The Mexican Healtcare Reform

Regina García Cuéllar
Patrick Lee
Eduardo Pesqueira
The Mexican Healthcare Reform:

The Next Step
It seemed ages ago, but just one month before, on August 26th, 2012, the elected President of Mexico had called Dr. Mauro Valdez into his office and asked him to evaluate the status of the National Healthcare System and propose a Health Policy Plan for the next six years. Valdez received thisinstruction with excitement but also with a heavy sense of responsibility. He understood that having been asked by the elected President to perform this duty was a clear signal that he could be appointed as the next Minister of Health, a major challenge in a country of the size, socio-demographic, and epidemiological characteristics of Mexico.
The elected President was convinced that the healthconditions of the population of the country were directly related to its level of development and wellbeing. During his campaign, he had placed health as one of the top priorities for his government.
As a specialist in quality of care, Valdez had a clear understanding of the importance of providing adequate access and quality healthcare to the population. This was especially important forlow-income populations living in rural areas who had been historically underserved, and who depended on the government for receiving health services. Valdez had only one month to review the health sector, to analyze past reforms that had been undertaken, and to come up with a Health Plan for the upcoming administration that would begin in December 2012.
Health coverage had increased significantlythroughout the previous two administrations. During President Vicente Fox’s administration (2000-2006), the Popular Health Insurance (Seguro Popular) instituted by Dr. Julio Frenk became the operational mechanism of the reform that created the System for Social Protection in Health. The Seguro Popular had grown dramatically and was providing health coverage for over 52 million affiliates, whichaccounted for almost one half of the Mexican population. (See Exhibit 1). The Seguro Popular had been designed to improve overall quality of services, equity in access and treatment, and financial protection for the users of health services. However there were still major issues lagging behind in order to reach a comprehensive reform. These issues constituted Mauro Valdez’s most important priorities.Twelve years earlier, Julio Frenk had been appointed Minister of Health by President Fox and had been in charge of the design and implementation of the initial phase of the reform. According to Frenk, the Health System had to respond by safeguarding different components of the right to health: protection of the population against risks to health; quality of care and access to health services;and financial protection by reducing the population’s risk of impoverishment caused by health problems.
Mauro Valdez had been a member of Dr. Frenk’s team and had a clear understanding of the fundamental concepts of the reform. He understood that while the implementation of the Seguro Popular had granted every Mexican the opportunity to have a public health insurance alternative, and whileuniversal affiliation had nearly been met, there were several aspects of the financial reform that had yet to be completed.
Regarding the protection against health risks, Valdez knew that issues such as epidemiological surveillance systems and control of international threats to health had still to be built up. He had held an important position at the Federal Commission for Protection against SanitaryRisks (COFEPRIS) (See Abbreviations for a list of all acronyms used in the case). COFEPRIS was a governmental entity that dealt with the regulation and supervision of areas that may threaten the health of the population. Such areas included air quality, water sanitation, and quality and safety of food and medications.
Relevant concerns related to quality of care were also present in Valdez’s...