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INSABI replaces Seguro Popular + alternative, affordable medical facilities in Guadalajara

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Chapala highway was done by the previous administration and it is definitely seriously shoddy work.

What was their response?  I'd like to read it.

 

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I received the official letter last week, dated Nov 29. It basically said the government was aware of the deficient quality and so the contractors were not paid. ( would love to see proof of that hahaha)  At the same time they required the company to make the repairs at their own expense. 

However the last paragraph explained  " Cabe hacer mencion que actualmente, el tramo se encuentra reparado"  It is worth mentioning that currently, the section is repaired

It was signed by the Director General of highway conservation.

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On 1/2/2020 at 10:15 AM, More Liana said:

I've read quite a bit about INSABI and in all instances, I've read the following, which would (IMHO) indicate that one must be a Mexican citizen in order to be attended. 

"Como parte de las acciones de transformación del sistema de salud pública que implementa el gobierno federal para garantizar atención médica y medicamentos gratuitos a toda la población, a partir del primero de enero de 2020, los beneficiarios del Insabi solo deberán presentar su credencial del INE, la Clave Única de Registro de Población (CURP) o su acta de nacimiento para recibir los servicios públicos de salud."

The above sentence translates to: "As part of the actions of transforming the federal government's public health system in order to guarantee medical attention and free medicine to the entire population, starting on the first of January 2020, the beneficiaries of Insabi need only present their INE CREDENCIAL, the Clave Única de Registro de Población, or their birth certificate to receive the services of public health."

This announcement, also IMHO, is confusing in that one might read it to believe that one can also show only the CURP to be allowed free medical care and medicines.  The language of this announcement is such that there is no 'or' after the INE mention, but there IS an 'or' after the mention of the CURP (before the mention of the birth certificate).  The announcement also says that "the whole population" is entitled to free medical attention, but again IMHO there's no indication that the foreign population is included.




 

 

https://www.lja.mx/2020/01/el-insabi-si-permite-el-cobro-de-cuotas/

Google Translation:

"Official morning version - Jan. 9, 2020

The official version of the López Obrador press conference, disseminated by the Government of Mexico, softens the president's challenge to reporters and the contradictions between the Ministry of Health's statement, multiple complaints for service charges and the position of the President. The statement is entitled “No one should worry; The right to free medical care and medicines is guaranteed, says President AMLO ”, here the text:

President Andrés Manuel López Obrador endorsed the commitment to provide free medical care and medicines to the entire population. He recalled that the replacement of the Popular Insurance by the National Institute of Health for Wellbeing (Insabi) eliminates the requirement of the affiliation policy, so since January 1 only INE or CURP is requested when attending a consultation.

He said that about 60 percent of Mexicans do not have social security, so “the purpose is that everyone who gets sick, who needs medical care and medication, can be treated, is guaranteed the right to health.”

“People shouldn't worry. If you were enrolled in the Popular Insurance, you will continue to receive medical service, that's what this plan is for, ”he added."

This might clarify the confusing law [at least to me, obviously] as to what is required to get service from INSABI. Legal foreign residents have a CURP ID printout page.

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https://pulsoslp.com.mx/opinion/salud-gratuita/1052358#.Xhx9tibXHIE.whatsapp

Google Translation:

"Free health

By: Sergio Sarmiento / PULSE

January 13, 2020 03:00 a.m.

"The medical care in Mexico and the medicines will be delivered, they will be free; the right to health will be guaranteed in practice." Andrés Manuel López Obrador

There is nothing free in life, just different ways to pay it. This truth applies to public services, which involve significant costs. The collection can be efficient or not, generate adequate or perverse incentives, be sustainable or not, pay it off of the user or the taxpayer, but it is inevitable.

The president has promised that medical care and medications will be free in Mexico. The first step is the creation of INSABI, the Institute of Health for Wellbeing. The "badly named " Seguro Popular charged a minimum fee to members who could afford it.

