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Budgetary suicide of public health

The federal government may be studying these days because of the biggest social policy mistake that has been committed in decades: the establishment of the Insabi (Institute of Health for Welfare).

It is a major surgery to the public health system, practiced without planning or rigor. Not a surgery, really, but, again, a machete.

On the weakness of the project of change in the health system, almost all the former secretaries of the branch had spoken out with eloquence and knowledge.

And on the cancellation of the Popular Insurance, axis of the reform, several specialists had written repeatedly, in particular the former secretary Julio Frenk and a group of co-authors of first quality.

Only in the magazine Nexos, over the past year, Frenk and his co-authors produced enough reflections and diagnoses to know precisely, in advance, the possible bad effects, uncertainties and damage to patients that such a poorly designed reform could provoke.

I refer to these texts: “Institute of Health for Well-being: Old wine in a broken bottle”, “Manual of a reactionary counter-reform”, “Privatization austerity”. “No place for chimeras”, “Red spotlights” or “Towards the universalization of health”, all available at https://www.nexos.com.mx/

None of these reflections, all based on data, history and experience, deserved any public consideration from the designers of Insabi.

The official diagnosis against Popular Insurance, whose cancellation is the axis of the reform implemented, was an easy false phrase. “Popular Insurance,” they said, “is neither safe nor popular.”

“Popular Insurance was not perfect, we will never dare to say yes,” said former Secretary of Health Salomón Chertorivski. “But I think there was already a solid base” (Interview with Ana Francisca Vega, MVS, January 9, 2020).

It was, at least, a financial base that allowed first, second and third level health care for 53 million Mexicans who were not in formal regimes: IMSS, Issste, Sedena, Pemex, etc.

By decreeing the disappearance of Popular Insurance, Insabi did itself the first structural damage: a reduction in equivalent spending, says Frenk, to a “budgetary suicide.” (MILLENNIUM, January 11, 2019).

hector.aguilarcamin@milenio.com

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