The Quest for Universal Health Coverage: Achieving Social Protection for All in Mexico

The Lancet, Volume 380, Issue 9849, Pages 1259 - 1279, 6 October 2012

Posted: 10 May 2013

See all articles by Felicia Knaul

Felicia Knaul

Harvard Global Equity Initiative; Mexican Health Foundation

Eduardo Gonzalez-Pier

Independent

Octavio Gómez-Dantés

National Institute of Public Health of Mexico (INSP) - Center for Health Systems Research

David García-Junco Machado

Consejo Nacional de Ciencia y Tecnología (CONACYT)

Héctor Arreola-Ornelas

Fundación Mexicana para la Salud, A.C.

Mariana Barraza-Llorens

Independent

Multiple version iconThere are 2 versions of this paper

Date Written: October 6, 2012

Abstract

Mexico is reaching universal health coverage in 2012. A national health insurance program called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganization of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries.

Suggested Citation

Knaul, Felicia and Knaul, Felicia and Gonzalez-Pier, Eduardo and Gómez-Dantés, Octavio and García-Junco Machado, David and Arreola-Ornelas, Héctor and Barraza-Llorens, Mariana, The Quest for Universal Health Coverage: Achieving Social Protection for All in Mexico (October 6, 2012). The Lancet, Volume 380, Issue 9849, Pages 1259 - 1279, 6 October 2012, Available at SSRN: https://ssrn.com/abstract=2262966

Felicia Knaul (Contact Author)

Mexican Health Foundation ( email )

Periférico sur 4809, El Arenal Tepepan, Tlalpan
El Arenal Tepepan, Tlalpan
Mexico, D.F., 14610
Mexico
(52) 55 56559011 (Phone)
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HOME PAGE: http://http//www.funsalud.org.mx

Harvard Global Equity Initiative ( email )

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Boston, MA 02115
United States
(617) 4327938 (Phone)

HOME PAGE: http://isites.harvard.edu/icb/icb.do?keyword=k62597&pageid=icb.page268594

Eduardo Gonzalez-Pier

Independent ( email )

Octavio Gómez-Dantés

National Institute of Public Health of Mexico (INSP) - Center for Health Systems Research ( email )

David García-Junco Machado

Consejo Nacional de Ciencia y Tecnología (CONACYT) ( email )

Justo Prieto esq. Teofilo del Puerto
Asuncion, 00001119
Paraguay

Héctor Arreola-Ornelas

Fundación Mexicana para la Salud, A.C. ( email )

Periférico sur 4809, El Arenal Tepepan, Tlalpan
México, D.F., 14610
México, 14610

Mariana Barraza-Llorens

Independent ( email )

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