2023-05-02 12:34:00
Dozens of ASF and OIC audits reviewed by Process document the disastrous operation of Insabi in its three years of existence: problems in the coordination of health services in the states, chaos in the acquisition and distribution of medicines, unjustified direct adjudication, absence of supporting documents… Given the accumulation of irregularities and folly, failure was foreseeable in the two main missions assigned to it: establishing a universal health system, and acquiring and distributing the medicines that the country’s hospitals need.
MEXICO CITY (Process).– Barely three years after it was born, the National Institute of Health for Well-being (Insabi) is in its terminal phase. The brand new institute failed in the two missions that President Andrés Manuel López Obrador had assigned it: it failed to establish a universal health system, and it was also unable to acquire and distribute the medicines needed by hospitals and health centers in the country, generating serious shortage situations.
Throughout its short life, both the Superior Audit of the Federation (ASF) and the Internal Control Body (OIC) have documented a number of irregularities in Insabi, which included difficulties inherent in the start-up of a new administrative colossus -it had more than 87,000 workers-, but also opacity problems attributable to the team of its director, Juan Antonio Ferrer Aguilar, from Tabasco, who already expressed his desire to compete for a popularly elected position in 2024.
Dozens of audit reports from the ASF and the OIC reviewed by Process They coincide in documenting problems in the coordination of health services in the states, disaster in the acquisition and distribution of medicines, unjustified direct awards, and the absence of supporting documents.
Added to these management deficiencies was the Covid-19 pandemic, which wreaked havoc on the country’s precarious public health system and put the Insabi, created three months before the health emergency was declared, to the test: along with the virus spread in the country, 15 million people in extreme poverty stopped having access to health.
Public hospitals stopped receiving patients, who had to go to the private system, and in parallel the shortage problem worsened to reach historic levels: in 2022, the Mexican Social Security Institute (IMSS) recognized that it could not supply 11 million 500 thousand recipes.
Between 2020 and 2022, Insabi spent 303 thousand 44 million pesos from its own budget, and operated the multimillion-dollar resources of the Health Fund for Well-being (Fonsabi), which for years went from being endowed with 102 billion pesos to 75 thousand 205 billion pesos. Between 2020 and 2021, 26 of the 32 state governments transferred part of their health systems to Insabi. Oaxaca and San Luis Potosí went to the extreme of handing over all medical care to the new body.
Just in March of last year, two years after the creation of Insabi, López Obrador had given the organization a first blow, when he announced that medical care work for the 66 million people who do not have social security would fall to a new entity : the “Decentralized Public Organization called Health Services of the Mexican Institute of Social Security for Welfare”.
The president baptized the new organism “IMSS-Bienestar”, creating a new confusion, since IMSS-Bienestar is the current name of a program that has existed since 1979. The new organism was born in a publication of the Official Gazette of the Federation (DOF). on August 31, 2022; The IMSS-Bienestar has its own legal and patrimonial structure, is headed by Gisela Lara Saldaña, a general director appointed by the president, and is administered by a Governing Board chaired by the head of the IMSS, Zoé Robledo Aburto.
After López Obrador amputated one of his essential tasks, Insabi was left with the no less important mission of centralizing the purchase of medicines for health sector agencies. The task fell under the responsibility of the Insabi Supply Coordination, headed by Alejandro Calderón Alipí, a former member of President López Obrador’s Assistant, and to whom journalists attribute a friendship with Andrés Manuel López Beltrán, one of the president’s sons.
There, too, it was a resounding failure: for two years, Insabi operated in chaotic collaboration with the United Nations Office for Projects and Services (Unops). Year after year, the institutions were unable to acquire all the medicines requested in the international markets, and faced problems distributing them in the country. This situation forced Insabi to set up urgent and untimely tenders, which aggravated the shortage situation.
Fragment of the report published in the 2426 edition of the magazine Processwhose digital edition can be purchased at this link.
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