Abstract
Nuria Homedes and Antonio Ugalde discuss 25 years of reform to the Mexican health care system and argue that although costs and accessibility have increased, health inequities, efficiency, productivity, and quality of care have not improved.
Highlights
N The second reform (1994) advanced the decentralization of the Ministry of Health (MoH) and attempted to increase the exposure of the major public social security scheme to private sector competition
N accessibility has increased, the Mexican reforms have not resulted in significant reductions of health inequities, or in increased efficiency, productivity, or quality, despite their costs
The program is still active in the states that did not decentralize and is called IMSS-Oportunidades
Summary
Mexico is a large country (population 109 million) with a per capita income of US$8,300 (purchasing power parity US$12,800) in 2007, and as can be seen in Table 1, a highly stratified society [1]. Mexico is a large country (population 109 million) with a per capita income of US$8,300 (purchasing power parity US$12,800) in 2007, and as can be seen, a highly stratified society [1]. In 2006, Mexico spent about 6.6% of its gross domestic product (GDP) on health care, of which 44% was public expenditure (see Table 1) [2]. Mexico is a federation of 31 states and the Federal District, but the federal government has always maintained centralized political and fiscal power. An important early innovation in health care was the extension of free Instituto Mexicano del Seguro Social (IMSS) services to very poor rural areas through a program known as the Coordinacion General del Plan Nacional de Zonas Deprimidas y Grupos Marginados (COPLAMAR, General Coordination of the National Plan for Deprived Areas and Marginal Groups). The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving health care in their societies
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