language or income discrimination.
6. The low quality and safety of health services when accessing ambulatory and hospital medical care.
SMA Missions and Trails for Christ maps to current IMSS-BIENESTAR opportunity areas on items 4 and 5:
Item 4
The Mexican government aligned with the Ottawa Charter for Health Promotion which delineates that health promotion should include the effective and concrete participation of the community in priority setting, and decision making to achieve a better level of health. In support of this opportunity area we provide counseling, and assistance to Mexican families to reorient health beliefs and healthy activities. This will provide a direct link to positive health behaviors, triggering similar behavior among other members of the community.
Item 5
Regarding availability of quality health services that are accessible to those who need them we will respond where the need exists including personnel availability, cultural relevance to health services, and practices, values and a realistic view of the population that requires needed services, whether indigenous, Afro-Mexican, or from another cultural origin without discrimination.
You can get involved by Supporting our Campaigns or Serving with Us or just by donating. There are seven (7) ways for you to get involved.
For further information, we recommend referring to:
OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/7a7afb35-en
https://www.dof.gob.mx/nota_detalle.php?codigo=5714544&fecha=17/01/2024#gsc.tab=0
http://www.imss.gob.mx/prensa/archivo/202301/031#:~:text=Actualmente%2C%20IMSS%2DBienestar%20opera%20en,y%20alrededor%20de%20236%20partos.
OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/7a7afb35-en
https://www.dof.gob.mx/nota_detalle.php?codigo=5714544&fecha=17/01/2024#gsc.tab=0
http://www.imss.gob.mx/prensa/archivo/202301/031#:~:text=Actualmente%2C%20IMSS%2DBienestar%20opera%20en,y%20alrededor%20de%20236%20partos.