Gesundheitssystem von Mexiko
Health care in Mexico is provided via public institutions, private entities, or private physicians. Health care delivered through private health care organizations operates entirely on the free-market system, i.e., it is available to those who can afford it. This is also the case of health care obtained from private physicians at their private office or clinic. Public health care delivery, on the other hand, is accomplished via an elaborate provisioning and delivery system put in place by the Mexican Federal Government. In 2012, Mexico achieved universal healthcare.[1] As of December 31, 2013, there were 4,466 hospitals in Mexico.[2]
History
Hospitals were established in Mexico in the early sixteenth century, including ones exclusively for Indians. Some were established by the crown, others by private endowment, but most by the Catholic Church. Bishop Vasco de Quiroga established hospital complexes in Michoacan in the sixteenth century. In Mexico City, conqueror Hernán Cortés established the Hospital de Jesús Nazareno for Indians, which still functions as a hospital.[3][4][5] The Hospicio Cabañas in Guadalajara, Jalisco, Mexico, was founded in 1791. The institution, still functioning, is now a World Heritage Site. It is one of the oldest and largest hospital complexes in Latin America. The complex was founded by the Bishop of Guadalajara to combine the functions of a workhouse, hospital, orphanage, and almshouse.
The Mexican health care program IMSS was founded in 1943 during the presidency of Manuel Avila Camacho.[6] In the early 1990s, Mexico showed clear signs of having entered a transitional stage in the health of its population. When compared with 1940 or even 1970, Mexico in the 1990s exhibited mortality patterns that more closely approximated those found in developed societies.[7] By 2009, during the notorious swine flu pandemic, the World Health Organization director said that Mexico "gave the world a model of rapid and transparent reporting, aggressive control measures, and generous sharing of data and samples". The CDC's flu director Nancy Cox, added that Mexico's response "impressed the entire world".[8]
Private health care delivery
While private hospitals account for 2/3rds of all hospitals in Mexico with 2,988 institutions, less than 10% of the Mexican population has private insurance coverage, paying for care mainly "out of pocket".[2]
Public health care delivery
Public Health care delivery is accomplished via an elaborate provisioning and delivery system instituted by the Mexican Federal Government. Public health care is provided to all Mexican citizens as guaranteed via Article 4 of the Constitution. Public care is either fully or partially subsidized by the federal government, depending on the person's (Spanish: derechohabiente's) employment status. All Mexican citizens are eligible for subsidized health care regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaria de Salubridad y Asistencia, or SSA) agency.
The Secretariat of Health's Seguro Popular offers health care coverage to Mexicans that do not have formal employment. The program currently covers over 55 million people.[9]
Employed citizens and their dependents, however, are further eligible to use the health care program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (englisch Mexican Social Security Institute). The IMSS health care program is a tripartite system funded equally by the employee, its private employer, and the federal government. There are 58 million people covered through IMSS.
The IMSS does not provide service to employees of the public sector. Employees in the public sector are serviced by the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (englisch Institute for Social Security and Services for State Workers), which attends to the health and social care needs of government employees. This includes local, state, and federal government employees. There are nearly 13 million people covered through ISSSTE.[9]
The government of the states in Mexico also provide health services independently of those services provided by the federal government programs. In most states, the state government has established free or subsidized healthcare to all their citizens.[10]
The Secretariat of Health (Secretaria de Salud) is the largest public healthcare institution, operating 809 hospitals throughout the country. The Mexican Social Security Institute (Instituto Mexicano del Seguro Social - IMSS) grants hospital care and services to employed citizens and their dependents - there are 279 hospitals affiliated to IMSS. The Institute for Social Security and Services for State Workers (Instituto de Serguridad y Servicios Sociales de los Trabajadores del Estado - ISSSTE) grants hospital care and services to government employees - there are 115 hospitales affiliated to ISSSTE. The remaining 279 hospitals are affiliated with 9 government dependencies, including State Facilities, Secretariat of National Defense (Secretaria de Defensa Nacional), Mexican Navy (Secretaria de Marina), Petroleos Mexicanos (PEMEX), and the Red Cross (Cruz Roja).[11]
The public hospital infrastructure required hospitals to be spread over a territory of 761,600 sq miles (1.973 million km²). As such, the public hospital infrastructure relies on a vast network of small hospitals. Over 50% of public hospitals have less than 50 beds.
