Protección Financiera En Salud: México, 1992 a 2004 (Financial Protection in Health: Mexico, 1992 to 2004)
Knaul F, Arreola H., Méndez O. (2005). "Protección financiera en Salud: México, 1992 a 2004". Salud Pública de México. Vol. 47 (6), Nov-Dec: pp 430-439
10 Pages Posted: 27 Apr 2012 Last revised: 18 May 2012
Date Written: Noviembre 15, 2005
To document trends in financial protection in the health care system in Mexico between 1992 and 2004, applying a series of indicators that measure catastrophic and impoverishing health spending and the Index of Fairness in Financial Contributions. Materials y Methods. This study uses the biannual time series of the Survey of Household Income and Expenditures (ENIGH) spanning the period 1992 to 2004. The methodologies seek to measure the level and distribution of the burden of health care finance on households, and the financial protection offered to them by the health care system. Four indicators are presented: 1) the Index of Fairness in Financial Contributions, 2) the proportion of households with catastrophic health expenditure, 3) the proportion of households with impoverishment due to health spending and 4) the sum of the proportion of households with catastrophic or impoverishing health spending, which is referred to as excessive health spending. The analysis presented in this document is descriptive, leaving for later studies a deeper analysis of causal aspects. Results. The number of families that suffer impoverishment due to health spending increased from 5.2% in 1992, reached a high of 9.9% in 1996, and then gradually declined to 1.8% by 2004. The proportion of households with catastrophic expenses began at 2.8% in 1992, increased to 4.2% in 1998 and then fell to a level of 2.6% in 2004. The improvements from 2000 on are concentrated among the uninsured population, families affiliated to Popular Health Insurance, and households in the poorest two quintiles of the income distribution. Conclusions. The patterns over time in excessive health spending reflect a worsening during periods of economic crisis, post-crisis recovery, and a sustained improvement beginning in the year 2000. The data suggest that part of the reduction in the number of households with excessive health spending is due to the extension of financial protection for Mexican families through the Popular Health Insurance, while another part is associated with a decline in poverty. In addition, this paper documents an important relationship between economic trends and catastrophic and impoverishing health spending, suggesting the importance of financially protecting families through health insurance. Financial protection assists in guaranteeing that when economic crisis — of a country or of a family — coincides with illness, health care payments do not become the cause of a long or permanent period of impoverishment for households.
Note: Downloadable document is in Spanish.
Keywords: financial protection, Popular Health Insurance, System for Social Protection in Health, out-of-pocket health spending, catastrophic health spending, index of fairness in financial contributions, impoverishment, economic crisis, Mexican health system, Mexico
JEL Classification: I18
Suggested Citation: Suggested Citation