Politics: Burying another successful program
The abrupt cancellation of the Seguro Popular reminds one of the old maxim regarding the advisability of abstaining from overhauling things that appear to be rendering positive fruits. By trying to conjure it into a free, universal healthcare delivery system, the government has managed to leave a highly successful 16-year effort to expand public medical care in tatters and interrupt the services that millions of Mexicans had come to rely upon.
Lacking proper oversight mechanisms, especially at the level of the states, the Seguro Popular suffered from significant instances of mismanagement, including corruption and collusion with pharmaceutical firms, but despite it all, it was a success story unsurpassed in any other area of social policy. Unprecedented and systematic increases in the health ministry’s annual budget made it possible to greatly expand medical coverage and lower the out-of-pocket expenses of millions of Mexicans for whom catastrophic care issues had been economically devastating or prohibitive. Thanks to the program’s increasing acceptance, its enrollment swelled to 55 million people or 43% of the national population, as it emerged as by far the main mechanism for delivering healthcare to the poorest members of society. The most recent Coneval report credits the program for cutting by more than half the number of people lacking access to health services since 2008.
Unfortunately, with his campaign slogan – that the program was neither “seguro” nor popular – transformed into a policy argument, AMLO canceled the Seguro Popular while marketing his newly unveiled National Healthcare Institute for Wellbeing (Insabi) as a universal and free service provider. With its January 1st launch, not only did it fail miserably to live up to such billing, but it fell far short of delivering Seguro Popular care while charging as much as four-to-five times higher fees.
Despite having had a full year in which to prepare Insabi’s launch, it arrived without operating rules, covenants with state governments, or any of the pre-existing budget guarantees. And while the administration tries to wing it, the policy challenges look all the more daunting going forward.
Now read on...
Register to sample a report