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As if it was a time bomb, in the first nine months of the administration of President Andrés Manuel López Obrador have denotated 11 crisis in the health sector , most of them related to austerity, but not because of a lack of resources , but for its use , experts agree, who also think a characteristic of the current administration is to take the streets, for it has helped to solve issues.
“It is clear that austerity is related to problems in the health sector, but because the administrative processes have changed; there were modifications without a diagnosis of how they would affect. It is not a problem due to a lack of money – the budget for Health is basically the same as the previous year – but about how resources are used,” commented Rodolfo de la Torre , director of Social Development of the Espinosa Yglesias Studies Center .
According to the Expenditures Budget of the Federation (PEF) , the Health Ministry received MXN $124,266,865,116 for the year 2019, an increment of MXN $652,078,402 compared to the amount in 2018. According to the First Annual Report of the Government of President Andrés Manuel López Obrador , until now, the current administration has saved almost MXN $4 billion in the purchase of medicines; however, the agency headed by Jorge Alcocer Varela has been in the eye of the storm tens of times.
The first crisis burst on April 9th : Resident doctors made a protest in Mexico City’s Downtown to denounce a delay in their payments and the discount of a bonus that was deposited in December 2018. After not reaching an agreement, on April 12, they announced a strike until Health gave them an answer. Pedro Flores , head of Administration and Finances, was in charge of fighting the fire: He received the complainers and compromised to do the corresponding payments.
In April, May, and June the biggest conflicts took place: Patients with HIV blocked the Paseo de la Reforma Avenue to demand the supply of antiretrovirals medicines ; in an unprecedented move, directors of nine National Health Institutes announced that the Finance Ministry (SHCP) froze resources approved in PEF, so they barely had money for their operations during two months.
In June , it was informed that medical interns would only receive scholarships if they did their community service in rural areas, which caused them to march in August. The last scandal happened last week: Families of children with cancer closed the accesses to Mexico City International Airport to demand the supply of methotrexate , a crisis that worsened when Alcocer Varela said that “it was not a medical urgency;” however, the officer apologized and guaranteed more medicines.
At the beginning of the 4T , the Mexican Social Security Institute (IMSS) and the I nstitute for Social Security and Services for State Workers (ISSSTE) starred a crisis: In April 23rd, Pedro Zenteno Santaella , director of administration and finances at ISSSTE, revealed that the institute was on the verge of bankruptcy; almost a month later, and after denouncing a “harmful interference” by the Finance Ministry, Germán Martínez Cázares quit as general director of Social Security.
For Rodolfo de la Torre , in the 4T, protests have been the clue to get favorable answers, and acknowledged that denouncing from inside the Health system has had a fundamental role for authorities to address demands since they are more than just “ citizens’ complaints. ”
“There have been two kinds of pressures : The one from members of the Health sector and the one that arose from the outside by users or those who suffer the shortages. I think that this combination, compiled by media outlets and researched by civil society organizations, has generated enough so that the sector is looked under a different light and patients are regarded not only as complainers,” he said.
Karen Arteaga
, member of the Communications Committee of the National Assembly of Medical Residents , commented that health professionals do not blame the federal government of “all the bad things happening in the Health sector,” for there are serious deficiencies since previous administrations, “but austerity measures are the ones that have reflected the most negative impact , that is why we protest,” she expressed.
The chief of residents of the National Public Health Institute (INSP) highlighted that the inconvenience is not because of austerity per se, but because of the “strict” cuts without explaining what will be done with the money.
“With the start of the Fourth Transformation, budgetary and staff cuts began, delays in the payments of residents (…) [but] it was just informed, without [saying] why or for what purpose.”
For his part, Gustavo Leal Fernández , researcher of Healthcare Policies of the Metropolitan Autonomous University (UAM) campus Xochimilco, pointed out that although austerity has had a direct impact on the health crisis, they have also tried to look to give solutions in the long term.
“I think there has been a misunderstanding [with] austerity : The issue [is because of] how resources are used; by not giving explanations, patients and health professionals are unhappy, but I think the current administration needs time to evaluate the improvements that these measures can bring,” he highlighted.
After the First Annual Report of the Government, experts warn that the main challenge on health matters for the President will be giving access to public health services to 20 million people who do not have any kind of social security and detailing how the system will be reorganized.
“The Health Institute for Wellness could have clinics under its charge and create agreements with others, but there are not enough resources to drastically improve attentions, or at least they have not told us how they will do so, “ said De la Torre.
Gustavo Leal agreed and highlighted that not only 20 million Mexicans without social security must be incorporated into the system, but the government must guarantee quality care at IMSS and ISSSTE .
“The main challenges for this administration are giving care for the open population (…) and for dependants of IMSS and ISSSTE to receive a first-level service .”
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