Health system reform in mexico 4 evidence is good for your health system : policy reform to remedy catastrophic and impoverishing health spending in Mexico

• Published in: The Lancet (British edition) Vol. 368; no. 9549; pp. 1828 - 1841
• Main Authors: KNAUL, Felicia Marie, ARREOLA-ORNELAS, Héctor, MENDEZ-CARNIADO, Oscar, BRYSON-CAHN, Chloe, BAROFSKY, Jeremy, MAGUIRE, Rachel, MIRANDA, Martha, SESMA, Sergio
• Format: Journal Article
• Language: English
• Published: London Lancet 18.11.2006; Elsevier Limited
• Subjects: Biological and medical sciences; Economic recovery; General aspects; Health care policy; Health insurance; Hospitals; Households; Medical sciences; Miscellaneous; Payroll taxes; Policy reform; Poverty; Public health. Hygiene; Public health. Hygiene-occupational medicine; Studies; Taxation; Central America; Mexico; America; Medicine; Health system; Health policy; Political aspect; Expenditure; Reform; Public health
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(06)69565-2

Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis. [PUBLICATION ABSTRACT]