Financing Common Goods: The Mexican System for Social Protection in Health Agenda

CONTENTS Conceptual Framework of the Mexican Health Reform Financial Architecture of the System for Social Protection inHealth Health-Related Common Goods of the SSPH References A series of studies developed in Mexico in the late 1990s identified disturbing rates of catastrophic health expenditures as a result of the fact that approximately half of the Mexican population, 50 million people, lacked health insurance. This analysis exposed a dreadful paradox: we know that health contributes to the reduction of poverty, yet medical care can itself produce financial stress when a country lacks the social instruments to assure fair financing of personal healthcare services. In 2003, the government of President Vicente Fox secured support from all political parties for legislation aimed at correcting that paradox. A reform to the National Health Law created the System for Social Protection in Health (SSPH). The most prominent component of SSPH is Seguro Popular (SP), a health insurance scheme funded predominantly through federal and state subsidies. Following congressional approval of SP, the government began implementation of the new system in January of 2004. Public expenditure was gradually expanded to finance healthcare coverage for non-salaried workers and their families, who had been excluded from conventional, employment-based social insurance. The mobilization of additional financial resources for health was made possible by the increase of oil prices between 1999 and 2008, a situation that benefited Mexico, an oil-exporter country. This allowed for a major increase of social expenditure. By 2018, over 53 million people were enrolled in the new scheme and had access to a comprehensive package of essential services and a package of high-cost interventions. The country was on track to achieving the goal of universal coverage. A lot has been written about SP, its financial innovations, and its impacts on healthcare coverage, health conditions, and financial protection. However, little is published about the other components of SSPH, more specifically, its common goods components. The purpose of this article is to describe and discuss the common goods for health elements