The long-term effects of the health insurance program called Seguro Popular, now eliminated and replaced by the Instituto de Salud para el Bienestar (INSABI) on the equity of out-of-pocket spending in the Mexican poor population are analyzed.
It highlights that the segmentation and fragmentation of health systems in low- and middle-income countries deepens health inequalities and shifts the economic burden of health care to families through out-of-pocket spending. Despite the implementation of public health insurance programs for poor people, there is a lack of knowledge about the equity of these programs.
The results of the study provide evidence of how the health insurance program in Mexico has had an impact on the equity of out-of-pocket health care spending in the poor population, which may have important implications for policy formulation and health care delivery in this country. The cancellation of the INSABI program highlights the complexity of continuing a financial health protection program and the possible effects that misguided policies can have on the structure of a program, its regulation, its financing and even its existence In Mexico and other low- and middle-income countries, achieving a universal health system requires guaranteeing access to comprehensive and quality services, without any discrimination and regardless of employment status.
The study findings highlight the complexity and challenges involved in implementing health financial protection programs and underscore the need for sound, evidence-based policies to improve equity in access to health care and reduce disparities in out-of-pocket health care spending in Mexico and other countries with similar contexts.