The permanent crisis of the health system

The permanent crisis of the health system

One of the social areas in which the most significant delays have accumulated in recent decades is that related to the guarantee of the right to health. Indeed, following the reform of Article 4 of the Magna Carta, published on February 3, 1983 in the DOF, this right was erected into constitutional status. This will give rise to the creation of the General Health Law, published in 1984, and which, with multiple reforms and additions, remains in force to this day.

The aim of this reform was to achieve the articulation of a health system based on competition and an increasingly balanced distribution of powers and functions, aimed at promoting increasingly normative capacities at the federal level, and growing care and operating capacities in the states and municipalities. Since then, different models and programs of care have been promoted, and the results have always been poor.

Next year will mark four decades of fruitless efforts, which today cost a staggering bill, since the most serious sequelae are found in the suffering of diseases that have become incurable, disabling and leading to the death of hundreds of thousands of people.

The underlying problem in all of this is that the construction of a comprehensive welfare system has not been approached on the basis of a broad consensus of the Republic; the most recent example is the failed transition from Seguro Popular to the so-called Insabi, and which should lead us to serious reflection on how to move towards a universal system capable of guaranteeing the widest level of enjoyment of the right to the health that we have as Mexicans.

One could say that the National Health Survey sums up this crisis that has become permanent in a single piece of data: in 2021, only 40% of the population requiring health care did so in public establishments; that is, only four out of ten. Disaggregated by sex, the data indicates that, among women, 42% of those who received medical care for their needs obtained it from public institutions, while among men, the percentage was only 37%. .

Seen by region, there are also very significant differences, since in the Central Pacific region, care in public facilities represented only 38% of the population requiring health services; in the State of Mexico region, it was only 37%; in the South Pacific, 35%; while in the Center region, there is only 33% of care in public establishments, or just under one in three people who need health care.

Additionally, Ensanut reports that 25% of the national population received care in private medical practices, plus 18% who received care in practices adjacent to pharmacies. If we add the two items, the figure is that 43% of the national population receives care in private clinics, a higher indicator than that of public sector care.

The fact is that a universal health care system with the capacity to provide timely and quality services requires extraordinary investments and without fiscal reform that will frankly be impossible. For this reason, the Federal Executive should take advantage of the two years remaining in its administration to build a reform that gives it the necessary means to build the foundations of a new system and that allows it, whatever its successor, to have leeway to move forward in this direction.

Preventable deaths and disease are signs of our times. And for this reason, the most urgent thing is that we leave behind a Mexico where every day there are thousands of deaths that should not be.

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