• Spending overview
• Policy overview
• Diseases overview

Spending overview

Spending on healthcare has increased markedly in recent years: after averaging less than 5% of GDP for much of the 1990s, healthcare spending rose during the 2000s, peaking at 6.7% of GDP in 2008, before slipping to 6.4% in 2009 on the back of a sharp domestic recession. Spending is expected to pick up gradually, to close to 7% of GDP by 2014.

Private healthcare spending is predicted to increase due to an uptake of private insurance among Mexicans. As income levels recover post-recession, there is substantial potential for the development of private health insurance in the long term. Over 90% of private spending—which equates to around 55% of all spending on healthcare—is paid at the point of delivery. According to the latest available data from the OECD, only 4.5% of Mexicans were covered by private health insurance in 2005, compared with 11% in the UK and far above 50% in some OECD countries such as the US and France.

Policy overview

The share of public funding of the total healthcare system has risen in recent years, but at 45% remains well below the OECD average of 72%. Reforms since the 1990s have widened access to care for the uninsured population and reduced inequalities in standards of care across regions (access is, in theory, open to all, but problems of distance and lack of supplies, qualified staff and resources limit uptake). The introduction of the Oportunidades scheme has provided cash incentives to around 5m extremely poor families to attend clinics, receive health education and keep children in school. However, it is the government’s flagship initiative to widen access—the Sistema de Protección Social en Salud, which centres on a voluntary health insurance scheme, the Seguro Popular—that has been the main factor behind a rise in healthcare insurance coverage from 40% of the population in 2004 to more than 70% in 2009. The scheme is financed mainly by contributions from federal and state governments. The target was initially to achieve universal coverage by 2010, but following slower than expected progress this has been pushed back until the end of 2011.

Expansion of private spending on healthcare will be partly underpinned by the growth of "healthcare tourism", comprised primarily of US visitors crossing the border for cheaper pharmaceuticals purchases, dental care, doctor consultations and, increasingly, surgery. Several Mexican and US healthcare companies are taking advantage of this trend to build new hospitals, including Grupo Empresarial Angeles (Mexico's largest private hospital chain), Grupo Star Medica (which is partly funded by Carlos Slim, a prominent Mexican billionaire) and Texas-based Christus Health.

Diseases overview

Diabetes and ischemic heart disease are the main causes of death, accounting for 14% and 11% of all fatalities in 2008. These are caused mainly by obesity, followed by problems associated with smoking, arterial hypertension and high cholesterol. A major challenge facing current and future governments is the dramatic rise in the level of obesity over the past 20 years. More than 70% of Mexican women and 66% of men are overweight, according to the results of surveys reported in 2008. If current trends continue, Mexico could be at risk of becoming the world's most obese nation (currently it ranks second, behind the US). The change reflects a shift towards a more sedentary lifestyle, combined with a dramatic rise in the consumption of fatty and processed foods.

Tobacco is still one of the main causes of premature deaths in Mexico. According to the OECD, the number of smokers has declined markedly in OECD countries over the last 20 years, but Mexico has bucked the trend, with the number of smokers rising from 25% of the population in 1993 to 26% in 2002, according to the most recent data. Around 35% of males aged between 25 and 29 are smokers, according to the health ministry. Arterial hypertension is the cause of around 40,000 deaths every year. Around 31% of the population above 20 years of age is affected by arterial hypertension, which is caused, among other things, by obesity.