Healthcare in Mexico is a multifaceted system comprising public institutions overseen by government departments, private hospitals and clinics, and private physicians. It is distinguished by a unique amalgamation of coverage predominantly contingent upon individuals' employment statuses. Rooted in the Mexican constitution's principles, every Mexican citizen is entitled to cost-free access to healthcare and medication. This constitutional mandate was translated into reality through the auspices of the Instituto de Salud para el Bienestar (), abbreviated as INSABI; however, INSABI was discontinued in 2023.
The 1917 Mexican Federal Constitution delineates the fundamental principles and structure of the Mexican government, including its obligations to its citizens in various sectors, notably health care. Within its provisions, the Constitution allocates primary responsibility to the state for ensuring the provision of national health services to the populace.Gutiérrez, N. Mexico: Availability and Cost of Health Care-Legal Aspects . The Law Library of Congress; 2014. The segmentation within the Mexican healthcare system has facilitated the emergence of private organizations and medical practices operated by physicians, thereby offering a diverse array of healthcare options to individuals with the means and inclination to procure such services.ManattJones Global Strategies. Mexican Healthcare System Challenges and Opportunities . Washington: ManattJones Global Strategies; 2015.
In the realm of epidemiological research focused on Mexico's healthcare landscape, Jorge L. León-Cortés has conducted significant investigations into the historical backdrop of the nation, particularly spanning the years 2012 to 2018. León-Cortés' studies have illuminated a concerning trend characterized by a marked increase in the prevalence of communicable diseases and chronic conditions within the Mexican populace, exerting considerable impact on life expectancies and mortality rates during this period. The structural configuration of the Mexican health system is characterized by ongoing evolution and considerable heterogeneity, manifesting in diverse national health statistics and varying accessibility standards observed across the country.
History
In Mexico, the sixteenth century Badianus Manuscript described medicinal plants available in Central America. Dr. Erick Estrada Lugo, Researcher-Professor in Phytotechnics at the State of Mexico's Chapingo Autonomous University, told the National Autonomous University of Mexico's digital magazine that "at least 90% of the population uses medicinal plants," citing figures from Mexico's Secretariat of Health. These include plants like Aloe vera, Arnica, and Valeriana.
Hospitals were established in Mexico in the early 16th century, including ones exclusively for Indians. Some were established by the crown, others by private endowment, but most by the Catholic Church. Bishop Vasco de Quiroga established hospital complexes in Michoacan in the sixteenth century. In Mexico City, conqueror Hernán Cortés established the Hospital de Jesús Nazareno for Indians, which still functions as a hospital.David Howard, The Royal Indian Hospital of Mexico City, Tempe: Arizona State University Center for Latin American Studies, Special Studies 20, 1979.
The Hospicio Cabañas in Guadalajara, Jalisco, Mexico, was founded in 1791. It is still functioning and is now a World Heritage Site. It is one of the oldest and largest hospital complexes in Latin America. The complex was founded by the Bishop of Guadalajara to combine the functions of a workhouse, hospital, orphanage, and almshouse.
The Mexican healthcare program, as we know it today, has its base on the creation of several health codes that ran during the first part of the 20th century. In 1943, the Mexican Secretariat of Health and Assistance was established to merge the Department of Public Sanitation and the Secretariat of Public Assistance. In that same year, the Mexican Social Security Institute and the Mexican Children's Hospital were founded, during the presidency of Manuel Avila Camacho.
After this, several and important changes came, aiming to provide better health for the population. In 1959, the Institute for Social Security and Services for State Workers (ISSSTE) was formed as a way of more effectively covering the health services of individuals employed in government institutions. The Seguro Popular, or Popular Health Insurance, was implemented countrywide in 2003 after the creation of the Social System during the presidency of Vicente Fox Quesada. In the world's largest randomized health policy experiment, Seguro Popular was evaluated at arm's length by a team at Harvard University, which concluded that "programme resources reached the poor," an unusual result for any country. In 2020, it was replaced by the Institute of Health for Welfare (INSABI), which was replaced in 2023 by the IMSS-Bienestar. Seguro Popular was closed in June 2020.
Public health
Public health issues were important for the Spanish Empire during the colonial era. Epidemic disease was the main factor in the decline of indigenous populations in the era immediately following the sixteenth-century conquest era and was a problem during the colonial era. The Spanish crown took steps in eighteenth-century Mexico to bring in regulations to make populations healthier.Donald Cooper, Epidemic Disease in Mexico City, 1761–1813: An Administrative, Social, and Medical History. Austin: University of Texas Press 1965. In the late nineteenth century, Mexico was in the process of modernization, and public health issues were again tackled from a scientific point of view. As in the U.S., food safety became a public health issue, particularly focusing on meat slaughterhouses and meatpacking.
