Twenty-Five Years of Convoluted Health Reforms in Mexico

Mexico's neoliberal health care reforms began in 1983 as a condition for Mexico to receive loans from the World Bank (WB) and International Monetary Fund (IMF), which were needed because of the 1980s world recession. The first reform (1983) was a failed attempt to decentralize the Ministry of Health (MoH) by transferring financial responsibilities without devolving adequate decision-making authority to the states. The second reform (1994) advanced the decentralization of the MoH and attempted to increase the exposure of the major public social security scheme to private sector competition. In 2003, a third reform, the Seguro Popular (SP), emphasized improved access and services for the poor. Although accessibility has increased, the Mexican reforms have not resulted in significant reductions of health inequities, or in increased efficiency, productivity, or quality, despite their costs.