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Mexico's Pilot Health Insurance Plan Gets High Marks

Officials in many countries say their governments are too cash-strapped to offer some form of health insurance to their citizens. But Mexico recently rolled out a program to protect poorer citizens from the expenses of a catastrophic illness.

When a member of a poor household becomes sick, the illness can result in financial ruin, says political scientist Gary King at Harvard's School of Public Health. King says just a few years ago, close to half of Mexico's population faced this kind of risk.

"About 10 percent of poor families in the country suffered what they call 'catastrophic health expenditures,'" he explains. "This is if you take a family budget, and you subtract a small amount of money for food, if more than 30 percent of the rest of that money goes to some big health expenditure, somebody has to have a big operation or whatever it is, and then they call that a catastrophic health expenditure."

But a few years ago, the Mexican government introduced a program called Seguro Popular. They've been slowly enrolling people since 2003, and King has been monitoring its effectiveness.

The program is designed to protect families from catastrophic health expenditure by providing improved medical facilities in combination with more medical professionals to deliver the care. King looked at what happened in communities where Seguro Popular has been rolled out. Before the introduction of the program, he and his colleagues surveyed tens of thousands of poor families.

"So, among the people for whom the program was intended, they actually signed up, 60 percent of the catastrophic health expenditures were eliminated just due to this program," he says.

King says what's unusual about the program is that money intended for the poor is actually reaching them.

"The vast majority of money that is intended for poor people in most countries actually doesn't make it to poor people," he says. "Even if you set aside fraud, you get better buildings and employees paid more and [better] government and things like that. And some money may make it. But it is widely known that relatively little money actually makes it to poor people."

King says this program is different because of the way the Mexican government distributes the money.

"They have a system that they call 'stewardship'... where they give the money to the localities, but then the central facility will really watch. They verify and then they provide more money when the locality performs."

King says he's continuing to monitor the rollout of Seguro Popular to see if it remains effective as more and more people in Mexico are enrolled.

His paper is published online now by the Lancet.