1 In general terms, how is healthcare, including access to medicines and medical devices, funded in your jurisdiction? Outline the roles of the public and private sectors.
The Mexican healthcare system comprises of public (social security institutions) and private institutions, insurers and independent professionals.
Individuals and private insurers fund the private sector. Private health insurance generally covers professional, executive and higher levels of the private sector. Enrolment in private health insurance has increased considerably over the past six years. According to official figures, up to 50 per cent of annual health spending in Mexico comes from out-of-pocket expenses related to private doctors, insurance and drug acquisitions.
The public sector comprises of:
- social security institutions exclusively directed to formal workers, in which the funding comes from contributions by the federal government, the employer and the employee; and
- public institutions exclusively directed to attend people not covered by social security, in which the funding comes from the federal government, states and patients.
The public health sector normally faces financial problems and implements measures to limit costs by, for example, pressing for price reductions in consolidated public tenders (involving the most important health institutions) and encouraging competition.
In the public sector, social security and public institutions provide medicines. However, if the medicine is not available when required, it can be dispensed in a private registered drugstore.
2 In general terms, how is healthcare delivered in your jurisdiction? Outline the roles of the public and private sectors.
The public sector comprises of:
- social security institutions exclusively directed to formal workers such as the:
- Mexican Institute of Social Security (IMSS);
- Institute of Social Security for State Workers (ISSSTE);
- specialised public institutions for members of the military and navy force (SEMAR);
- PEMEX Medical Services, for Mexican petroleum workers; and
- public institutions exclusively directed to attend people not covered by social security, such as the People's Health Insurance and state health institutions.
The private sector comprises of private institutions, insurers and independent professionals, the users of which are not restricted.
3 Identify the key legislation governing the delivery of healthcare and establishing the regulatory framework.
Key legislation includes the following:
- the General Health Law;
- the General Health Law Regulations;
- the Health Supplies Regulation;
- the Official Mexican Standards (NOMs); and
- the Mexican Pharmacopoeia.
4 Which agencies are principally responsible for the enforcement of laws and rules applicable to the delivery of healthcare?
The Federal Commission for Protection against Sanitary Risks (COFEPRIS), is an administrative agency of the Ministry of Health that is funded by the federal government.
The General Health Law entitles COFEPRIS to recover income derived from insurance rescue and other exceptional incomes.
Scope of enforcement
5 What is the scope of their enforcement and regulatory responsibilities?
In accordance with the General Health Law, COFEPRIS is in charge of the following:
- the sanitary regulation, surveillance and control of public social security institutions and private institutions;
- the sanitary control of products and services, and their importation and exportation;
- the sanitary control of the processing, use, maintenance, import, export and disposal of medical equipment, prosthetics, orthotics, functional aids, diagnostic agents, dental supplies, surgical materials, healing and hygienic products;
- preparing and issuing NOMs relating to health facilities, products and services;
- evaluating, issuing or revoking sanitary authorisations;
- exercising control and sanitary surveillance of drugs and other health supplies;
- disposal of organs, tissues, human cells and their components, toxic or dangerous substances, biotechnological products and raw materials;
- exercising control and surveillance of the advertising of sanitary activities, products and services; and
- imposing sanctions and implementing security measures.
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