OECD Reviews of Health Systems: Mexico 2016

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Ten years after the introduction of publically-funded universal health insurance, the Mexican health system finds itself at a critical juncture. Unquestionably, some measures of health and health system performance have improved: those previously uninsured now use health services more often, whilst numbers reporting impoverishing health expenditure having fallen from 3.3% to 0.8%. Other indicators, however, remain worrying. Rates of survival after heart attack or stroke are markedly worse than in other OECD countries. Prevention is a particular concern: with 32% of the adult population obese, Mexico ranks as the second most obese nation in the OECD and almost 1 in 6 adults are diabetic. Other key metrics imply deep-rooted inefficiencies in the system: administrative costs, at 8.9% of total health spending, are the highest in the OECD and have not reduced over the past decade. Likewise, out-of-pocket spending has stuck at nearly 50% of total health spending - the highest in the OECD - and implies that individuals feel the need to visit private clinic despite having health insurance. In short, Mexico’s massive public investment in its health system has failed to translate into better health and health system performance to the extent wished and a programme of continued, extensive reform is needed. This report sets out the OECD’s recommendations on the steps Mexico should take to achieve this.

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Foreword and acknowledgements

This is the OECD’s second Health System Review of Mexico, published as reforms to Mexico’s Ley General de Salud are being debated. Much progress has been made since the first review, a decade ago. Public investment in the health system has risen from 2.4% GDP to 3.2%; the publicly-subsidised health insurance plan Seguro Popular now covers around 50 million Mexicans, and reports of recent impoverishing health expenditure have fallen from 3.3% to 0.8% of the population. Many of Mexico’s policy innovations are studied and emulated across the world, particularly in the field of prevention. Infant and maternal mortality rates have fallen, and life expectancy is now just under 75 years.

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