Health statistics
Aggregate health statistics for Mexico have improved greatly since the 1970s. However, Mexico lags well behind other OECD countries in health status and health care availability.[12]
| 2012 | 2000 | Rank among OECD countries (2012) | |
|---|---|---|---|
| Life expectancy at birth (years) | 74.4 | 73.3 | 34 out of 34 |
| Life expectancy at birth, men (years) | 71.4 | 70.5 | 33 out of 34 |
| Life expectancy at birth, women (years) | 77.3 | 76.1 | 33 out of 34 |
| Life expectancy at 65, men (years) | 16.7 | 16.5 | 28 out of 34 |
| Life expectancy at 65, women (years) | 18.6 | 18.4 | 31 out of 34 |
| Mortality from cardiovascular diseases (age-standardized rates per 100,000) |
272.9 | 298.1 | 34 out of 34 |
| Mortality from cancer (age-standardized rates per 100,000) |
125.1 | 140.2 | 34 out of 34 |
| Tobacco consumption among adults (% daily smokers) |
11.8 | 12.9 | 34 out of 34 |
| Alcohol consumption among adults (liters per capita) |
5.7 | 5.1 | 32 out of 34 |
| Obesity rates among adults, measured | 32.4 | 24.2 | 2 out of 16 |
| Health expenditure as % of GDP | 6.2 | 5.0 | 32 out of 34 |
| Health expenditure per capita (US$ PPP) | 1048 | 497 | 33 out of 34 |
| Pharmaceutical expenditure per capita (US$ PPP) |
70 | 97 | 33 out of 33 |
| Pharmaceutical expenditure (% health expenditure) |
6.8 | 19.9 | 32 out of 33 |
| Public expenditure on health (% health expenditure) |
50.6 | 46.6 | 32 out of 34 |
| Out-of-pocket payments for health care (% health expenditure) |
45.2 | 50.9 | 1 out of 34 |
| Number of doctors (per 1000 population) | 2.2 | 1.6 | 31 out of 34 |
| Number of nurses (per 1000 population) | 2.6 | 2.2 | 33 out of 34 |
| Hospital beds (per 1000 population) | 1.6 | 1.8 | 34 out of 34 |
| Source: OECD Health Statistics, 2014[13] |
| Cause | Deaths (in thousands) |
Percent |
|---|---|---|
| Diabetes mellitus | 87.6 | 14.5% |
| Ischaemic heart disease | 76.0 | 12.6% |
| Stroke | 33.1 | 5.5% |
| Interpersonal violence | 32.7 | 5.4% |
| Cirrhosis of the liver | 25.0 | 4.1% |
| Chronic obstructive pulmonary disease | 23.3 | 3.8% |
| Lower respiratory infection | 20.8 | 3.4% |
| Hypertensive heart disease | 20.7 | 3.4% |
| Road injury | 15.0 | 2.5% |
| Kidney diseases | 13.9 | 2.3% |
| Source: Global Health Observatory data from the World Health Organization[13] |
During 2005, 45.5 percent of health spending was paid from public sources—comparable to the share of public spending in the United States but significantly below the OECD average. Private financing in Mexico is almost entirely in the form of out-of-pocket payments, as only 3.1 percent of total expenditures on health are funded through private health insurance.[12] Consistent with every other major industrialized country (except the U.S.), government healthcare in Mexico is universal, making private programs' health insurance unnecessary except for use in private hospitals.
Some authorities have noted that while Mexico has some 3000 private hospitals, some private “hospitals” could hardly be considered hospitals at all, since they have no laboratories, radiography equipment, or even nurses.[15] The remaining 1000 or so public hospitals account for the majority of hospital beds and, in fact, the bulk of private hospitals are institutions with less than 20 beds.
