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Assessing the effect of the 2001-06 Mexican health reform: an interim report card

2007; Instituto Nacional de Salud Pública; Volume: 49; Linguagem: Inglês

10.1590/s0036-36342007000700011

1606-7916

Emmanuela Gakidou, Rafael Lozano, Eduardo González-Pier, Jesse Abbott-Klafter, Jeremy Barofsky, Chloe Bryson‐Cahn, Dennis M. Feehan, Diana K Lee, Héctor Hernández-Llamas, Christopher J L Murray,

Poverty, Education, and Child Welfare

Since 2001, Mexico has been designing, legislating, and implementing a major health-system reform.A key component was the creation of Seguro Popular, which is intended to expand insurance coverage over seven years to uninsured people, nearly half the total population at the start of 2001.The reform included five actions: legislation of entitlement per family affiliated which, with full implementation, will increase public spending on health by 0.8-1.0% of gross domestic product; creation of explicit benefits packages; allocation of monies to decentralised state ministries of health in proportion to number of families affiliated; division of federal resources flowing to states into separate funds for personal and non-personal health services; and creation of a fund to protect families against catastrophic health expenditures.Using the WHO health-systems framework, a wide range of datasets to assess the effect of this reform on different dimensions of the health system was used.Key findings include: affiliation is preferentially reaching the poor and the marginalised communities; federal non-social security expenditure in real per-head terms increased by 38% from 2000 to 2005; equity of public-health expenditure across states improved;