By MARK LORENZANA

On Tuesday, April 26, Mexico’s Chamber of Deputies — the majority bloc of which is composed of legislators from Mexican President Andrés Manuel López Obrador’s (AMLO) leftist ruling party, the National Regeneration Movement (Morena) — approved a reform to the General Health Law, which fast-tracked the closure of the Institute of Health and Well-Being (Insabi).

The irony of the Insabi’s shuttering at the hands of Morena legislators is that it was the López Obrador administration that originally established the agency on Jan. 1, 2020, effectively replacing the Seguro Popular — a public policy that sought, through public health insurance, to provide financial protection to Mexicans who lacked social security, ensuring their access to health services.

Former Health Secretary Salomón Chertorivski, who served under Mexican President Felipe Calderón from 2011 to 2012, said that López Obrador’s decision to replace the Seguro Popular was one of the biggest blunders of the AMLO administration — and that the closure of its replacement, the Insabi, is an admission of the agency’s failure.

“Removing the Seguro Popular was one of the worst decisions that López Obrador has ever made. As one of the consequences of this, as a country we regressed four years in life expectancy at birth. Never in the history of our nation has this happened,” said Chertorivski during the debate at the San Lázaro Legislative Palace on Tuesday, where he now serves as a deputy for the Citizen’s Movement Party (MC). “Out-of-pocket spending on health increased 40 percent. Three thousand children died because cancer medicines were not available. And this failure as a whole might cost even more lives.”

Likewise, for Octavio Gómez Dantés, a public health expert, the Insabi closure was “simply the announcement and the formalization of a failure.”

“The Insabi was born dead due to a lousy design and disastrous implementation,” said Gómez Dantés, in an interview with Mexican daily newspaper Reforma. “Now the death of that agency is formalized, and the responsibility is transferred to the IMSS-Bienestar.”

The Health Services of the Mexican Social Security Institute for Welfare, simply known as IMSS-Bienestar, is a decentralized public body of the Mexican government, previously a decentralized program of the Health Secretariat, administered by the Mexican Social Security Institute (IMSS).

Opposition groups in the Chamber of Deputies have criticized the fast-tracking of the Insabi’s closure — headed by Morena and its satellite parties, the Labor Party and the Green Party — “without discussion, without dialogue and knowing that the Insabi was a disaster,” according to Margarita Zavala, a member of the Chamber of Deputies for Mexico City’s 10th District since 2021.

Chertorivski, for his part, also zeroed in on the decision by Morena lawmakers to unfairly place the burden of the Insabi’s closure on the IMSS-Bienestar.

“When the ‘invention’ that they made failed, and now they made it disappear as a result, they clearly recognized its failure,” said Chertorivski, “but instead of studying and analyzing the errors, what they will do is transfer those same failures to another institution, the IMSS-Bienestar.”

Ignacio Mier, Morena’s parliamentary coordinator in Congress, lamented the creation of the Insabi, but said that “it is always good to rectify wrongs, it is never too late.”

“The institute (Insabi) had the resources — we approved it — but the states lacked the infrastructure and resources to operate,” said Mier. “I believe that this time, a cooperation between Mexican states and the federal government should materialize in an instrument of well-being, and that is the IMSS-Bienestar.”

Mexican Interior Secretary Adán Augusto López Hernández — who is filling in for López Obrador, while he recovers from his third bout of covid-19 — said in a press conference on the morning of Wednesday, April 26, that he believes the closure of the Insabi actually benefits the IMSS-Bienestar, which will be “strengthened” as a result.

“It (the IMSS-Bienestar) will be strengthened, because it is supported by the Mexican Social Security Institute, which had been strengthening the agency over the years,” said López Hernández. “With the IMSS-Bienestar system, all Mexicans will have access to free healthcare.”

But for political commentator F. Bartolome, in his Wednesday column for Reforma, Morena’s decision to move on from the Insabi to the IMSS-Bienestar is a ruse, “tacking on more work to the IMSS by adding the surname ‘Bienestar,’ but without providing it with the necessary resources, personnel or facilities.”

“The government of Andrés Manuel López Obrador led Mexico’s health sector to a crisis never seen before: medicine shortages, 45 million unfilled prescriptions, a pandemic that killed countless Mexicans, millions of people without medical coverage, desertion of Mexican medical personnel due to poor conditions and hiring Cuban personnel to try to fill in the gaps (and incidentally sending money to Cuba),” Bartolome wrote.

“And at the same time, the president was disregarding national health professionals, even accusing them of being mercenaries. The last straw is that to create the Insabi, Seguro Popular disappeared, which was far from perfect, but it was a young and functioning institution that could have been improved. But the president doesn’t even care because, after all, he and his family are treated by military doctors.”