Last Tuesday, President Andrés Manuel López Obrador pointed out that in 2023 there will be a public health system “at the level of what the people deserve”.
After during his administration he stated on several occasions that the country would have a “Nordic” health system, the objective was slightly modified, although “what the people deserve” is undoubtedly an efficient system that satisfies the needs in the matter.
The problem is that, in order to achieve close quality standards in the medical services provided in the Nordic countries, much more than a good intention is required, money is needed, a lot of money, same that comes from public resources that are oriented by governments.
If next year the country is going to have a health system at the level of “what the people deserve”, it should begin by channeling many more resources than are considered now, otherwise the objective simply and simply does not it will be achieved
In order not to enter into a barrage of figures that are only confusing, let us make comparisons of the percentages allocated by some of the nations that stand out the most in high-quality public health services.
Nordic system, first class, but expensive
The Nordic countries (Iceland, Norway, Sweden, Finland and Denmark) are, without a doubt, a reference in public health services, not for nothing during the first three years of the current administration they were taken as a reference and objective for our country, although not even a minimum resemblance to the services of these countries was achieved.
But the countries involved allocate ample resources to finance these public health systems.
If the goal is to have a Nordic health system, we must spend on it as if we were Nordics.
But how much do countries and some others that have top-notch health systems spend?
Mexican vs Nordic health system
Let’s put first the case of Mexico; our country spent last year the equivalent of 5.3 percent of GDP on public health
The good news is that this percentage will increase this year, the bad news is that it will be marginal since it will only rise to 5.4 percent.
This percentage rate of GDP for public health has been almost constant for more than 20 years.
The most recent time that there was a significant rebound was in 2001, in the neoliberal period as they call it today, at that time the rate rose from 3.8 to 5 percent, and since then it has remained in very close ranges.
This current level of 5.4 percent is low, very low compared to what is spent in the Nordic countries and in other nations, for public health.
It is no secret that the countries of the Organization for Economic Cooperation and Development (OECD), with the highest levels of insurance (social security) of their population, are also the ones that spend the most on health, including several Nordic countries.
For example: Norway allocates 10.9 percent of GDP to this sector; Denmark spends 11.2 percent; For its part, Sweden allocates 11.9 percent of GDP.
Iceland, a small country with just under 400,000 inhabitants, understands where the key to a world-class public health system lies and spends 9.5 percent of its GDP to achieve it; the United Kingdom allocates practically 10 percent of its GDP to its public health system.
For its part, Finland, another reference Nordic country, spends 9.8 percent of its GDP on public health, and not to go too far to another continent, we have the example of our trading partner, Canada, which allocates 10.7 percent of GDP to the national health system.
In the case of Mexico, due to budget cuts, the current level of GDP allocated to the health sector has deteriorated and it is below 6.2 percent, our historical maximum, registered in the middle of the administration of Enrique Peña Nieto.
a good wish
It is not about criticizing without rhyme or reason, nor about wanting the country to do badly, it is simply applying common sense.
At the beginning of the six-year term, it was said that Mexico deserved and was going to have a health system like that of the Nordic countries. Today, it is said that the following year, that is to say in 2023, there will be a public health system at the level of “what the people deserve”.
One or another concept cannot be achieved with the levels of spending that the country currently has in its public health systems.
It has been demonstrated for decades in the Nordic countries that achieving efficient health systems requires intense investment, the rest is just wishful thinking. In 2023 we will not have a Nordic health system and that concept of “what the people deserve” is very ambiguous, but the following year we will have something similar to what we see today, the levels of public investment leave no room for doubt.
For 2023, the federal government proposes spending 892 thousand 849 million pesos (mdp), 4.2% more than in 2022, but clearly insufficient for the needs of the country. To measure how little public spending is on health, next year Mexico will pay close to a billion pesos in interest payments on public debt. In other words, we will spend more on public debt than on health.