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The healthcare infrastructure in Mexico has a long history, which has paid off in the form of a stable, high-quality healthcare system, although inequalities remain in the system. The history of Mexican healthcare dates back to the Hospicio Cabañas hospital located in Guadalajara, which was built in 1791. This hospital is one of the oldest and largest hospital complexes in Spanish America. It is still functioning and providing care and shelter for the underprivileged, including: the ill, orphans, the poor, the elderly, and the handicapped. During the 1930's the Mexican government started to implement and lay the ground work for the foundation of its healthcare system. By 1943, the infrastructure of the modern Mexican healthcare system and its social security schemes were established when both the Ministry of Health (SSA) and the Mexican Institute for Social Security (IMSS) were created. The Ministry of Health is the most important institution involved with the purpose of delivering medical care to the population. The Mexican Institute for Social Security (IMSS) is a social insurance and pension that attends to the public health needs in order to protect the employees and employers. The employed citizens, mostly in the private run companies, and their dependents are able to use the benefits provided by the Mexican government. The IMSS services covers: doctors, diagnostic studies such as x-rays and lab work, hospitals and medical procedures, as well as prescription drugs. The IMSS is funded by contributions from the private employees, employers, and the government.
After the creation of the Ministry of Health and the Mexican Institute for Social Security (IMSS) the government started extending the public welfare programs to include more citizens under coverage. The Institute for Social Security and Services for State Workers (ISSSTE) was established in 1959, in order to cover government employees and their families. This program is government funded and ran, which provides assistance only to government employees who need assistance in case of illness, disability, retirement, or death.
The IMSS-Solidarity Insurance was established, in 1979, to expand the health coverage to new demographics of the population such as: the unemployed, self-employed, part-time workers, seasonal workers, street vendors, domestic workers, and the retired that were not covered by the existing social security networks. The IMSS-Solidarity is fully funded by the government and approximately one-third of the population is covered by it. The Mexican government introduced another program called Seguro Popular (Popular Health Insurance) in 2003, with the goal to provide health services to the underprivileged (poor) members of the population. Participation in this program is voluntary, free to the poor, and provides them with access to: health clinics, regular and preventive medical care, drugs, and money to pay for all of these services. The program’s main purpose is to protect against catastrophic health expenses that could exceed 33% of a household's yearly expenses. The trends look promising; the System of Social Protection in Health (SSPH) was set up in 2006, to improve the healthcare coverage in the rural and poorer regions in Mexico. More advances through the implementation of new programs and schemes will take place in the coming years, as Mexico strives for universal healthcare by the year 2011.
Mexico has a pluralistic healthcare system that is generally divided between a public sector that is run by, and either fully or partially subsidized by, the federal government, depending on the person's employment status and a private sector that is ran independently and funded mostly from out-of-pocket expenditures. The Mexican healthcare system has historically been dominated by the public sector (government) and, as mentioned above, various Government run social security programs are provided. The public sector consists of: hospitals, urban and rural maternity facilities, medical clinics, pharmacies, and most medical training is carried out at public teaching universities. The private sector has been generally small and mostly limited to the major cities, but within the last decade this sector has increased 100%. The private sector covers close to 3 million people and is funded from either out-of-pocket payments or private health insurance. The private sector is expensive and is mostly used by the upper and middle class although, many who are poor have recently have chosen it and have been paying for it out-of-pocket.
As a result of modernization efforts over the years, the Mexican healthcare system has made great strides forwards and the general health of the population in the country has greatly improved. Access to healthcare in both urban and rural areas has increased, there are over 4,000 hospitals in Mexico with over 20,000 primary care units. There are currently 10 hospital beds per 100,000 people. The number of medical schools has continually increased since the early 1990's. There are now over 78 medical schools and 300 nursing schools in Mexico. As of 1997, there were 463,611 public healthcare workers, 116,047 doctors, and 161,303 nurses and the number of doctors to population went up from one doctor per 1000 people, in 1990, to two doctors per 1,000 in 2007.
