1.  Passed in 2003, the Sistema de Protección Social en Salud or System of Social
Protection in Health for the initiated the beginning of universal healthcare
coverage in Mexico
 This would cover the poor who previously could not afford or qualify for
traditional Social Security the ability to apply for the Seguro Popular or
People’s Insurance
 The Seguro Popular aims to achieve universal healthcare coverage for all
Mexican citizens by the year 2010
 All access to care would be provided by the Ministry of Health and the
Instituto Mexicano de Seguridad Social
 Public health services in Mexico are covered through the Ministry of Health as
well as the Fondo de Protección contra Gastos Catastróficos or Fund for
Protection against Catastrophic Expenditures (FPGC).
 Other public health insurance payers come through those who are:
 Self-employed
 Out of the labor market
 With the informal sector of the economy
Bonilla-Chacín, M. E., & Aguilera, N. (2013). The Mexican social protection system in health.
Gutiérrez, N. C. (2014, July). Mexico: availability and cost of health care – legal aspects.
Retrieved from https://www.justice.gov/sites/default/files/eoir/legacy/2014/07/14/2014-
010632%20MX%20RPT%20FINAL.pdf
Frenk, J., Gómez-Dantés, O., & Knaul, F. M. (2009). The democratization of health in Mexico:
financial innovations for universal coverage. Bulletin of the World Health Organization, 87,
542-548. doi:10.2471/BLT.08.053199
Organisation for Economic Co-Operation and Development. (2005). OECD reviews of health
systems: Mexico. Retrieved from http://www.borderhealth.org/files/res_839.pdf
Puig, A., Pagán, J. A., & Wong, R. (2009). Assessing quality across health care subsystems in
Mexico. Journal of Ambulatory Care Management, 32(2), 123-131.
doi:10.1097/JAC.0b013e31819942e5
World Health Organization. (2006, April). WHO country cooperation strategy at a glance.
Retrieved from
http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_mex_en.pdf?ua=1
World Health Organization. (2015). Global Health Observatory. Mexico; Country Data and
Statics. Retrieved from http://www.who.int/gho/countries/mex.pdf?ua=1. March 24, 2015.
 Unequal access, financing, and health outcomes as a result of segmentation in the
delivery of services
 Need to guarantee high quality services and adequate health financing.
 The need for additional public funding in order to extend access to care for non-
communicable diseases such as cardiovascular disease, diabetes, and cancer.
 Healthcare disparities remain between the different states in Mexico due to socio-
economic factors:
 Richer states benefit from more social insurance and resources for the
uninsured
 Yet the rural populations remain underserved
 Improving the fragmented insurance program as well as consolidating the Mexican
insurance system.
 More attention in the area of healthcare quality:
 More emphasis on preventive care
 Increasing regulations on medical schools and certification of healthcare providers
OVERVIEW
FINANCING/ REIMBURSEMENT
PAYER SYSTEM
CHALLENGES
HEALTHCARE PROVIDERS
REFERENCES
WHO RANKING
MEXICO HEALTH CARE AND EXPENDITURES
Fundamentally, the answers to our challenges in
healthcare relies in engaging and empowering the
individual. - Elizabeth Holmes
 The Mexican health system comprises three subsystems:
 Social Security
 Social Protection System in Health (SPSS)
 SPSS includes Seguro Popular
 Private system.
 Social security system provides health care services to
employed
 covers approximately 47% of the population
 SPSS is open to any Mexico resident without Social
Security, which has 3 health services packages
 PHI (covers 284 primary and secondary care
interventions), FPGC (covers 57 interventions
associated to catastrophic spending), & SMPG (covers
any other services not covered by PHI or FPGC).
 97% of SPSS enrollees do not pay based on financial
status.
 Payment of providers in the public sector
are paid on a salary basis through the
institution they work for
 Payment of providers in the private sector
are paid on a fee-for-service basis
 In the public sector, wages are based on
seniority and vary between institutions who
care for the uninsured as well as those
providing care to those with Social Security
 Most healthcare providers, specifically
doctors, rank among some of the lowest
salaries when compared to the average
income in Mexico
 Low wages reduce the incentives for
providers to remain in healthcare or to pick
up a second job outside of the healthcare
profession
 Current World Health Organization
(WHO) Ranking: # 61
 WHO top causes of Death:
 Diabetes
 Ischemic Heart Disease
 Stroke
 Interpersonal violence
 Cirrhosis of the Liver
 COPD
 Lower respiratory tract infections
 Hypertensive heart disease
 Road injury
 Kidney diseases
MEXICO’S HEALTHCARE SYSTEM
Worthy Walker, MSN, FNP-BC; Ashley York MSN, AGNP-BC, WHNP-C; Cory York, BSN, SRNA
Faculty Advisor: Shari Wherry, DNP, APRN, FNP-C
Union University School of Nursing, Jackson, Tennessee
 Financing for healthcare occurs through the following
ways in Mexico:
 Social Security funded by payroll contributions from
federal government, employers, employees, and a
subsidy from the state.
 SPSS publicly subsidized, funded by federal and state
government (All from general government revenues).
 Federal: Social Contribution & Federal Solidarity
Contribution
 States: Individual contribution (State Solidarity
Contribution)
 Private funding is all out-of-pocket.
 reimbursement for healthcare services occurs in two
ways:
 The public sector sets annual global budgets
 Private sectors arrange fee-for-service as the
predominant reimbursement service
Expenditure Total % of GDP (2013) 6.24
Expenditure, public % of government (2013) 15.38
Per Capita US dollar (2013) 664.34
Expenditure, private % of GDP in Mexico (2013) 3.01
Expenditure, public % of total health) (2013) 51.74
Hospital beds (per 1;000 people) (2009) 1.6
Physicians (per 1;000 people) (2009) 1.96
Nurses and midwives (1;000 people) (2000) 1.1
Outpatient visits per capita (2000) 2.5
Life Expectancy (in years) 75
MEXICAN POPULATION RESOURCES
 Mexico has the 3rd largest population per country behind
the United States and Japan
 In 2011, only 14 (5.1%) out of 273 Federal Programs and
Actions for Social Development were aimed at the
indigenous population
 0.1% of GDP allocated to total national social policy
 25% of the Mexican population reported having no health
insurance coverage
 In 2002, 41 million Mexicans had Social Security
insurance coverage while 52 .5 million qualified for this
same coverage.