Universal health coverage: Everyone, everywhere
The World Health Organization celebrates World Health Day every 7th of April. This year, the theme is “Universal health coverage, everyone, everywhere.” Universal health coverage (UHC) is defined as an equal access to health services (promotion, prevention, treatment, rehabilitation) throughout the life cycle of a person and according to their needs, without exposing users to financial difficulties to pay. The whole population must have timely and effective access to health, evidence-based, with a quality system and a good users’ perception.
Without effective access, there is no universal coverage. Some key strategies for universal health coverage are:
- Approach of social determinants of health, in order to improve living conditions and healthy environments in the communities.
- Expansion of access to health services, to guarantee the right to health to all the population residing in the country.
- Financing increase and improvement with the objective of eliminating cost, since it represents a main barrier to seek medical attention. This through public funding, efficient and health-sustainable, thus increasing public resources for this purpose.
- Self-governance enhancement of the health system, in terms of development and implementation of inclusive policies with defined goals.
According to the Pan American Health Organization (PAHO), Mexico has two health sectors that seek to encompass universal health coverage: public (social security and the Ministry of Health) and private. The latter includes the population with the capacity to pay and can acquire private health providers.
Within the public sector, social security covers formal workers, their families and the pensioners through contributions from the government, employer or employees. Employees are affiliated to the Mexican Social Security Institute (IMSS), the Institute for Social Security and Services for State Workers (ISSSTE), as well as Mexican Petroleum (PEMEX), and the Ministries of National Defense (SEDENA) and of the Navy (SEMAR), among others.
The Ministry of Health and the State Health Services also provide healthcare in the public sector, through contributions from federal and state governments. This category includes the Seguro Popular de Salud (Social Protection Health System) and the Oportunidades IMSS program. Coverage includes informal, self-employed and unemployed workers.
Seguro Popular has over 57 million members who are not covered by other social insurance scheme. Through this system, they have access to health services: medical consultation, hospitalization, laboratory tests, medication and surgical procedures. This service aims to guarantee universal health coverage in Mexico.
Through Seguro Popular, the affiliated population can receive medical attention in the corresponding health centers or seguro popular clinics based on the 287 interventions (representing around 1,663 diseases) covered in the Universal Catalogue of Health Services.
In Mexico, chronic diseases’ healthcare, especially in the most vulnerable population is a key measure to reverse its high prevalence. Chronic diseases covered by Seguro Popular include:
- Preventive actions for men and women over 20 years of age, including diabetes detection
- Diagnosis and treatment, with laboratory tests that can identify diseases such as diabetes and dyslipidemia
- Prediabetes and diabetes diagnosis through blood glucose analysis
- Prediabetes and diabetes treatment with medication and insulin schemes, glucose analysis, as well as detection of related diseases (through lipid profile and microalbuminuria)
- Treatment of diabetes complications: diabetic ketoacidosis (diagnosis tests, emergency treatment, hospitalization and intensive care), peripheral neuropathy (emergency treatment), diabetic foot infection or ulcer (emergency treatment, preoperative assessment, surgery, hospitalization and intensive care)
- Treatment of gestational diabetes, with laboratory tests and insulin scheme.
- Diagnosis and treatment with medication scheme, including laboratory tests such as blood chemistry, electrocardiogram and lipid profile
- Medical care treatment including medication, hospitalization and intensive care
- Emergency treatment of hypertensive crisis including medication
- Mild and moderate preeclampsia, including medication, emergency treatment and hospitalization
- Diagnosis through lipid profile and medication for its treatment
Universal health coverage represents an investment in the country’s human capital, because it provides quality medical care to the population, together with financial protection. By improving people’s health and their life expectancy, poverty is fought by promoting country’s economic development.
National Comission of Social Protection in Health. Universal catalogue of health services 2016. Ministry of Health. Available from: http://seguropopular.tamaulipas.gob.mx/wp-content/uploads/2016/11/CAUSES_2016.pdf
Dmytraczenko T, Almeida G. Towards universal coverage in health and equity in Latin America and the Caribbean: Evidence from selected countries. World Bank, World Health Organization and Pan American Health Organization. Available from: https://openknowledge.worldbank.org/bitstream/handle/10986/22026/9781464811777.pdf?sequence=8&isAllowed=y
World Health Organization. World Health Day, 7th April 2018. Available from: http://www.who.int/campaigns/world-health-day/2018/campaign-essentials/es/
Pan American Health Organization. 2013. Universal health coverage: International lessons learned. HSS Mexico Team. Available from: http://www.senado.gob.mx/comisiones/seguridad_social/docs/Mesa03_1.pdf
Pan American Health Organization. 2018. Universal health coverage. Available from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=9392%3Auniversal-health-coverage&catid=6253%3Auniversal-health-coverage&Itemid=40244&lang=es
Ministry of Health. Seguro Popular. Available from: http://www.seguropopular.org/