There have been many dramatic improvements to the health of the population. There were many clear signs that showed the health of the country's population had begun to improve and begun to enter into a transitional stage. By the early 1990's, the government has made progress towards its goal of improving the access to clean drinking water and providing basic sanitation. Now over 95% of the population in the urban regions had access to clean water and 91% had adequate sanitation. Mexico has developed one of the world’s most successful vaccination programs where over 95% of the population are now covered. The prevalence of most of the communicable diseases such as: Pertussis, Polio, Diphtheria, Measles, Tuberculosis, Whooping Cough, Diarrhea, and Respiratory Diseases has fallen throughout the country. Pertussis declined from 122 cases per 100,000 people in the 1940's to only 0.2 cases per 100,000 people in 1991, Polio and Diphtheria were eradicated in 1991, Measles went from 24 cases per 100,000 people down to 5.9 in 1991, and Tuberculosis declined slightly from 16 cases per 100,000 people during the 1980's to 14.3 cases in 1990.
Malaria continues to be an issue, as it actually increased in prevalence during the 1980's but has dropped within the last decade. There has been a significant progress in the reduction of the Dengue fever which is a flu-like illness that is spread by the bite of an infected mosquito. There were 74 cases per 100,000 people of Dengue Fever in the 1980's but, by the mid 1990's the rate has dropped to 7 cases per 100,000 people. The average life expectancy rose from 59 years during the1960's up to 76 years in 2009. The implementation of immunization programs for children has managed to cover over 97% of one year olds for: Diphtheria, Pertussis, Tetanus, and Measles. The Infant mortality rate was lowered from 146 deaths per 1,000 live births during the 1940's down to 18.42 deaths per 1,000 in 2009, comparable to Bulgaria and Sri Lanka. The government has educated the public of the awareness of birth control and as of 2000, an estimated 51% of women (ages 15 to 49) were using some form of contraceptive. The total fertility rate decreased to 2.34 in 2009, from 5.30 in 1987. The Mexican government and civil society have taken significant steps to address HIV/AIDS. The HIV/AIDS prevalence rate in Mexico is 0.3%, which is among the lowest in the region and is also lower than the average rate for Latin America at 0.5% and the global rate of 0.8%.
The improvements to the Mexican economy have allowed the country to modernize, leading the population to begin living lifestyles that have contributed to the large increase of many non-communicable diseases. In 1955, 70% of the deaths were from communicable diseases and by the year 2006, it went down to 12%. Causes from death from non-communicable diseases in 1955, was 25%, by the year 2006, it dangerously increased to 75%. Chronic non-communicable diseases such as: Cardiovascular, Malignant Neoplasms, Hypertension, Obesity, Diabetes, and accidents are now the leading causes of death instead of Malaria, Cholera or Tuberculosis.
Despite the fact that the healthcare system in Mexico has dramatically improved, the country's level of medical care is still in a profound state of transition. The healthcare system is not perfect and there are many disparities in the access to treatment and the quality of medical service throughout Mexico. The World Health Organization (WHO) in the year 2000, ranked Mexico 51 out of 191 countries in the overall quality of its healthcare, but was ranked very low at 144 on financial fairness. This is evident by the fact that there are still over 50 million Mexicans that have no medical insurance.
Depending on your location the quality of medical treatment will vary. The population in the urban regions, especially the Northern regions of the country, exhibit social indicators on par with those of developed countries, whereas statistics for the Southern part of Mexico and most rural areas are comparable to those of the developing world. The infant mortality rate will differ depending on where the baby was born. If the baby was born in the Northern regions of the country or in the major cities the potential death rate will be around the mid 20's per 1,000 live births but, if the baby was born in the rural or Southern regions the rate will be much higher, somewhere around 50 deaths out of 1,000 births.
Mexico has an unequal distribution of doctors and nurses. About 80% of the doctors and nurses are practicing in the urban region. In the lowest income regions, there are fewer than five doctors per 100,000 members of the population, which varies widely from the nearly twenty doctors per 100,000 in the highest income areas. Hospital beds likewise vary from fewer than one per 100,000 people to nearly fifteen between the poorer and more affluent areas respectively. The urban areas often have doctors and nurses in abundance, while the rural areas are most often neglected, under staffed, under trained, and limited in the care that they are able to provide.
