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OECD Reviews of Health Systems: Mexico 2016

image of OECD Reviews of Health Systems: Mexico 2016

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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Realigning financing to better meet individual health care needs

Mexico’s fragmented approach to health care financing reinforces the patchwork nature of the health care system, impeding both the effective generation and allocation of resources. A more unified approach is of particular urgency given that large numbers of individuals transfer between the social security institutes and Seguro Popular each year due to changes in employment, which disrupts continuity of care. Steps towards more pooled funding – or the functional equivalent – would enable care to be more easily transferrable across insurers and potentially lead to efficiency gains.

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