Social Health Insurance

Between the 1990s and the two thousands, the government of Mexico defined principles of reform to health insurance and has sought to implement them. Major approved initiatives defined voluntary schemes, in one case private insurance (which has very low penetration), and in another a new public program, the Seguro Popular, that operates as a mechanism for distribution of federal spending to the states. Currently, the main challenge, as it was thirty years ago, is the integration of care plans for every family. Each citizen faces great uncertainty about which institution is responsible for financing his or her health care and providing services. In this context, there are multiple proposals for reform, most of them guided by the same principles. We argue that possibly the government of Mexico does not have incentives to carry out a reform in those terms; it is converging to a model of reimbursement to states as providers for low-income populations, with most of the population staying in social security facing risks in service provision. We put forward steps we believe define a feasible evolutionary process to alter that course, taking a road that focuses on the proper integration of health plans for the family. This process will allow consolidation of financing and service provision for each family, without mandating the horizontal integration of financing agencies or even of service provision agencies, or the growth of new service agencies to compete with the ones already existing. Existing institutions will be transformed into more flexible providers, and participation in an insurance plan will be mandated for all residents