Politics: Rebellion in the health system confirms a crisis in public health services
The health system’s crisis has erupted through union mobilization. On October 13, IMSS workers protested in 37 cities across 25 states over low wages, long shifts, unstable contracts, run-down facilities, and shortages of equipment and medicines. Two days later, the more than 400,000 unionized workers rejected a 2.9% wage increase plus 3.9% in benefits, forcing new negotiations.
The discontent dates back to 2019 and stems from a chain of errors. These include the dismantling of the consolidated drug-purchasing system, the successors of which never ended the shortages; the replacement of Seguro Popular with INSABI, and then with IMSS-Bienestar; a rise in the the share of the population lacking access to health services from 16.2% in 2018 to 34.2% in 2024; and a pandemic response on the part of the Federal Government that is blamed for excess deaths during that period.
Federal health spending, although rising, remains between 2.5% and 2.9% of GDP against the WHO’s 6% recommendation, and spending per person for the uninsured has fallen. Vaccination coverage collapsed in 2019, fueling a measles outbreak, and Mexico has the OECD’s lowest endowment of doctors, nurses, and hospital beds. Sheinbaum is rebuilding drug purchasing, building hospitals, and launching a Universal Health Service in 2027. However, with tight finances and little capital spending, the expectation of universal coverage may deepen frustration, and the conflict will very likely persist.
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