Even during the Mexican Revolution (1910–20), public health was an important concern, with a text on hygiene published in 1916. During the Mexican Revolution, feminist and trained nurse Elena Arizmendi Mejia founded the Neutral White Cross, treating wounded soldiers no matter for what faction they fought. In the post-revolutionary period after 1920, improved public health was a revolutionary goal of the Mexican government. The Mexican state promoted the health of the Mexican population, with most resources going to cities.
Concern about disease conditions and social impediments to the improvement of Mexicans' health were important in the formation of the Mexican Society for Eugenics. The movement flourished from the 1920s to the 1940s. Mexico was not alone in Latin America or the world in promoting eugenics.Nancy Leys Stepan, The Hour of Eugenics: Race, Gender, and Nation in Latin America. Ithaca: Cornell University Press 1991. Government campaigns against disease and alcoholism were also seen as promoting public health.
The Mexican Social Security Institute was established in 1943, during the administration of President Manuel Avila Camacho to deal with public health, pensions, and social security.
Private healthcare delivery
The private healthcare sector makes up a substantial portion of the Mexican healthcare system with respect to both spending and activity. Recently, higher activity within the private sector of the Mexican healthcare system has been observed in comparison to its public counterpart. Overall spending being attributed to the private institutions accounts for approximately 52% of total health spending in the country. Furthermore, this proportion appears to be subject to a sustained increase in recent years.
The services provided by private institutions and private physicians in their offices are afforded by a part of the population, either by contracting a private insurance or by paying directly for the services obtained. It is estimated that around 6.9% of the Mexican population has private insurance coverage, mainly paid as an out-of-pocket expenditure. Generally, utilization of this sector of the healthcare system is limited to Mexicans of higher socioeconomic status.
To meet the needs of the population, relationships between the private and public healthcare sectors are beginning to form in various capacities. Recently however, studies have shown little coordination between this system and the other public sector institutions. The high fragmentation of the system has been observed to affect spending trends as well as the services received from beneficiaries.
Private healthcare delivery is a heterogenous institution, with varying levels of regulation, quality, and government association being observed within the institutions which compose it. In 2005, Mexico had around 28.6 private facilities per 1 million inhabitants, which accounted for two thirds of all hospitals in Mexico, with 2,988 institutions.
The increased use of the private healthcare sector may be attributed to the association of public forms of healthcare with restriction in accessibility and quality. The belief that these services are superior in quality appears to widespread—many patients depend heavily upon these forms of healthcare, even though public services are at times provided at no cost. Private services tend to be associated with shorter wait times, less crowding, a stronger and more satisfying patient-provider interaction, and higher quality equipment and medications. The duration of a visits in a private hospitals tend to be more than double that of their public counterparts. The quality of services performed in these institutions, however, is of debate. Especially in the field of prenatal care, disparities in quality exist among private and public institutions.
In addition to members of the Mexican populace, some individuals with connections to Mexico—including citizens, undocumented immigrants residing in the U.S., and even permanent U.S. residents with Mexican ties—associate private Mexican institutions with convenience, affordability, and efficacy, even rating them above their American public counterparts. This has created a phenomenon, known as medical returns, in which select populations, such as migrants, preferentially return to Mexico in order to receive medical treatment.
Mexican providers, especially in the private sector, but also in its public counterpart, appear to be less restricted by the possibility of lawsuit in their practice, especially when compared to their equivalent American counterparts, which may contribute to a higher perceived standard of care.
Medical tourism Mexico is a prominent destination for medical tourism, attracting thousands of international patients each year, primarily from the United States and Canada. The sector is driven by the availability of affordable procedures, proximity to the U.S., and a growing number of accredited hospitals and clinics in cities such as Tijuana, Guadalajara, and Cancún. Common treatments include dental procedures, cosmetic surgery, bariatric surgery, and orthopedic care. Many private healthcare facilities offer English-speaking staff, international accreditations, and packages specifically designed for foreign patients. Roughly 600 dentists practice in the community, catering mainly to tourists, leading the community to be nicknamed "Molar City".
Public healthcare delivery
Public healthcare has an elaborate provisioning and delivery system instituted by the Mexican government. It is provided to all Mexican citizens, as guaranteed by Article 4 of the Constitution.Gómez, C. The Health System in Mexico. Mexico: Revista Conamed, Vol. 22 Núm 3; 2017.