Julio Frenk, Mexican
health secretary turned
Harvard School of
Public Health faculty
dean, at the Francois-Xavier Bagnoud Center
for Health and Human
Rights, February 13, 2012.
was appointed secretary of health in 2000 as
part of a social transformation that brought
a change in Mexico’s ruling party for the first
time in 71 years. I had already spent about 20
years studying health care and advocating for
a universal health system when then-President
Vicente Fox appointed me to the post. The first thing
I proposed to him was Seguro Popular—a sweeping
public health insurance program.
Mexico, like many Latin American countries, had
evolved into a segmented health care system, where
access to insurance was not a right of citizenship
but a benefit of employment. Seguro Popular turned
health insurance into a right of the people.
Politically, the revolution in Mexico’s health care
system was possible because of the change of power
that brought an end to seven decades of one-party
rule. Completing Mexico’s transition to democracy
meant making sure that civil and political rights were
guaranteed, and that social rights—most importantly,
the right to health care—were universal.
At the time, more than half of the Mexican popula-
PHOTOGRAPH BY COREY HENDRICKSON/AURORA SELECT
By Julio Frenk
tion ( 50 million people) was uninsured. Most citizens
paid for health care out of their own pocket. That effectively forced 4 million Mexican families into poverty each year due to the illness of a family member.
Seguro Popular was not just an insurance reform. It
changed the way government budgets for care. Now
money follows people. The state (responsible for the
care of people) has an incentive to enroll people in
the program, and providers have an incentive to provide quality care because it is financially rewarding.
Beyond the health benefits of universal coverage,
Seguro Popular has shown that good health is a powerful way to fight poverty. Healthy people are more
productive, and healthier children are more likely to
succeed in school and have better economic opportunities than those who are sick or malnourished.
Like Mexico, countries have to commit to the ethical conviction that health care is a condition for
equality of opportunity, just as education is. Today,
there are 52 million people enrolled in Seguro Popular,
and this year Mexico will achieve universal health insurance coverage. Others can do the same.
Americas Quarterly SPRING 2012