Membership In Seguro Popular In Mexico Linked To A Small Reduction In Catastrophic Health Expenditure.

In 2004 the government of Mexico initiated an ambitious program, Seguro Popular, to extend health insurance coverage to poor and informal-sector workers. While the program had a protective effect during its early stages, its impact on out-of-pocket health spending over time is unclear. This study used two waves of the Encuesta Nacional de Salud y Nutricion (from 2006 and 2012) to analyze the protective effects of Seguro Popular and social security programs on out-of-pocket and catastrophic health spending. While, given the endogeneity of Seguro Popular enrollment, we found no link between membership and out-of-pocket health care spending in the study period, we did find a robust, albeit small, link between membership and a reduction in catastrophic health spending. A significant part of overall out-of-pocket health spending goes to purchase medications. Policy decisions are necessary to address gaps in coverage and access to medicines. Improving the quality of care as well as including more clinically effective and cost-effective medicines in the Seguro Popular package could significantly reduce out-of-pocket health care spending in Mexico.