1. Health Care Policy in Mexico and Compression Morbidity GERN 474 – Maria Claver & Casey Goeller Alma Madrid, Lisa Medrano, Kim-Anh Pham, Michelle Prado, Lorrie Russell.

2. Some Definitions Health Care –The maintaining and restoration of health by the treatment and prevention of disease especially by trained and licensed professionals.

3. Definitions cont… Compression of Morbidity –Term used to describe one of the goals of health aging and longevity. –Morbidity is the presence or rate or incidence of the disease or medical condition. –Refers to the burden that an illness or health conditions causes. –Compression refers to the concept of pushing all the morbidity of one’s life into as small a time period as possible. Minimize number of years that a person spends suffering while maximizing the total number of years.

4. Compression of Morbidity Compression of Morbidity is the goal of living disease and illness free for as long as possible. Morbidity in Mexico is largely an environmental problem. Lack of clean water Airborne diseases Obesity, HIV/AIDs, Violence/War Scarcity of resources Facilities Natural fresh water

5. Health Care for Older Adults in Mexico Health care provided for older adults include: Preventive care: vaccinations, health education/literature etc. Health promotion programs: nutrition, sexuality, exercise etc. Specialists: Rheumatologist, Geriatrics, Alzheimer’s care etc. Rx coverage No co-pays for office visits/surgiers Hospitalization X-Rays Laboratory Basic dental services Low cost funeral services

6. Health Care Coverage Social Security Institutions cover almost half of Mexico’s population –40% is covered through institutions. –5 % use private sectors. –11% no access to health system facilities. About 50% of population is aged 65 or older. –Reported to have no health care coverage.

7. Health Care System in Mexico General revenues to pay for health care for middle and low income groups. Upper income families use private insurances. Coverage by government is determined by participation in formal labor market. –Discrimination towards agricultural, domestic, small commercial industry workers. Access based on two factors: –Level of urbanization. –Population forms part of the social security system.

8. Health Care System in Mexico Composed of institutions fostered to social security. Private sector/health insurance. La Cruz Roja (Red Cross) – provides urgent care and emergency services. Defensa Nacional (National Defense) – members of national defense (present, retired & family members) have their own health care program. Secretary of Health, SESA & IMSS-Oportunidades – provide service that have no social security & unemployed funded by federal & state government.

9. A Closer Look at Institutions IMSS –All workers with salaries & their families, retired & actively working, also entity to cover issues/accidents similar to workers comp. (LARGEST) ISSSTE –All government agency workers, at all levels federal, state, city. (2 ND LARGEST ) PEMEX –Workers and family members of PEMEX petroleum. (3 RD LARGEST)

10. Health Care System Contribution to Morbidity Greatest damage to health care is concentrated in older adults & non-transferable diseases. 84% of deaths are the result of non transferable diseases. 53% of those concentrate on older adults over the age of 65.

11. Causes of Death (65+ yrs old) Diabetes Hearth Disease Cerebral-Vascular Disease (Stroke) Obstructive Pulmonary Disease Hypertension Cancer Adults ages 65+ have a higher prevalence of alcoholism and smoking. Women are at greater risk of dying from diabetes. Men are at greatest risk of dying from obstructive pulmonary disease and cirrhosis.

12. Health Care Inequalities Health is more precarious and access to health services is limited in certain states: –Southeastern states, rural areas, indigenous communities. Delivering quality of care is heterogeneity among principal health care service providers.

13. Office Wait Time IMSS –90 minutes ISSTE –80 minutes SESA –70 minutes PEMEX –50 minutes Private –30 minutes

14. Affects of Waiting Patients tend to miss appointments Time with Dr. is reduced (no time for questions or explanations). Other contributions –Cancelation of surgeries due to impacted schedules –Waiting lists for surgeries are up to 6 months –Lack of hospitals with ICU –Lack of personal physicians –Travel time for office visits

15. Conclusion Mexico’s health care system made of institutions by the government. Health care contribution to morbidity is concentrated on older adults Health care inequalities contribute to morbidity. No health care program is perfect. –Size of country, population, environment influences and what works for one country does not mean it will work for another.