Neonatal Organisms in Health and PEF 2023

Talking with my friend Mr. Jorge Espinosa Fernández about the newborn organizations -INSABI and SS-IMSS-Well-being- we agree about the need to restore the constitutional order in health matters through budget regulation in the Federation Expenditure Budget, EFP 2023.

The background is compelling:

1) The Constitution establishes that the health authorities in matters of general health are only the President of the Republic, the General Health Council, the Ministry of Health and the State Governments. 2) According to the Magna Carta, general health -1908- is concurrent between the Federation (Secretariat of Health) and the State Governments, according to the federal system constitutionally established since 1857. 3) The content of the General Health Law is general health and the regulation of access to public health services, as expressly provided by the Constitution.

However, the constitutional structure of the right to health protection and general sanitation has been distorted and undermined by two types of measures: a) By provisions of a budgetary nature and management of public resources and, b) By the creation of organizations that do not have the legal-constitutional status to assume general health services such as the INSABI and SS-IMSS-Well-being neonates, the first created by Law and the second by the customary decrees of the government of the fourth disorder (sic.)

These pseudo-planning measures made on the knees with great frustration – from the Nordic health vision – due to the very poor results obtained in the first four years of government, in terms of hundreds of thousands of deaths and the same number of suffering homes, fall Unprecedented life expectancy, an impoverished economy with inflation rates higher than family income, and an excess in the number of households without access to health services and extreme poverty, have led to the alteration of the Federal Health System through the decline of attributions of the Federal Sanitary Authorities -Secretariat of Health- and of the majority of the Governments of the States, where the head of the Governor’s Office, the Secretary of State Health and the H. Municipalities that integrate the federative entities are health authorities .

We make visible that as a whole, the deformation and non-compliance with the constitutional order in health matters are hindering the functioning of the National Health System, have seriously deteriorated the operation of public health services and are damaging the public health of the country, affecting with greater severity to the population without social security in health care services to the person who have had to resort to natural and legal persons from private services and social assistance as evidenced in the National Survey of Household Income and Expenses (ENIGH ) and the most recent National Survey of Health and Nutrition (ENSANUT) Covid-19.

The problem of the INSABI and SS-IMSS-Well-being neonates combines both resource (budgetary) and organizational (institutional arrangement) factors. The budgetary aspect of the problem lies in the fact that a large part of the federal resources for public health and for services to the population without social security are managed and channeled by the Ministry of Health, instead of being transferred directly by the Ministry of Finance. (SHCP) to state services. This intermediation and administrative management has been going on for two decades, and has intensified in recent years with both Branch 33 and Branch 12, adding that even part of the state solidarity contribution resources, at least 70%, must be delivered to the newborns in cash in accordance with the signed coordination agreements and that there are no longer available resources from recovery fees, even from people who would have the ability to pay them.

As a consequence, public spending has been exposed to deviations and has prevented public spending on health from being fixed, stable or adjustable; The per capita allocation was even eliminated, thereby reducing the ability to deliver essential health services to a larger population to serve, as occurred with the 15 million more Mexicans without access to health services revealed by the Population Census and Housing 2020 ratified by the National Council for the Evaluation of Social Development Policy (Coneval).

That is why there are approximately 100,000 health workers throughout the country without job stability, without benefits and without social security conditions, that is, without a budget position and working in precarious conditions.

The non-allocation of the budget directly to the State Services and their public bodies decentralized by territory and function such as health jurisdictions, hospitals, state public health laboratories, state blood transfusion and transplant centers, as well as other medical units of the local health systems. health, has made possible the current referrals, reversals and systematically irregular channeling of public resources for the care of the population in general and public health.

I will comment on the aspects of institutional organization and others that should take us to the legislators, insofar as it is the power that should be a balance between the executive and judicial powers, in the next column with a view to the approval of the Expenditure Budget of the Federation 2023 .

*The author is a medical surgeon, specializing in public health, with a doctorate in health sciences and public administration, and was re-elected as a deputy of the PAN parliamentary group in the LXIV Legislature.