Mexico Health Review talked to Román Rosales, former Minister of Health of Mexico City, about the possible economic and productivity impact of chronic degenerative diseases for the entire population.
Q: What role does the Ministry of Health of Mexico City play in promoting prevention and access to care?
A: While it is often said that individuals should be responsible for their own health, it is also the responsibility of institutions like ours to properly educate residents on how to care for themselves. According to WHO, it is necessary to focus on cost-effective initiatives, such as reducing salt consumption, eliminating smoking and replacing saturated fats. In addition to providing care for those who are already
sick, it is necessary to ensure that those who are healthy remain so. The Ministry of Health conducted 3,760,590 consultations in 2017, mostly to address respiratory infections, obesity-related ailments and psychiatric issues. That year, we performed about 75,000 surgeries, most of them related to obstetrics, followed by appendicitis and accident-related-injuries.
Q: Considering the accelerated growth of chronic diseases, what needs to be done to ensure the health system keeps pace?
A: It is necessary to reinforce primary care because the main economic pressure will come from chronic diseases, diabetes, hypertension, hepatic diseases, cardiovascular diseases, addictions and lung diseases are among the ailments that are influenced by lifestyle. It is also necessary to develop a multidisciplinary approach, integrated by medical personnel and trained health professionals, that allows the participation of the individual in his own health. Currently, people can suffer from several chronic illnesses at the same time; this is called multimorbidity and requires a holistic approach to patient-centered attention instead of tackling each disease individually.
Q: How are costs related to the growing number of diseases being managed?
A: Strategies to contain budgets include public-private associations, consolidated purchases and integrated services. Consolidated purchases have been a huge advantage as they allow us to buy a large number of products at lower prices. Integrated services include those for dialysis, hemodialysis, laparoscopic surgery, hemodynamics and blood testing, among many others. The Ministry of Health of Mexico City prioritizes universal, equal and free healthcare for everyone in the city. All our services are free of charge thanks to two budgets: the federal and the local. These services are free not just for residents of Mexico City but also for people visiting the city.
Q: What progress has been made to achieve universal healthcare?
A: Mexico City Health Law specifies that in the CDMX “inhabitants, regardless of their age, gender, economic or social condition, ethnic identity or anyone else, have a right to health protection, which will be governed by the principles of universality, equity and gratuity.” The principle of universality emphasizes that coverage of health services must respond to people’s health needs and the principle of equity establishes the obligation of local authorities to guarantee access to health services to the inhabitants of the city and free of charge, as is set out in the regulations. By being affiliated with both modalities of federal and local financing, the benefits for the population are strengthened and out-of-pocket expenses are avoided. For this reason, SEDESA provides diagnostic, healing and rehabilitation services at no cost for the first and second level of attention to the population that has no access to social security through an employer. The “physician in your house” includes general and specialty consultations. SEDESA also offers services related to dental and other areas related to health, such as laboratory studies, cabinet and x-rays, therapy sessions rehabilitation, attention for immediate childbirth and puerperium, the management of the newborn, the performance of surgical procedures, hospitalization, emergency care and the prescription of medicines.
Industry Analyst and Journalist at Mexico Business Publishing