The mortality rate for children younger than five years was 17 per 1,000 live births in 2005, and Mexico has shown a faster acceleration to lower mortality rates than the U.S., Cuba, and Canada in the last 10 years. Ninety-seven percent of the population had direct access to potable water and 80 percent to sanitation. Also in 2005 the incidence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) among persons aged 15 to 49 was 0.3 percent.[12] At 11,000 deaths/year vs. 22,000/year in the U.S., this represents a 44% higher per capita death rate than the United States.[16]
Affordability
Some of Mexico's top-rate hospitals are internationally accredited.[17] Residents of the United States, particularly those living near the Mexican border, now routinely cross the border into Mexico for medical care.[18] Popular specialties include dentistry and plastic surgery. Mexican dentists often charge 20 to 25 percent of U.S. prices,[19] while other procedures typically cost a third what they would cost in the US.[18]
Universal health care
Vorlage:Further On December 1, 2006, the Mexican government created the Health Insurance for a New Generation (also called "Life Insurance for Babies").[20][21][22] This was followed by a February 16, 2009, announcement by President Felipe Calderon where he stated that at the current rate of progress Mexico would receive Universal Health Coverage by 2011,[23] and a May 28, 2009, announcement in which his administration made public Universal Care Coverage for Pregnant Women.[24] In August 2012 Mexico installed a universal healthcare system.[1]
Social determinants
Social determinants of health in Mexico are factors that influence the status of health among certain populations in Mexico. These factors consist of circumstances in which people grow, live, work, and age, as well as the systems put in place to deal with illnesses. In Mexico, the health inequality among the population is influenced by such social factors. In the past decade, Mexico has witnessed immense progress within their health care system that has allowed for greater access to health care and a decrease in mortality rate, yet there are still various health inequalities caused by social factors.
References
Vorlage:Mexico topics Vorlage:North America topic
- ↑ a b Mexico achieves universal health coverage, enrolls 52.6 million people in less than a decade. Harvard School of Public Health, 15. August 2012, abgerufen am 16. September 2013.
- ↑ a b Global Health Intelligence, "Global Health Intelligence". Retrieved 19 January 2015.
- ↑ David Howard, The Royal Indian Hospital of Mexico City, Tempe: Arizona State University Center for Latin American Studies, Special Studies 20, 1979.
- ↑ Carmen Venegas Ramírez, Régimen hospitalario para indios en la Nueva España. Mexico 1973.
- ↑ Josefina Muriel, Hospitales de la Nueva España. 2 vols. Mexico 1956-60.
- ↑ Mexico's health care lures Americans. Chris Hawley. USA Today. 9/1/2009. Retrieved 24 August 2012.
- ↑ Health Care and Social Security. Tim L. Merrill and Ramón Miró, editors. Mexico: A Country Study. Washington: GPO for the Library of Congress, 1996. (Quoted as: "Source: U.S. Library of Congress.") Retrieved 24 August 2012.
- ↑ Mexico Wins Praise for Swine Flu Response. Maria Cheng (London) and Vicente Panetta (Buenos Aires). Associated Press. Retrieved 4 July 2009.
- ↑ a b Mexican National Statistics Institute, "INEGI". Retrieved 22 January 2015.
- ↑ Quienes Somos. Secretaria de Salud. Federal Government of Mexico. Retrieved 4 July 2009.
- ↑ National Health Information System, "SINAIS". Retrieved 1 June 2014.
- ↑ a b c Country profile: Mexico. Library of Congress Federal Research Division (July 2008).
- ↑ a b c OECD Health Statistics 2014: How does Mexico compare?, OECD Health Statistics 2014.
- ↑ Global Health Observatory data: General health statistical profile: Mexico, World Health Organization (last updated Janaury 2015).
- ↑ Health care quality improvement in Mexico: challenges, opportunities, and progress. Enrique Ruelas. Baylor University Medical Center Proceedings. (Proc (Bayl Univ Med Cent). 2002 July; 15(3): 319–322.) July 2002. [PMCID: PMC1276627] Retrieved 10 July 2009.
- ↑ Country Comparison :: HIV/AIDS – deaths – Mexico. U.S. Central Intelligence Agency. World Fact Book. Retrieved 24 August 2012.
- ↑ Some Hospitals are Internationally Accredited. Retrieved 10 July 2009.
- ↑ a b Philip J. Hilts, Quality and Low Cost of Medical Care Lure Americans to Mexican Doctors, New York Times (November 23, 1992).
- ↑ Manuel Roig-Franzia, Discount Dentistry, South of The Border, Washington Post (June 18, 2007).
- ↑ Message to the Nation from the President of Mexico, Felipe Calderón Hinojosa, on the occasion of his first State of the Union Address. Mexican Federal Government. Office of the Presidency. 2006. Retrieved 4 July 2009.
- ↑ President Calderón during First National Week of Affiliation to Medical Insurance for a New Generation. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.
- ↑ President Calderón at Launching of Affiliation to Medical Insurance for a New Generation. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.
- ↑ Mexico to Achieve Universal Health Coverage by 2011. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.
- ↑ International Women's Day. Federal Government of Mexico. Office of the Presidency. 2006. Retrieved 4 July 2009.