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Healthcare is a cornerstone of life, the economy and future prospects, but healthcare matters have been mostly left out of the discourse by the candidates vying for the presidency on July 1.

There are, however, a number of key issues that industry insiders hope the next administration will tackle. The top candidates (Andrés Manuel López Obrador, Ricardo Anaya, José Antonio Meade and Margarita Zavala), have addressed some, but few clear policy details have emerged.

What is clear is that much of the nation needs better care. Late last year, the International Labor Organization stated that up to 62 million Mexicans might lack access to healthcare services. This can include access to doctors, hospitals, clinics, medications or surgeries. This is an area of concern for the healthcare sector itself. Javier Cortés, Counsel at Jones Day, told Mexico Health Review that “the new administration should make quantifiable commitments to increase the volume of drugs and medical devices available in the system.”

All presidential candidates agree this is an issue must be confronted, although they have yet to say exactly how. Meade, the candidate for the coalition Todos por México, says on his webpage that “we will work to ensure everyone is guaranteed access to health from the moment they are born.”

Similarly, Anaya, the candidate for Coalición por México al Frente, plans to increase access to care by establishing a universal healthcare policy that guarantees access to quality care for all Mexicans. He has, however, provided some details, such as his desire to guarantee the supply of medicines in all public hospitals and clinics through alliances with pharmaceutical companies.

The leading candidate according to the latest polls, López Obrador, of the coalition Juntos Haremos Historia, says that he is also aiming toward the generation of a universal coverage model in which medications and public services in hospitals and clinics will be free of charge, while Zavala, the top independent candidate, is taking a different approach for the goal  by making health insurance mandatory for all Mexicans and offering it free of charge to the low-income segment of the population.

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HEALTHCARE SYSTEM FRAGMENTATION

Among the many barriers to care, the fragmentation of the existing public healthcare sector plays a pivotal role. While most Mexican workers should be assigned a healthcare provider according to their workplace, in reality many workers do not receive social security. By late 2017, two out of every three workers did not have access to healthcare services, for a total of 32.6 million. For those who do have access, the quality and availability of the service they receive fully depends on the provider they have been assigned. The number of hospitals, clinics and doctors available vary widely between one institution to the next.

In his proposal to INE, Anaya plans to “consolidate a healthcare system that guarantees full coverage with international quality.” His proposal includes the creation of a Single Health Fund to eliminate the existing fragmentation within the healthcare system. Meade also proposes the transition toward a Single Healthcare System that provides universal coverage as the only way for all Mexicans to have access to care under the same conditions. In his election plan submitted to INE, he called unacceptable for every subsystem to have different coverage. Zavala also agrees there is a need to unify existing healthcare systems. López Obrador states that Mexico owes its people healthcare and proposes strengthening the current healthcare system, although he has not proposed concrete policies so far.

HEALTHCARE BUDGET

Public financing of the health sector will be one of the themes that will play a leading role in the campaign, especially after the pressure that budget cuts have exerted on the institutions. While the Federal Budget for 2018 proposes an increase of 0.48 percent for healthcare, this number is expected to be only 2.5 percent of GDP in comparison to 2017’s 2.7 percent. The reduction is expected to be felt the most among those who receive a lower income. This can be prevented by prioritizing the healthcare sector. “A properly funded program can save many lives and can even result in economic benefits for private hospitals and insurers,” says José Aburto, Director General of CENATRA.

On his webpage, López Obrador proposes increasing the healthcare budget by at least 1 percent of the GDP and to finance it through fiscal policy based on equitable contributions from everyone’s income. In a different approach, Meade proposes a budget of MX$30 billion for supplying 100 percent of the needs of the almost 3,000 hospitals and clinics in the country. Anaya’s proposal gives no figures concerning healthcare, but states a goal to perform a comprehensive financial reform of the healthcare system and expenditure to incentivize more investment and resources. Anaya also plans to include within the federal budget of every fiscal exercise healthcare expenditure as a percentage of GDP in accordance with international standards. Zavala promised to raise the healthcare budget during a recent campaign rally in Cuernavaca, but she has not given information on how or by how much.

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CHRONIC DISEASES, PREVENTION

The new president of Mexico will be welcomed by a country where 50 percent of all its citizens die from chronic diseases. Furthermore, the rate of diabetes, cardiovascular diseases and cancer is only expected to rise as the population ages and becomes increasingly obese. Overall, all candidates see prevention as the strategy for addressing this concerning death rate.

Zavala proposes shifting the focus of the existing healthcare model toward prevention, which she hopes will also reduce the costs of healthcare in the future. Anaya also proposes a shift toward a preventive model by focusing on educational programs and preventing diseases during primary care. On his webpage, López Obrador promises to push forward sports as a means for prevention. Finally, Meade’s proposal explains the need to ensure equitable financing and the assignation of resources that answer to Mexico’s epidemiology, paying special attention to diabetes, obesity, cardiovascular diseases and cancer at all ages.

Many other topics concerning healthcare have not been addressed so far by the candidates, including COFEPRIS’ role and capabilities, access to food and nutrition and clinical trials. However, the campaign is far from over. Follow this blog for updates on the candidate’s positions concerning healthcare.

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