The Rural Disadvantage of Popular Insurance: Navigating Mexico’s “Universal” Health Care Plan

• In Event: Aspirations to National Health: Social Medicine and Political Subjectivity in Latin America

Abstract

Health is identified as a human right for all citizens, according to the Mexican constitution. In 2004, Seguro Popular (Popular Insurance) came into effect in Mexico serving those not covered by other forms of social security (e.g. IMSS or ISSTE). Since it’s creation, millions of Mexico’s most vulnerable citizens (e.g. rural inhabitants) have become registered affiliates of Seguro Popular through state sponsored efforts. Yet, being an affiliate does not always guarantee equity or access to necessary services. To date, little research is known concerning the experiences of healthcare for rural affiliates or how these families attend to any unmet health needs. The present research is based on a larger ethnographic study completed during 2009 and 2018 in rural Michoacan and at a non-profit, serving family members of patients in Morelia. The goal was to better understand how citizens engage with state narratives regarding universal health care and the realities of what individuals experience as affiliates. Interviews and observation data revealed that affiliates were frustrated and felt neglected when trying to access care. Participants reported challenges when navigating a system with unavailable or limited resources. Findings also highlight how individuals strategize both locally and transnationally to address unmet needs. These narratives are foundational for understanding structural inconsistencies and deficiencies found throughout Seguro Popular. Implications of the research are useful in the development of policies and processes that could address the state’s lack of attention to the direct and indirect health needs of the infirm.

Author

• Isabel Montemayor