Knaul Felicia Marie, Arreola-Ornelas Héctor, Méndez-Carniado Oscar, Bryson-Cahn Chloe, Barofsky Jeremy, Maguire Rachel, Miranda Martha, Sesma Sergio
Fundación Mexicana para la Salud, Periférico Sur No. 4809, CP 14610, México, DF.
Salud Publica Mex. 2007;49 Suppl 1:S70-87.
Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.
卫生领域缺乏财务保护是卫生系统最近才被诊断出的一种“疾病”。最明显的症状是，家庭因支付医疗费用而面临经济崩溃和贫困。墨西哥是最早诊断出这一问题、将其归因于缺乏财务保护并通过卫生改革提出系统性治疗方案的国家之一。在本文中，我们评估了墨西哥如何通过创建大众健康保险（Seguro Popular de Salud）的改革，将灾难性和致贫性卫生支出的证据转化为机构革新的催化剂。我们展示了灾难性和致贫性卫生支出演变的15年趋势，包括情况如何改善的证据。墨西哥经验的结果表明，卫生系统的组织和融资在减少贫困以及在个人和集体金融危机期间保护家庭方面发挥着重要作用。