"Everyone in the country without social security has the right to receive free public health services, medicines and other associated supplies," says an announcement from INSABI. "Affiliation is no longer required. Care includes medications, analysis, studies, clinical diagnoses, surgical interventions and hospitalization where appropriate, all for free."

The announcement points, however, to a great exception. "Free" services will only be available to those who are "without social security [IMSS]." Members of IMSS or ISSSTE, and the companies or institutions that employ them, will have to continue paying fees. Without these, or without fresh resources, the two institutions would fail in a very short time.

Seguro Popular sought to apply the same scheme to those who do not have IMSS or ISSSTE. It always suffered from a great shortage of resources, because many members were exempt from payment, but it fulfilled the purpose of providing health services to those without social security [IMSS].

Some serious specialists offered criticism of the system. Santiago Levy argued, in his now classic Good Intentions, Bad Outcomes of 2008, that by offering medical services to people without social security, the creation of formal jobs was weakened. Levy suggested using tax resources, from the application of IVA to food and medicine, to finance everyone's social security, with or without formal employment. The original sin of INSABI is not to understand that services and medications must be financed in some way. The institution has eliminated insurance charges and expanded the number of beneficiaries, without identifying additional sources of income. That is why it is cutting services.

Denmark [25 percent IVA  tax], which the president uses as an example, finances 84 percent of his medical expenses with taxes and the rest with private insurance. The system is good, but far from being free it is very expensive: 10.4 percent of gross domestic product. If Mexico has a GDP of 24 billion current pesos (INEGI), a system like Denmark's would cost around 2.5 billion pesos annually. How close are we? The Secretary of Health will have a programmable budget of 128,600 million pesos in 2020, 20 times lower.

We would all like to have a health system like Denmark's, but we will not succeed if we persist in the lie that it will be free. Preventing catastrophic medical expenses from falling on the family at the time of illness is a good public policy objective, which Seguro Popular already had, but to achieve this we will have to cover the expense with taxes, insurance or a combination of both. In life, after all, there is nothing free. Much less health care.

Experience?

The INSABI is poorly designed. Not even a public health expert could get it right. But it doesn't help anything that the Director of INSABI, Juan Antonio Ferrer, has no experience in public health. In spite of that, he receives a monthly salary of $97,000 net pesos, around $130,000 gross pesos."

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Those excellent health care systems in some European countries took decades to build and this president thinks that he can do it within 2 years, with a budget that is only 5 % of those European counterparts !? ( he likes to compare to Denmark )....with the same infrastructure, highly skilled staff, newest equipment, less corruption ???.....  Keep on dreaming, Mr President

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4 minutes ago, Rony said:

Those excellent health care systems in some European countries took decades to build and this president thinks that he can do it within 2 years, with a budget that is only 5 % of those European counterparts !?

I guess Rony the doctors etc are paid a fraction of the salaries they recevive in Europe hence the "affordable" care available in MX. ..  or not

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4 minutes ago, lakeside7 said:

I guess Rony the doctors etc are paid a fraction of the salaries they recevive in Europe hence the "affordable" care available in MX. ..  or not

Yes.  But not 20 times more ( see articles above )...and about half of a Danish doctor s salary goes back to the state

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I just got back from the Seguro Popular in SAT and had no problem. The new Dr. there (Dr. Santiago) reviewed blood and urine tests that I take there every 6 months or so. Did not even want to take a look at my 'booklet". Cholesterol a little high so he wrote me a prescription and only asked me for my CURP (which I had just printed out the new version of). In and out in half hour. No problema. .  

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https://www.google.com.mx/amp/s/mvsnoticias.com/noticias/estados/gobernador-de-jalisco-rechaza-unirse-al-insabi/amp/

Google Translation:

"Governor of Jalisco refuses to join Insabi

FÁTIMA AGUILAR / CORRESPONSAL IN JALISCO
13 JAN 2020

Being destined to fail, being a centralist and absurd model, the governor of Jalisco, Enrique Alfaro Ramírez justified that the state will not be part of the Institute of Health for Wellbeing (Insabi).

