The Employers’ Confederation of the Mexican Republic (Coparmex) considered this Monday that the creation of the IMSS-Well-being lacks a legal structure and generates division with entities governed by politicians emanating from the PAN and the Citizen Movement.
“The proposal is announced without a legal structure or a clear guide that determines the implementation route, which translates into a high risk of improvisation, as happened with INSABI,” said the organization in charge of José Medina Mora Icaza.
The commitment to the centralization of health has generated division because some entities such as Aguascalientes, Chihuahua, Guanajuato and Tamaulipas, which are governed by politicians emanating from the PAN, as well as Jalisco and Nuevo León, in charge of governors of the Citizen Movement, that is to say , opponents of the government of Andrés Manuel López Obrador, will not join the IMSS-Wellness program, said the employers’ organization.
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One of the first actions in this six-year term was the disappearance of Seguro Popular to create INSABI in its place, said Coparmex.
“More than three years away, the balance has been painful. Millions of Mexicans were left defenseless without access to health services, at a time as critical as the Covid-19 pandemic, ”said the business body.
Coparmex added that on April 1, 2022 there was a change of direction with the start of a new stage of implementation of the IMSS-Wellness program, which aims to provide medical services to Mexicans without social security.
The IMSS-Wellness is not a new program, since it was created in 1979 under the name of IMSS-Coplamar to bring medical services to the population not protected by the social security systems throughout the country, much of this population in extreme poverty and deep marginalization, according to the employer body.
“First INSABI and now IMSS-Well-being have presented themselves as alternatives to Seguro Popular, which demonstrated achievements in coverage of the population, of diseases that cause catastrophic expenses and in the reduction of communicable diseases, although there were also cases of diversion of resources. and inconsistencies that were reported by the Superior Audit Office of the Federation”, he pointed out.
At the moment, said the agency, it has not been clarified what will happen to third level care, since it has been stated that the new scheme is focused on the first and second level, with a focus on prevention.
“Apparently, highly specialized care is not being included,” said Coparmex.
He added that it is unclear if the budget granted to IMSS-Wellness is sufficient to operate the infrastructure and cover the payment of workers in each incorporated entity.
Currently, IMSS-Wellness operates in 19 entities in the country, providing health services to 11.6 million people, free first and second level medical services.
Its medical network is made up of 3,622 Rural Medical Units, 45 rural obstetric care centers, 140 Mobile Medical Units, and 184 health brigades at the first level of care; and 80 rural hospitals in the second level where the specialties of Pediatrics, Obstetrics-Gynecology, Internal Medicine and General Surgery are covered.
The renewed IMSS-Wellness program seeks to reach 13 entities in 2022: Baja California Sur, Campeche, Colima, CDMX, Durango, Michoacán, Nayarit, Oaxaca, Sonora, Sinaloa, Tlaxcala, Veracruz and Zacatecas. Three of them (Nayarit, Colima and Tlaxcala) have already signed the agreement for the federalization of their health services.
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Coparmex explained that the IMSS-Wellness Program will operate with the Comprehensive Health Care Model (MAIS), which includes modernizing, rehabilitating and equipping hospitals starting with first-level care and later second-level care, as well as designing the hiring scheme and all those actions to transfer personnel
Other actions of the IMSS-Wellness Program are to have supply levels and prescriptions filled in each medical care unit and improve the working conditions of more than 87 thousand workers hired due to the pandemic, respecting seniority and job performance.
“We are pleased with the recent announcement by the President of the Republic, that as of May, progress in strengthening the public health system will be reported weekly to enforce article 4. Constitution that enshrines the right of all Mexicans to health protection,” said Coparmex.
However, there is a false dilemma between covering more people and serving them better because health is not an expense but an investment and the highest coverage with the highest quality of services should be privileged, considered the employer body.
“This implies well-paid health professionals, supply of drugs and innovative medical devices, but above all indicators,” said Coparmex.
Realistic and transparent qualitative and quantitative indicators are required to measure whether services are improving in quality and coverage, he added.
“Technical indicators, not political ones, to strengthen what works and correct what doesn’t,” he explained.
One aspect that seems to us that is not contemplated in the initiative is the need to provide sufficient resources to the IMSS, because additional and sufficient money must be contemplated to alleviate the lack of financing and the cuts that the sector has had, Coparmex concluded.