TY - JOUR
T1 - Comprehensive reform to improve health system performance in Mexico
AU - Frenk, Julio
AU - González-Pier, Eduardo
AU - Gómez-Dantés, Octavio
AU - Lezana, Miguel A.
AU - Knaul, Felicia Marie
N1 - Funding Information:
We thank Mariana Barraza-Lloréns, María Lilia Bravo, Emmanuela Gakidou, Cristina Gutiérrez-Delgado, Rachel Maguire, Héctor Peña-Baca, Maja Pleic, Gloria Saldaña-Uranga, Tania Martínez, Karina Rincón, and Armando Vargas-Palacios for their valuable comments and help with various aspects of this paper. F M Knaul received research support from the International Development Research Centre of Canada (Research Matters programme) for work that provided background for this paper, as well as from the Health and Competitiveness Council of the Mexican Health Foundation. E González-Pier and F M Knaul received research support from the National Council for Science and Technology of Mexico.
PY - 2006/10/28
Y1 - 2006/10/28
N2 - Despite having achieved an average life expectancy of 75 years, much the same as that of more developed countries, Mexico entered the 21st century with a health system marred by its failure to offer financial protection in health to more than half of its citizens; this was both a result and a cause of the social inequalities that have marked the development process in Mexico. Several structural limitations have hampered performance and limited the progress of the health system. Conscious that the lack of financial protection was the major bottleneck, Mexico has embarked on a structural reform to improve health system performance by establishing the System of Social Protection in Health (SSPH), which has introduced new financial rules and incentives. The main innovation of the reform has been the Seguro Popular (Popular Health Insurance), the insurance-based component of the SSPH, aimed at funding health care for all those families, most of them poor, who had been previously excluded from social health insurance. The reform has allowed for a substantial increase in public investment in health while realigning incentives towards better technical and interpersonal quality. This paper describes the main features and initial results of the Mexican reform effort, and derives lessons for other countries considering health-system transformations under similarly challenging circumstances.
AB - Despite having achieved an average life expectancy of 75 years, much the same as that of more developed countries, Mexico entered the 21st century with a health system marred by its failure to offer financial protection in health to more than half of its citizens; this was both a result and a cause of the social inequalities that have marked the development process in Mexico. Several structural limitations have hampered performance and limited the progress of the health system. Conscious that the lack of financial protection was the major bottleneck, Mexico has embarked on a structural reform to improve health system performance by establishing the System of Social Protection in Health (SSPH), which has introduced new financial rules and incentives. The main innovation of the reform has been the Seguro Popular (Popular Health Insurance), the insurance-based component of the SSPH, aimed at funding health care for all those families, most of them poor, who had been previously excluded from social health insurance. The reform has allowed for a substantial increase in public investment in health while realigning incentives towards better technical and interpersonal quality. This paper describes the main features and initial results of the Mexican reform effort, and derives lessons for other countries considering health-system transformations under similarly challenging circumstances.
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U2 - 10.1016/S0140-6736(06)69564-0
DO - 10.1016/S0140-6736(06)69564-0
M3 - Review article
C2 - 17071286
AN - SCOPUS:33750353404
VL - 368
SP - 1524
EP - 1534
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 9546
ER -