Mexico has taken significant steps to advance universal health coverage, among them creating Seguro Popular program which reduced out-of-pocket costs, medical bankruptcies, improved vaccine coverage and treatment for many diseases and significantly lowered infant mortality and maternal deaths. Unfortunately however, Seguro Popular had difficulty adapting to changes in healthcare needs and technology and faced political setbacks; its rise, plateau and now apparent reversal exemplify the challenges large social protection systems encounter when operating within highly polarized political environments.

Mexico currently provides its citizens with coverage through several healthcare programs that assist with medical expenses. These programs include the Instituto Mexicano de Seguro Social (IMSS) and Seguro Popular systems, along with individual state programs. All are funded through taxpayer contributions, providing basic healthcare benefits to Mexico’s 92 million inhabitants.

In addition to offering health coverage, IMSS and ISSSTE also cover pensions and disability benefits for employees in Mexico. Employees working in formal sectors are automatically enrolled into IMSS; contributions are deducted directly from paychecks; those in informal sectors can voluntarily enrol. Together, IMSS and Seguro Popular systems cover approximately half of Mexico’s employed population; however individual states also operate independent healthcare systems, while military members receive healthcare services provided directly by them.

While the current Mexican government has plans in place to unify three federal level healthcare systems into one national one, they have had difficulty finding sufficient funds and implementing reforms necessary for creating an efficient healthcare system that benefits all.

Mexico’s challenges aren’t unique to that country alone, however. Worldwide governments are grappling with healthcare reform in increasingly complex political and economic environments. Reaching universal health coverage requires substantial financial investments as well as sustained reforms to meet changing needs and technologies. Achieve this requires organizational capacities capable of handling an array of healthcare issues including innovative medical devices/drugs/supply shortages/corruption reduction and improving quality and access.

Michael Touchton is an associate professor of political science and faculty lead for global health at the Pardee RAND Graduate School, as well as a visiting scholar of the Institute for Advanced Study of the Americas at University of Miami. Felicia Marie Knaul serves as director of the Institute for Advancement of the Americas as well as founding president of Tomatelo a Pecho, A.C. Mexico. Additionally, Hector Arreola Ornelas teaches entrepreneurship and management at Tecnologico de Monterrey as well as co-founding and co-chairing Tomatelo a Pecho nonprofit A.C Mexico as associate professor in School of Business Administration at University of Miami while post doctoral fellow Tim McDonald works as post doctoral fellow for Pardee RAND Graduate School.