Association for Public Policy Analysis & Management

It has been demonstrated that it is not enough to spend more on the health system, but it is essential to spend well. In Mexico, the Ministry of Health and the IMSS were created in 1943, the first to attend the population in general and the second for workers, with a health and social security perspective. By 1960, ISSSTE provides expanded social protection for the government sector; this is the origin of the design of the Social Protection in Health System that in 2003, seeks a health system with universal coverage with public policy on health. To identify if the benefits of “Seguro Popular” reduced catastrophic spending, given that, for the population in the lowest income quartile, each health expenditure implies a probability of over 20% to become a catastrophic expense. A particular risk for the health system is that households that are insured incur out-of-pocket expenses and worse, catastrophic, reflecting dissatisfaction with the services to which they would be entitled without having to suffer disbursement. In general, families that are dissatisfied with care provided by institutional public insurers suffer impoverishment close to 6%. With data from the National Household Income Expenditure Surveys (1992-2016), it is proposed to show that there is a change in the structure of family expenditure on health. The first analysis presents that the dissatisfaction and low perceived quality of public health providers, prevents facing the disease with financial certainty in the Mexican health system.