Seguro Popular and private initiatives of health insurance for rural population in Mexico: incompatibility or complementarity?

Since 2003, the law in Mexico, through the System of Social Protection in Health, has forced the implementation of the universal right to health proclaimed by the Constitution. This means an access for people who remained without protection for a long period of time. People who currently don't dispose of any Social Protection can access the "Seguro Popular"(SP), which covers an extended range of primary and secondary care and some tertiary care. In its early years (2004), the SP cared only for 1.5 million families which where affiliated; in 2010, this turned to 42.5 individuals. The money injected by the SP in the country's health units has permitted better attention for people in need of healthcare, especially for people located in marginalized regions. In this context, the private initiative of microinsurance concerning health care seems irrelevant as well as non-viable. Nonetheless, in spite of the SP, Microfinance Institutions that develop these initiatives continues to observe, in their targeted affiliated population, a true impoverishment due to catastrophic costs in health. They argue that a effective solution to compensate for the timid results from the public sector is to implement, in partnership with traditionnal insurance companies, microinsurance products which impacts in the reduction in the vulnerability to health risks in rural homes. They precise that private microsinsurance initatives have to be complementary to the public security system because the SP is constant and permanent. Many solutions are presented in that perspective. Because important expenses that come from healthcare (transport, lodging, disability) aren't considered by the SP, they are perceived as a niche market for microinsurance. The insolvable lack of specialists in marginalized areas proved by the public experience is another one. Microinsurance can provide its users to access more easily the services by means of long distance medical attention and telemedicine