A healthy trend

A revamp of Mexico’s beleaguered health-care system is proving to be a runaway success and offers a model for other nations seeking to reform their own systems, according to a review published this week in The Lancet. The key to the scheme’s success is the way in which it has modified its reforms in response to scientific assessments of their effectiveness, the authors say.

(Eric Vance in Nature 17 August 2012)

I just wanted to point to this article in Nature, dealing with one of the bigger successes in Mexico… the public health system.  While there are the occasional scandals (and always present  scandalitos), the system works very well here.  As Vance notes in his article it’s not perfect 100% coverage, it’s pretty close to minimal 100% coverage.  While there is better coverage through employer-paid plans (like my own, through IMSS, the Mexican Social Security Institute), basic coverage through  Seguro Popular — which covers those with no other insurance — has enrolled 50 million clients since it was set up in 2003.

There are “challenges” (benefits being calculated on their cost-effectiveness, meaning some chronic illnesses are excluded from coverage).    Seguros Popular system clinics and hospitals are “woefully poor, particularly in rural areas” — but then, so are the clients, and doctors often complain that they are overworked and underpaid.  That is true, but one needs to remember that doctors do not enter their profession with a mountain of debt, their education being paid for by the state.  They do have to pay back the state with public service work, and many supplement their income working in the country’s numerous private clinics.

Those latter are probably the biggest surprise to visitors — the pharmacy chains all advertise their walk-in clinics, and compete to offer the lowest prices.  They even run ads  like “HALF OFF ON ALL PROSTATE EXAMS THIS WEDNESDAY” though whether that pulls in the casual shopper I can’t say.  While I still can’t understand how a “sophisticated” country like the United States managed to create such a complicated health system (and only in theory, and subject to change), it seems that a simple public health system or two is no real threat to capitalism… maybe to the insurance companies, but not to the doctors.