“The Deterioration of Institutional Medicine in Mexico: Understanding the Challenges Faced by IMSS and ISSSTE”

2023-05-03 16:04:00

How does the so-called Institutional Medicine work in Mexico, call it IMSS; ISSSTE or SSA? (Photo: special)

It is nothing new, institutional medicine in Mexico, represented by the Mexican Institute of Social Security (IMSS) and the Institute of Security and Social Services for State Workers (ISSSTE), due to various circumstances, has experienced a progressive deterioration for several years. six-year terms, a deterioration that has worsened since the beginning of the so-called 4Q as the budget for the Health Sector has been cut, in real terms, and at the same time coverage has been expanded without sufficiently increasing hospital resources, medical equipment, and personnel, which This has caused the indicators of deferral in consultations, scheduling of surgeries and non-filled prescriptions to have skyrocketed to levels never seen before.

The Mexican Social Security Institute was officially born on January 19, 1943 in response to the need to provide medical care to the working population. It is worth remembering that before the existence of the IMSS, medical attention was paid by the employer and the Virgin of Guadalupe, which is the same as saying that it virtually did not exist.

The birth of the IMSS was not easy, since its inception it faced rejection and blockade by the employers’ segments of that time, helped, to make matters worse, by some union centrals, incapable of understanding the concept of social security. Currently, no one doubts the importance of the IMSS, which is by far the largest medical institution in Mexico. 80 years after its foundation, the IMSS serves almost 74 million beneficiaries. But with the recent reform approved by the legislature, when the ghostly INSABI disappeared, another 12 million will be added. Sufficient resources and infrastructure to serve them? Those that exist, and do what you can.

For its part, the ISSSTE, which was born on December 30, 1959, is in charge of providing health and social security services to state workers. The approximate number is 13.5 million. The ISSSTE, like the IMSS, has suffered serious problems that have affected the quality of medical care.

A serious problem shared by both institutions is the one generated by the incompetence of improvised central-level officials, who, without a valid reason, hindered and continue to hinder the adequate purchase of medicines in a timely quantity and time, which has made the medical landscape institutional darkens even more. In short, the deterioration of institutional medicine has a first and last name, and this is Incompetence and Corruption. To make matters worse, the work overload in both institutions has reached alarming levels that managers do not want to see, much less solve. Although we must accept that they can do little at their level, the decisions come from the central level, and they are not precisely dictated with knowledge or good sense.

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The foregoing has led many citizens to resort to private medicine, using from the reasonably cheap offices of some pharmacy chains, to large private hospitals with prohibitive costs, capable of ruining the most solid economy by handling charges that exceed half a million. of pesos per day.

It is evident that private medicine -speaking of hospitalization, surgical interventions and Intensive Care Units- is not a viable solution to the health problem in Mexico. The vast majority of Mexicans simply do not have sufficient financial means to pay for it.

That is why it is imperative that the government and the competent authorities take adequate measures to improve the deteriorating situation of institutional medicine in Mexico. It is necessary to increase financing and resources allocated to health, hire, in an expeditious, agile and adequate manner, the necessary personnel for hospital units, improve the quality and efficiency of their administrative personnel and fight corruption at high levels. . Make the old and forgotten institutional motto of providing care with Quality, Opportunity and Human Relations a reality.

It is a priority that both citizens and officials and political leaders realize the importance of health as a fundamental right, that the IMSS and ISSSTE stop being used as an electoral tool or worse, as “petty cash” for party expenses in power as it has traditionally been for decades. No less important is to promote awareness about the importance of prevention and self-care, to reduce the burden of diseases that weighs on the health system. Giving the importance it deserves to Preventive Medicine, the traditional ugly duckling of both private and institutional medicine. There is no other way.

Medical care better than in Denmark? Please, that’s a cruel joke. It is making fun of the citizens.

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