Posted January 9, 2007
Yesterday, Mexican President Felipe Calderón inaugurated the so-called "Medical Insurance for a New Generation" program in the state of Morelos. With this, he put into effect one of his campaign promises, to provide universal health coverage for children born in Mexico after his presidency began, that is, children born after December 1, 2006. The President announced that, with the increase in affiliation to this new insurance for children, as well as growth in affiliation to Seguro Popular, and the new Women's Hospital opened yesterday, infant mortality would fall to one third of its present level by 2015.
The confluence of the introduction of this new insurance modality and a new hospital opening is promising. A major criticism of the Seguro Popular (SP) has been that the program provides a package of insured services, but does not adequately address the fact that Mexico lacks the infrastructure to provide covered services to the entire population. This has been a source of tension from the early days of SP, with health analysts arguing over the relative proportion of funding which should go to infrastructure versus expanding the package of covered services. Undoubtedly, Mexico needs both high quality health infrastructure and a robust health insurance package.
What Mexico does not need is yet more health programs with new names that are difficult to comprehend for the average citizen, and lack transparency for even the seasoned analyst. So there is some concern about how exactly this Medical Insurance for a New Generation is going to work, how people are being signed up for it, and where the money is coming from. Does the program simply tack on new benefits to SP or does it create a separate bureaucracy with its own resources? Are children signed up while their parents are denied services? As far as I can tell, this information is not yet in the public domain. It should be placed there as soon as possible. Mexicans have a right to health care, as the president acknowledges, but they also ought to have a right to know who is providing it and how.
An interesting twist to the introduction of this new Medical Insurance for a New Generation is that the Secretary of Health appears poised to try to use it to push forward health service contracting. This part of the Seguro Popular has been largely a dead letter. The 2003 health reform was supposed to open the public system up to both internal and external contracting for health services. Put another way, the 2003 reform was supposed to create a true insurance scheme, in which Mexicans could use multiple providers with the same publicly provided insurance. This has not happened. However, in his speech at the opening of the Women's Hospital, Health Secretary José Ángel Córdova Villalobos said that he was in the process of finalizing contracts with all public sector and some NGO providers to offer the services covered by the new insurance for children.
If that is true, then maybe this Medical Insurance for a New Generation will really live up to its name. And then, Mexicans, accustomed to a long history of monopoly service provision, will finally have some choices about providers.