In Mexico, 24.3 million households spend out of pocket on health

In Mexico, 24.3 million households pay out of pocket when they need medical care or medicine because of the inaccessibility or inadequacy of health care. The lowest income households suffered the most. But in addition, the entire population is being abused in the private sector, according to a study by Civic Action Against Poverty this Tuesday.

Access to work-related health does not work; it is unique to most. 61% of the employed population does not belong to social security, there are 34.5 million people, half of them are part of the informal work, but the other half have a job, their employers are not affiliated with them, he noted during the presentation of the survey. Norma Lorena Loessa, Civic Action Against Poverty Health Specialist.

The situation of women is worse, 16 million are left out of the healthcare system. The other big exception is people in extreme poverty, of whom 10.8 million, according to Koneval, do not have access to social security, and 57% have access to health care.

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Although having social security does not mean that Mexico has effective, efficient access to health. Not only does the increase in out-of-pocket medical care correspond to the unmet need to access the public system, but 57% of people affiliated with ISSSTE went for private counseling in 2020, the same as 45%. IMSS 29 29% of those who are affiliated with other services, according to the National Health and Nutrition Survey (Ensanut 2020).

“This is serious because with social security, the shortcomings of the system make people turn to private care, and sometimes they run into private services that are also flawed and have high costs,” she said.

According to the Data México platform of the Ministry of Economy, the cost of hospital care for a COVID-19 patient in a mid-level hospital is 603 thousand pesos, while in a high-end hospital – 522 thousand pesos. This means that hospitals with lower ratings pay more.

As for medicines, Loesa said that Rendesivir, for example, cost an average of 27,000 pesos, and six months later it cost 107,000 pesos, almost four times as much.

Between January 1, 2019 and September 25, 2021, the Federal Office for Consumer Protection reviewed 418 complaints against hospitals and clinics. There was also a 15 to 20% increase in the cost of services in private hospitals.

Arantxa Colchero, a researcher in the Department of Health Economics at the National Institute of Public Health (INSP) Research Evaluation Research Center, has a legal status in this analysis, without a general population analysis. 57% participated in a private place, only 43% in a public place. 18% of those who attended private services did so at the pharmacy office.

From 2018 to 2020, according to the analysis of the Acción Ciudadana Contra la Pobreza, out-of-pocket health expenditures increased by 44% of the total population. In 2018, households spent an average of 902 pesos on quarterly spending on health, compared to 1267 pesos in 2020.

“All of this is due to a fragmented, unequal health care system that depends on employment status,” Colcero said. For pharmacies that are not regulated, the out-of-pocket costs are higher for all the medicines they prescribe, և Doctors are less qualified than doctors in the public sector.

Colchero stressed that the regulation of antibiotics in CAFs is very important, where there is an incentive to prescribe and sell them, “they also abuse” the fact that people think that if they are not given antibiotics, they will not be cured, for example, viruses. In case of COVID, they are not treated with antibiotics. ”

In the analysis conducted by Acción Ciudadana Contra la Pobreza, the organization states that in order to guarantee the right to health, it is necessary:N system with universal coverage, focused on people, reduce out-of-pocket expenses, exclude access to health from employment benefits և prioritize the primary care model which prevents diseases և their complications.

In order for the health care system to move gradually, without employment status or on the basis of ability to pay, it is necessary to remove the main barriers to entry, especially for those living in poverty and in more socially disadvantaged areas.

The integrated vision of the health care system, the analysis says, includes the private sector պատասխանատվ the responsibility of the authorities to oversee compliance with regulations to avoid abuses, such as overcharging or overpricing drugs.

The new plan for the population without social security announced by the federal government on March 15, which offers to re-focus the provision of health services through agreements with IMSS Welfare, presents risks, the organization’s analysis emphasizes, as it: does not seem to take into account the required additional budget; it is very focused on hospital infrastructure և equipment. But at the same time, it opens up opportunities for functional integration that can bring us closer to universal coverage, overcoming segmentation.

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