The public hospitals and clinics are not distributed evenly throughout the country. In the rural and poorer regions the medical services are generally inadequate because of the shortage of doctors and nurses and the general lack of modern equipment. In rural and even in the urban areas patients using the government facilities can expect a lengthy wait to see a physician. The main cause is the lack of funds going into the healthcare system. The total expenditure on healthcare accounts for 6.4% of the country's gross domestic product (GDP), which is below the worldwide average of 8.4%, and the per capita expenditure was USD$675, in comparison Canada spent $5,000 per person. This has led to drastic budget restraints causing widespread personnel problems. Highly-trained and qualified staff have left for better paying positions in the private sector and the staff that has stayed, are often poorly-trained, resulting in facilities that are often under-staffed relative to the workload. Budget restraints also mean basic maintenance and hygiene levels are usually not kept to the standard of modern hospitals in the developed world. Patients often sleep on worn out cots in unventilated rooms, increasing the possibility of contracting an infection in the hospital. The lack of funds have left the some government run hospitals operating outdated medical equipment and unable to provide some basic medicine and supplies. These factors have resulted in public hospitals and facilities becoming overcrowded and generally debilitated, with staff that are over-worked. Dissatisfaction with public hospitals and clinics has forced some low-income patients to attempt to seek treatment at expensive private clinics at even greater personal expense.
There are notable disparities in the funding to the Mexican healthcare system which has caused it to become fairly unbalanced, where 33% is paid by the government (public), 13% from the public social insurance (Ministry of Health and IMSS-Solidaridad), 4% from private insurance, and 50% of the healthcares costs are covered by the households (out-of-pocket). Government funding for the public healthcare has been unable to keep up with the increased demand. The general population who have free health coverage from the government facilities have turned increasingly to the expensive private sector and are paying out of their pockets to meet their health care needs. Considering that close to 60% of the population are poor and living on less than USD$2 dollars a day, being in the position of having to pay 50% of the costs of healthcare out-of-pocket is a tough proposition. This economic burden on the population is substantial, especially on the poor who are likely to spend a significant proportion of their income on the private facilities even though many public services are available free of charge.
Privately run hospitals on the other hand tend to be concentrated in the cities and, if you can afford it, will be able to provide adequate medical care that in most cases will be equal to most modern nations. Many of the doctors working in the private sector are Western trained and speak English. Most of the well trained doctors and nurses prefer working in the private hospital and clinics, rather than being employed in the publicly funded facilities. As a result, fewer than 20% of all doctors and barely 10% of the nurses in the country service rural areas or villages. The private hospitals and clinics are very expensive and cater to the higher income earners, foreigners and expatriates who can afford the high prices. Most private hospitals require cash or credit payment prior to admission or treatment. However, if you are injured or in grave health, a private hospital will attempt to stabilize your condition and then transfer you to a government hospital.
There are over one million U.S. citizens and 300,000 Canadians who have established residency in Mexico. Many have chosen to move to Mexico for the affordable healthcare that is offered in Mexico. Affordable compared to the U.S. and Canada's healthcare but to the 50 million uninsured Mexicans the healthcare system is not affordable and many are paying out-of-pocket or not seeking medical treatment at all.
If you are considering visiting or relocating to Mexico you may have already arranged the accommodations needed, but you may not have given much thought to what might happen if you needed access to medical treatment once you arrived. You should seek medical advice before traveling to Mexico and ensure that all appropriate vaccinations are up-to-date.
Having the comfort of knowing that medical costs will be covered in case of an accident or illness of a loved one is important to everyone. With the assistance of our friendly expert consultants, you can be advised on the most suitable level of coverage required wherever life may take you. Globalsurance can offer you a comprehensive international medical insurance plan in Mexico that will typically provide you with an affordable number of coverage options including; benefits for in-patient and out-patient treatment, specialist consultations, dental care, and emergency evacuation. For more information, please contact our dedicated advisors today, or fill out this quick and easy online form by clicking here. |
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