title: Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.
abstract: Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.
authors.affiliation: Mexican Health Foundation, Periferico Sur 4809, Col Arenal Tepepan, 14610 Mexico City, Mexico. fknaul@funsalud.org.mx
authors.forename: Felicia Marie
authors.initials: FM
authors.lastname: Knaul
authors.forename: Héctor
authors.initials: H
authors.lastname: Arreola-Ornelas
authors.forename: Oscar
authors.initials: O
authors.lastname: Méndez-Carniado
authors.forename: Chloe
authors.initials: C
authors.lastname: Bryson-Cahn
authors.forename: Jeremy
authors.initials: J
authors.lastname: Barofsky
authors.forename: Rachel
authors.initials: R
authors.lastname: Maguire
authors.forename: Martha
authors.initials: M
authors.lastname: Miranda
authors.forename: Sergio
authors.initials: S
authors.lastname: Sesma
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D018166:Health Care Reform / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006291:Health Policy / Q000191:economics / Q000639:trends*; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008800:Mexico; D008875:Middle Aged; D011203:Poverty