Alfaro Ramírez added that what happens in health matters at the federal level is a real disorder, since there are many doubts about this new model, which Jalisco does not intend to accompany.

Related information: The Insabi and the disappearance of  Seguro Popular 

The governor recalled that in 2019 the state was able to circumvent the lack of federal resources because of the delay in the delivery of those funds coming from Seguro Popular, which did not arrived until the end of the year.

However, this Tuesday will hold a meeting with the President of the Republic to know the implications of not adhering to this model, how will the coordination and commitment of the federal government with Jalisco in health care."

Smart politician. IMO

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Interesting.  So now we have Jalisco and Aguascalientes opting out.  Those are two really major states.

 

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11 minutes ago, Mainecoons said:

Interesting.  So now we have Jalisco and Aguascalientes opting out.  Those are two really major states.

 

6 governors have decided it is in the best interest of their state's health services not to join INSABI because of the obligation they have to service residents with all 3 levels of health care guaranteed to be funded by federal laws under rights of access to health services.

INSABI violates these federal laws and by greatly limiting funding to the individual states health services and CDMX and centralizing administration of funding only though the federal govenment on their whim. The obligation is not being fufilled with INSABI so expect federal injunctions from states who will be starved out of giving all 3 levels of health care through their state health services as INSABI as it is now incorporated will definately do.

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Just now, AlanMexicali said:

6 governors have decided it is in the best interest of their state's health services not to join INSABI because of the obligation they have to service residents with all 3 levels of health care guaranteed to be funded by federal laws under rights of access to health services.

INSABI violates these federal laws and by greatly limiting funding to the individual states health services and CDMX and centralizing administration of funding only though the federal govenment on their whim. The obligation is not being fufilled with INSABI so expect federal injunctions from states who will be starved out of giving all 3 levels of health care through their state health services as INSABI as it is now incorporated will definately do.

Is this the simplistic answer...The Federal Government say's This is the program,  you provide the services and we will reimburse you....Problem, the Federal government  has not lived  up to its obligation in the past and therefore what are the guarantees it will in the future...also now there is more coverage and more financial exposure.

 

Question; where is the federal government getting all the extra monies to fund this new program?

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 https://lasillarota.com/amp/especialeslsr/desmantelar-el-seguro-popular-seria-catastrofico-julio-frenk-seguro-popular-salud-imss-issste/270610

Google Translation:

"Dismantelling the Seguro Popular as proposed by President Andrés Manuel López Obrador and allocating the resources of the Fund for Protection against Catastrophic Expenses for other purposes would be "a catastrophe" for thousands of people receiving treatment for complex and expensive diseases, said Julio Frenk Mora, Former Secretary of Health. [creator of the Seguro Popular - Now president of the University of Miami]

One effect, I think very positive of  the Seguro Popular was that with the legislation that was passed in 2003, the tax obligation of the Mexican Federal State for each person who joins the Seguro Popular was put into federal law.

Because it is a financial scheme, something that is very confusing, that people often think that it is the program to provide services and it is not, it is a mechanism that finances.

That is a line of justice, because what we had before this legislation is that there was an IMSS law and one of the ISSSTE where the Federal State obligation for each affiliated person was stipulated."

Now there is still some federal laws alloting federal tax money to states to provide healthcare to its' residents. There is no more Seguro Popular so the above mentioned tax obligation is gone plus there is federal law and constitutional law that 3.5 percent of the yearly GNP be used for socialized medicine.

AMLO last year 2019 illegally reduced that to 2.5 percent, underfunded the Seguro Popular by almost 30 percent of the 2018 budget which caused turmoil in the delivery of services, laying off Dr.s, nurses, lab workers etc. and ordered just over 40 percent of the medicine requested in the previous administation's projected budget for 2019.

With less laws governing and the ones still in place being ignored the obligated expenditures incorporated into the CDMX and state health services budget is now at the whim of the federal government. In states where there was federal obligations as stated above in the quoted piece there now is a federal government  using the tax money as they wish and if they are inclined use it as a weapon to get state governments to be under the control of the party in power not automonous as before.

