Health Care Policy in Mexico and Compression MorbidityGERN 474 – Maria Claver & Casey GoellerAlma Madrid, Lisa Medrano, Kim-Anh Pham, Michelle Prado, Lorrie Russell.

Some Definitions

• Health Care– The maintaining and restoration of health by the

treatment and prevention of disease especially by trained and licensed professionals.

Definitions cont…

• Compression of Morbidity– Term used to describe one of the goals of health

aging and longevity. – Morbidity is the presence or rate or incidence of

the disease or medical condition. – Refers to the burden that an illness or health

conditions causes. – Compression refers to the concept of pushing all

the morbidity of one’s life into as small a time period as possible. • Minimize number of years that a person spends

suffering while maximizing the total number of years.

Compression of Morbidity

• Compression of Morbidity is the goal of living disease and illness free for as long as possible.

• Morbidity in Mexico is largely an environmental problem. • Lack of clean water• Airborne diseases• Obesity, HIV/AIDs, Violence/War

• Scarcity of resources • Facilities• Natural fresh water

Health Care for Older Adults in Mexico

• Health care provided for older adults include:

• Preventive care: vaccinations, health education/literature etc. • Health promotion programs: nutrition, sexuality, exercise etc. • Specialists: Rheumatologist, Geriatrics, Alzheimer’s care etc. • Rx coverage• No co-pays for office visits/surgiers• Hospitalization• X-Rays• Laboratory• Basic dental services• Low cost funeral services

Health Care Coverage

• Social Security Institutions cover almost half of Mexico’s population– 40% is covered through institutions.– 5 % use private sectors.– 11% no access to health system facilities.

• About 50% of population is aged 65 or older. – Reported to have no health care coverage.

Health Care System in Mexico

• General revenues to pay for health care for middle and low income groups.

• Upper income families use private insurances. • Coverage by government is determined by

participation in formal labor market. – Discrimination towards agricultural, domestic, small

commercial industry workers. • Access based on two factors:

– Level of urbanization. – Population forms part of the social security system.

Health Care System in Mexico

• Composed of institutions fostered to social security. • Private sector/health insurance.• La Cruz Roja (Red Cross) – provides urgent care and

emergency services.• Defensa Nacional (National Defense) – members of

national defense (present, retired & family members) have their own health care program.

• Secretary of Health, SESA & IMSS-Oportunidades – provide service that have no social security & unemployed funded by federal & state government.

A Closer Look at Institutions

• IMSS– All workers with salaries & their families, retired & actively

working, also entity to cover issues/accidents similar to workers comp. (LARGEST)

• ISSSTE– All government agency workers, at all levels federal, state,

city. (2ND LARGEST)• PEMEX

– Workers and family members of PEMEX petroleum. (3RD LARGEST)

Health Care System Contribution to Morbidity• Greatest damage to health care is concentrated in

older adults & non-transferable diseases.• 84% of deaths are the result of non transferable

diseases. • 53% of those concentrate on older adults over the

age of 65.

Causes of Death (65+ yrs old)

• Diabetes• Hearth Disease• Cerebral-Vascular Disease (Stroke)• Obstructive Pulmonary Disease• Hypertension• Cancer• Adults ages 65+ have a higher prevalence of

alcoholism and smoking.

Women are at greater risk of dying from diabetes.Men are at greatest risk of dying from obstructive pulmonary

disease and cirrhosis.

Health Care Inequalities

• Health is more precarious and access to health services is limited in certain states:– Southeastern states, rural areas, indigenous communities.

• Delivering quality of care is heterogeneity among principal health care service providers.

Office Wait Time

• IMSS – 90 minutes

• ISSTE– 80 minutes

• SESA– 70 minutes

• PEMEX– 50 minutes

• Private– 30 minutes

Affects of Waiting

• Patients tend to miss appointments • Time with Dr. is reduced (no time for questions or

explanations). • Other contributions

– Cancelation of surgeries due to impacted schedules– Waiting lists for surgeries are up to 6 months– Lack of hospitals with ICU– Lack of personal physicians– Travel time for office visits

Conclusion

• Mexico’s health care system made of institutions by the government.

• Health care contribution to morbidity is concentrated on older adults

• Health care inequalities contribute to morbidity. • No health care program is perfect.

– Size of country, population, environment influences and what works for one country does not mean it will work for another.