Mexico plans to reform its healthcare system — but can it deliver?

In Mexico, healthcare is supposed to be universal. It’s guaranteed in the Constitution.

But patients tell a different story.

After The World spoke with nearly a dozen residents in Mexico City, a pattern emerged: People complained of long wait times, months-long delays for appointments and clinics stretched beyond capacity.

Faced with these barriers, many people said they skipped public services altogether and turned to private options.

Now, Mexican President Claudia Sheinbaum said that her administration wants to fix the system by making it easier to use. But whether that will be enough remains an open question.

A system that’s hard to use

Some people in Mexico say that even a basic doctor’s visit can take up most of the day.

“You line up at 9:00 in the morning and don’t leave until 4:00 or 5:00 in the afternoon,” said Naomi Nazario, a college student in Mexico City.

For others, the biggest hurdle has been getting an appointment at all. Jusef Arredondo, a 46-year-old security guard, said it can take months just to be seen. When he does get in, he said that clinics are often overcrowded and short-staffed.

Maricarmen Olivares, who is a young professional, has faced similar issues. She said medications frequently run out, and, at times, she hadn’t received the care she needed.

Distance adds another challenge. Many patients are assigned to clinics far from home. In a city as large as Mexico City, that can mean a commute of up to two hours.

As a solution, many people have been looking for private alternatives, especially pharmacy clinics.

These small offices, often attached to drugstores, have become a common sight across Mexico. Patients can walk in without an appointment and see a doctor within minutes — a stark contrast to the long waits in the public system.

For many, that convenience makes all the difference.

“They see you very quickly, and the doctors are qualified,” Arredondo said.

Consultations are cheap — sometimes just a few dollars, and occasionally even free.

But these clinics were never meant to replace a full healthcare system.

Doctors often don’t have access to patients’ medical histories. Follow-up care is limited. And because the clinics are tied to pharmacies, there can be pressure to prescribe medications on the spot.

Still, for millions of Mexicans, this is where primary care actually happens.

An unequal and underfunded system

Health experts say the rise of pharmacy clinics points to deeper structural problems.

Alejandro Macías, an infectious disease specialist and former health official, said Mexico has long underinvested in public healthcare.

“Healthcare has never been something politicians win elections on,” he said.

The Mexican government spends about 3% of its GDP on public healthcare — roughly half of what international health authorities recommend.

But funding isn’t the only issue.

The system is also divided based on a person’s employment.

Felicia Knaul, a health economist and professor at UCLA, said access depends largely on job status.

“There is a split between those who have social security because they work in a salaried position, and everyone else,” she said.

People with formal employment are covered through social security institutions funded by payroll contributions. Government workers are covered through a separate system.

But more than half of Mexico’s workforce operates outside the formal economy — including street vendors, domestic workers and freelancers.

And they have to rely on a different system, one that has historically received fewer resources.

Viri Ríos, a Mexican public policy analyst, said the system often struggles to meet demand.

“A large share of care is delayed, and many households still pay out of pocket because the system just can’t deliver the services they need,” she explained.

About 40% of total health spending in Mexico comes directly from patients — several times higher than in the United States.

Knaul says that can have serious consequences.

“The worst way to finance a health system is to have people pay at the point of service,” she said, because it can push families into financial hardship.

Can the system be fixed?

President Sheinbaum’s plan aims to make the system easier to navigate, by connecting different health institutions and allowing patients to access care across them.

It also includes a new health card that would give doctors access to a patient’s medical history across the system.

Knaul said that could be an important step. Making records easier to share could help doctors treat patients more quickly — and more safely.

But experts warn that reform alone won’t be enough.

Mexico has tried to expand access before. The Seguro Popular program, launched in the early 2000s, extended coverage to millions of people without formal jobs. But it was scrapped in 2020 and replaced with a new system that struggled to deliver care, leaving many patients navigating an even more fragmented system.

Salomón Chertorivski, who previously led Seguro Popular, said those earlier efforts helped expand coverage but didn’t fix the underlying problem: access.

He said the system has long struggled to deliver consistent, reliable care — and that recent changes have made coordination between institutions even more difficult.

Analyst Viri Ríos said the current plan will face similar limits without significantly more investment — more doctors, more hospitals and stronger supply chains.

“You can’t declare universal healthcare,” she said. “You have to build it.”