Screening Seguro Popular: The Political Economy of Universal Health Coverage in Mexico

Abstract

Seguro Popular is the most prominent component of the System of Social Protection in Health launched in Mexico in 2003 to provide health services to 52.7 million of uninsured people, mostly the poorest households. After reaching universal enrollment less than a decade from its origin the system faces several challenges, among them insufficient quality of health services threatening the main objectives of the strategy: to provide effective health coverage and reduce out of pocket expenditure. This study analyzes the allocation of resources at state level destined to Seguro Popular and provides a simple model and empirical evidence that support: i) electoral politics play an important role finding a significant increase in public sector hiring of health workers and infrastructure building when state-level elections take place; and ii) parties adopt different allocation strategies according to their constituencies responsiveness to the type of good provided. Finally, it discusses its implications in service quality and raises concerns over the effective impact of Seguro Popular given its current financing and operating structure.