Mexican President Claudia Sheinbaum has implemented a plan to roll out universal healthcare for all Mexicans. Sheinbaum has chosen the path of least resistance. Instead of completely tearing down Mexico’s healthcare system, she has instead opted to reform the system from within to try and ensure that the uninsured (20-30% of the population) can access healthcare.
Will it succeed? Only time will tell. What is certain is that the USA, the largest economy in the world, will remain the only developed country with a multi-payer system. While its neighbors, Canada and Mexico, will be ensuring that all citizens have access to their human right – healthcare.
How does healthcare work right now in Mexico? Mexico’s current public healtchare system is divided into four main areas: (1) for salaried private sector workers, (2) for the public sector, (3) workers at the state oil company, and (4) the 33 million or so laboring rest of the population. Mexico’s healthcare system was founded in 1943, and is a fully contained public-health institute similar to European systems. However, Mexico’s healthcare system is financed U.S.-style: by means of employer-employee payroll contributions. This means, in practice, dueling bureaucracies with decades of tradition, protocols, and infrastructure behind them.
Mexico’s sprawling network of public health institutions should provide most people with coverage, but in reality the poor and people in rural communities often cannot get the medicines or treatment they need without out-of-pocket expenses. Private health insurance, meanwhile, fills the gap, creating a two-tier system based on income.
Mexico has tried to expand access before. The Seguro Popular program, launched in the early 2000s, extended coverage to millions of people without formal jobs. But it was scrapped in 2020 and replaced with a new system that struggled to deliver care, leaving many patients navigating an even more fragmented system. These previous reforms have been roughly equivalent to the Obama-era expansion of Medicaid, and a minority of states have hampered the roll out because right-wing governors have refused to opt in.
So what is President Sheinbaum’s reform to Mexico’s healthcare system? Sheinbaum is NOT trying to completely tear down Mexico’s healthcare system — merging everything into a new model that shifts the burden onto the general budget. Instead Sheinbaum is trying to make the current healthcare system more open and portable. There will be a new health card that would give doctors access to a patient’s medical history across the system, no matter your institution. Sheinbaum’s plan aims to make the healthcare system easier to navigate, by connecting the four health institutions and allowing patients to access care at any institution.
Will Mexico’s healthcare reform succeed? The idea of Sheinbaum’s reform is that Mexico’s healthcare system will be portable and eventually anyone can attend any public institution, so they won’t be shunted into certain healthcare ghettos.
Unfortunately, we have seen this story played out before. Massive change of a system, such as healthcare, cannot happen under capitalism. Instead, so-called progressive politicians under capitalism must rely on reforms of the system, which at best can lead to incremental change, and at worst can further complicate and even cause harm in an already broken system. Still Mexico is trying something, which is more than the U.S. can say for itself. Healthcare is a human right, and not a single person should ever have to choose between a meal or care, debt or treatment.
