44.5 million people lacked access to health services in 2024. Although this was an improvement from 50.4 million in 2022, it remained substantially higher than the 20.1 million recorded in 2018. The indicator identifies people who reported no affiliation or right to receive medical services from a public or private institution; it does not mean that every one of them was completely unable to obtain medical care.

Mexico spends approximately 2.8% of GDP in public funds on healthcare. That is less than half the 6% benchmark cited by the researchers. Total healthcare spending, including public and private expenditure, was approximately 5.5% of GDP in 2023. The report identifies chronic public underfunding as a major obstacle to improving healthcare services.

Excessive medical expenses affect millions of Mexican households. In 2024, the quarterly incidence of catastrophic or impoverishing healthcare expenses reached 4.2% of households. The report estimates that this equates, on an annualized basis, to approximately 5.7 million households. The incidence increased by 73% between 2014 and 2024. Catastrophic spending exceeds 30% of a household's capacity to pay, while impoverishing spending pushes a household below the subsistence threshold or deepens existing poverty.

Mexico has significantly fewer hospital beds than the OECD average. The country has approximately 1.1 hospital beds per 1,000 residents, compared with an OECD average of 4.3. The report also documents limited diagnostic and treatment equipment, including approximately 7.2 CT scanners, 2.9 MRI machines, and 1.7 radiotherapy units per million residents.

Healthcare staffing remains below OECD averages. Mexico has approximately 2.5 doctors and 2.9 nurses per 1,000 residents, compared with OECD averages of 3.7 doctors and 9.2 nurses. Mexico's nursing workforce is particularly limited, with fewer than one-third as many nurses per capita as the OECD average.

Many healthcare professionals work under precarious employment conditions. In 2022, approximately 75.5% of doctors and 67.3% of nurses experienced at least one condition classified as precarious. These included inadequate pay, missing employment benefits, lack of written contracts, and unusually short or long working hours.

Approximately 82 million prescriptions went unfilled in public healthcare institutions between 2019 and 2023. The report also identifies problems with pharmaceutical procurement and distribution that affect the availability of prescribed medications. Approximately three-quarters of spending on medicines is paid directly out of patients' pockets.

Diabetes treatment outcomes remain poor despite high treatment rates. Diabetes affects approximately 14.4 million people, equivalent to 18% of Mexico's adult population. Although 90.9% of diagnosed patients receive treatment, only about one-third achieve adequate disease control. The transition from Seguro Popular to Insabi and subsequently IMSS-Bienestar was associated with a 14.8% increase in avoidable diabetes hospitalizations and a 3.2% decline in the proportion of patients whose diabetes was controlled.

Early-stage breast cancer diagnosis is more common in private healthcare institutions. The researchers examined 15,427 women treated at six institutions between 2012 and 2022. Private institutions diagnosed 42.9% of cases at an early stage, compared with 27.4% in social-security institutions and 18.1% in facilities serving patients without social security. However, the leading public cancer centers included in the study achieved survival outcomes comparable to private institutions once patients received treatment.

Mexico records more than 400 avoidable deaths per 100,000 residents. That is nearly three times the rates reported in Japan and Switzerland. Maternal mortality also increased from 44.1 deaths per 100,000 live births in 2018 to 76.4 in 2021. The increase began in 2019, before the COVID-19 pandemic, and accelerated during the pandemic. In 2024, late maternal deaths accounted for 32.7% of maternal deaths among women with social security, pointing to weaknesses in postpartum follow-up.

Healthcare coverage has deteriorated sharply in communities with high or very high social deprivation. In these municipalities, the percentage of households without health insurance increased from 6.2% in 2018 to 62.7% in 2024. The researchers also documented substantial geographic and socioeconomic inequalities in healthcare access and financial protection.