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All of this bla, bla, bla here is crazy. All we need to know is how this will affect us expats here lakeside. As far as I know, if you are registered with Seguro Popular (as I am) there are no changes; so please stop all of the fine print government press release blather. All is good... chill out...and enjoy this amazing place we have ended up at. 

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1 hour ago, gringohombre said:

All of this bla, bla, bla here is crazy. All we need to know is how this will affect us expats here lakeside. As far as I know, if you are registered with Seguro Popular (as I am) there are no changes; so please stop all of the fine print government press release blather. All is good... chill out...and enjoy this amazing place we have ended up at. 

I don't expect many retired foreigners to give a damn about Mexico's institutes or her problems so you confirm my belief being a legal alien resident of Mexico it is very unusual to assimilate to a foreign environment where you only came to "chill out" and live out your golden years in a nice place.

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On 1/4/2020 at 11:06 PM, Honorandfaith said:

I have very mixed feelings about the new system. There are 60 million poor Mexicans without health care. After seeing the gringos in Ecuador who moved there largely to use that "free" system & exploited it unfairly, I feel that it should be the responsibility of the American/Canadian population to provide for their own care, thru insurance or self-insuring. 

There simply isn't enough money to go around, and the Mexicans who have done without for so long should be the beneficiaries. 

I will probably get flamed for this comment, LOL. I say this after getting a quote yesterday for private health insurance. I am keeping my Medicare, BTW. 

Wholeheartedly agree. We carry Best Doctors for catastrophic medical events. Otherwise self pay. I would love to have free medical care but the Mexican community gives us so much. I just cannot in good conscience take money out of their medical care. This is a very poor country

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10 hours ago, gringohombre said:

All of this bla, bla, bla here is crazy. All we need to know is how this will affect us expats here lakeside. As far as I know, if you are registered with Seguro Popular (as I am) there are no changes; so please stop all of the fine print government press release blather. All is good... chill out...and enjoy this amazing place we have ended up at. 

We are but it is up for renewal.  Not sure what to do about this.  We first registered at the hospital in Jocotepec.  We have it as a backup only and have never used it.

 

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My experience has been that the Mexican govt "makes announcments"  without doing the hard background work in advance to make sure that the facilities have adequate funding, regulations are clear, every contingency has been taken into account and planned for. Looks like one big PR stunt to me. People will suffer. 

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14 hours ago, AlanMexicali said:

I don't expect many retired foreigners to give a damn about Mexico's institutes or her problems so you confirm my belief being a legal alien resident of Mexico it is very unusual to assimilate to a foreign environment where you only came to "chill out" and live out your golden years in a nice place.

My point is that nobody seems to know nothing about this situation. Even on this thread there are mounds of new government fine print that is contradictory itself and then this seems to be a situation that might change state to state.Your statement "I don't expect many retired foreigners to give a damn about Mexico's institutes or her problems" makes no sense in this context since I was only addressing those on this board who are almost all expats from somewhere else. I was just imparting what, in my extensive experience here including decades doing business, as well as a long time "retired foreigner" (and still conducting business) I have learned. Nothing is done until it is done here. It makes no sense to get your whities or panties in a kerfuffle over all of this typical barrage of government conflicting non-information information "press releases" and especially the know-all "experts" on this board. As my Doctor at Seguro Popular told me on Thursday when I brought this up as I was leaving, "Don't worry, nothing is changing here...hasta luego"

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15 hours ago, Joyfull said:

Wholeheartedly agree. We carry Best Doctors for catastrophic medical events. Otherwise self pay. I would love to have free medical care but the Mexican community gives us so much. I just cannot in good conscience take money out of their medical care. This is a very poor country

