Diagnosis: chronic statism, prognosis: acute inefficiency

Nothing hurts more than getting sick and having to wait for the budget to arrive…, Macraf

One of the main problems facing the current administration, a direct legacy of the mistakes made by the previous government, is the deterioration of the health sector. During Andrés Manuel López Obrador's six-year term, the country faced one of the most severe pandemics in recent times. This forced the government to open its eyes to the enormous deficiencies of the system: lack of infrastructure, low salaries for medical and nursing staff, and a clear refusal by the government to hire more personnel or adequately staff institutions.

The central argument was the same as always: there was corruption in the purchase of medicines and within health institutions. The result is clear: today we have a collapsed system. Anyone who has set foot in a public clinic can attest not only to the shortage of medicines, but also to the deplorable conditions under which much of the system operates.

One of the most sensitive issues has been the distribution of medicines. The shortage continues. Although the former president repeatedly denied its existence, he also promised that it would soon be resolved. The contradiction has reached the new government, which claims there is no shortage, but is working to reverse it.

A digression is in order here. Although I have been highly critical of these decisions, I must acknowledge that some recent actions appear to be a good first step. The implementation of a reverse auction mechanism for the purchase of medicines generated, according to official data, savings of approximately 12 billion pesos. The measure was announced at the president's morning press conference and celebrated by the undersecretary of health. If these resources are effectively reinvested in health, they would directly benefit citizens. In that sense, it is a public policy worthy of expansion.

However, the optimism was short-lived. A week earlier, at the conference, it was announced that, starting with the biennial drug procurement in 2026, participating pharmaceutical companies would be required to demonstrate their investment in the country. The logic behind this decision, according to them, is simple: if the government spends 150 billion pesos on medicines every two years, it wants some of that money to stay in the country.

At first glance, this sounds good. Tax incentives and facilities for companies investing in Mexico were even announced, with special emphasis on the role that BIRMEX, the state-owned vaccine producer, could play. But several questions arise here. Who is the State to determine where and how a company should reinvest its profits? Investment decisions are based on criteria of efficiency, profitability, and the regulatory environment, not ideological decrees.

Forcing foreign investment under this logic doesn't promote development; it distorts it. If we truly want to attract productive capital, what we need is a stable business environment, clear rules, infrastructure, and legal certainty. We shouldn't impose requirements reminiscent of failed models of the past.

Furthermore, why maintain a state-owned company to produce vaccines? What justifies the state assuming a productive role in sectors where the market has proven more efficient? The recent experiences with Pemex, CFE, and the failed Gas Bienestar are examples of the high fiscal cost and low profitability of these public ventures.

The attempt to resolve a problem as delicate as access to medicines through statist policies and pressure mechanisms is not only inefficient, it's irresponsible. They are attempting to cure the cancer of the healthcare system with the same formulas that afflicted it decades ago.

While all this is happening, reality sets in. Those who continue to bear the brunt of the lack of medicines, personnel, and infrastructure are the citizens. Those who, day after day, face the frustration of not finding timely medical care. Instead of focusing on the urgent needs of the present, plans are being made for 2026… as if time were standing still or patients could wait.

In this way, we continue to live among glittering figures and pockets that are not deep enough.

* The author is a professor at the School of Government and Economics and the School of Communication at the Universidad Panamericana, an expert consultant on economic, financial, and government issues, general director and founder of the website El Comentario del Día, and the host of the analysis program Voces Universitarias.

Contact and social media: https://eduardolopezchavez.mx/redes