Mexican health system needs urgent reform, says OECD report
The OECD has called on the Mexican government to urgently reform its health system, which it says is “fragmented, inefficient and unresponsive.”
In its first review since Mexico introduced publicly-funded universal health insurance ten years ago, the OECD said that modernisation must start now and that if it does not, the Mexican health system “risks becoming enveloped in crisis.”
Public investment in Mexico’s health care system has increased from 2.4% to 3.2% GDP between 2003 and 2013.
But, the OECD’s review, published last week, questions “whether this money is translating into tangible health gains.”
One key challenge, according to the review, is that Mexican health care is provided through a cluster of disconnected sub-systems: each sub-system offers different levels of care, at different prices, with different outcomes.
Individuals effectively have neither choice of insurance plan nor of provider network, as affiliation is determined by their job, the document states.
People working in the private sector are affiliated to a benefit package and one set of providers belonging to the Mexican Institute of Social Security (IMSS), whereas federal civil servants are covered by a different package and a different set of providers belonging to the Institute for Social Security and Services for State Employees (ISSSTE).
Anyone who is unemployed is likely to have to enroll in yet another programme – Seguro Popular – with a different package and different set of providers.
The OECD describes this arrangement as “wasteful, because individuals need to repeatedly re-engage with multiple systems” and as “bad for patients and bad for taxpayers.”
Mexico’s health system should become more people-centred, and “move from being a set of vertical subsystems whose operations are rigidly determined by historical and institutional legacies, to one that is responsive to the changing needs of individuals and communities across the life course,” the review says.
Though its review acknowledges that progress has been made over the last decade – “some 50 million Mexicans previously at risk of unaffordable health care bills now have access to health insurance” and “key parameters such as infant mortality, and deaths from heart attacks or stroke, have improved”, it says that “serious and urgent challenges have intensified.”
Mexico’s healthcare needs are complex and challenging, the document says, with the country now having the lowest life expectancy of all OECD countries – 74.6 years, compared to an OECD average of 80.4.
Mexico also shows “worrying” rates of obesity, the document says: “Between 2000 and 2012, rates of overweight or obesity increased from 62.3% to 71.3% of the adult population; one in three children is also overweight or obese.
“Unsurprisingly, diabetes, the chronic disease most directly linked with obesity, is spreading rapidly and now affects many adults. In Mexico, 15.9% of adults have diabetes, more than double the OECD average of 6.9%.”