I have posted before, this is an old principle "do unto others as you would have them do onto you". In Canada, under a system I paid into with taxes for over 60 years, immigrants, refugees, (legal or illegal) and workers from Mexico are given free medical and free education. There are a few crackpots who moan about this but the vast majority of Canadians are proud of this nation defining role. There are far more Mexicans enjoying their new life in Canada than ex- Canadians in Mexico. In the U.S.A. ,in another nation defining role, immigrants from Mexico, or any brown country, are treated with fear and disdain. Whole families are forever split up and destroyed. I don't know how Mexicans are medically treated, but I mentioned that the nearest Seguro Popular hospital charges 16,000 pesos for a caesarian delivery, the average cost in the U.S. is $50,000 U.S. No wonder the population is declining there and the U.S. leads the world in medical related personal bankruptcies. Also relying on a U.S. based insurer while living in Mexico is not good idea. They are genetically prone and trained to just say no as soon as a claim hits their desk. Then there is not a darn thing you can do about it.

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On 1/13/2020 at 8:59 PM, AlanMexicali said:

I don't expect many retired foreigners to give a damn about Mexico's institutes or her problems so you confirm my belief being a legal alien resident of Mexico it is very unusual to assimilate to a foreign environment where you only came to "chill out" and live out your golden years in a nice place.

 

On 1/14/2020 at 12:02 PM, gringohombre said:

My point is that nobody seems to know nothing about this situation. Even on this thread there are mounds of new government fine print that is contradictory itself and then this seems to be a situation that might change state to state.Your statement "I don't expect many retired foreigners to give a damn about Mexico's institutes or her problems" makes no sense in this context since I was only addressing those on this board who are almost all expats from somewhere else. I was just imparting what, in my extensive experience here including decades doing business, as well as a long time "retired foreigner" (and still conducting business) I have learned. Nothing is done until it is done here. It makes no sense to get your whities or panties in a kerfuffle over all of this typical barrage of government conflicting non-information information "press releases" and especially the know-all "experts" on this board. As my Doctor at Seguro Popular told me on Thursday when I brought this up as I was leaving, "Don't worry, nothing is changing here...hasta luego"

I guessed correctly. It appears you have no desire or interest in comprehending the current healthcare situation brought on by the current administration and it's attempt to centralize power in Mexico in the federal government once again and take power away from the automonous states. This is real and confirmed recent mainstream news plus some opinions. The conflicting information, as you have noticed, is only from AMLO, his friend Juan Ferrer from Tabasco and Archaeologist the new Director of INSABI and the new Secretary of Health Dr. Jorfe Alcocer Varela. 

Your simple answer is:

"As my Doctor at Seguro Popular told me on Thursday when I brought this up as I was leaving, "Don't worry, nothing is changing here...hasta luego" "

This is real injustice to anyone who is getting screwed over by INSABI and needs concrete assurance they will have health care free of charge when they need it and not pay for it now that their Seguro Popular contract is no longer valid as many witnesses have had to pay since Jan. 1st. and many more will have to pay because there appears to be no end it sight at this time especially level 3 health care. Too bad you aren't the least bit concerned for them as long as you can get your level 1 routine checkup from your GP still. It appears  too complicated for you to follow. IMO

 

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2 minutes ago, AlanMexicali said:

 

I guessed correctly. It appears you have no desire or interest in comprehending the current healthcare situation brought on by the current administration and it's attempt to centralize power in Mexico in the federal government pmce again and take power away from the automonous states. Your simple answer is:

"As my Doctor at Seguro Popular told me on Thursday when I brought this up as I was leaving, "Don't worry, nothing is changing here...hasta luego" "

This is a real injustice to anyone who is getting screwed over by INSABI and needs concrete assurance they will have health care free of charge when they need it and not pay for it now that their Seguro Popular contract is no longer valid as many witnesses have had to pay since Jan. 1st. and many more will have to pay because there appears to be no end it sight at this time especially level 3 health care. Too bad you aren't the least bit concerned for them as long as you can get your level 1 routine checkup from your GP still. It appears  to complicated for you to follow. IMO

 

You can believe what you want and I will believe what I know. The word ATTEMPT in your first paragraph above is the operative word. Why try to get everyone riled up when this is still very much a work in progress, Lets all calm down here and I am confident that in the end, as always here, not much will change. 

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