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Achieving Higher Performance: Enhancing Spending Efficiency in Health and Education in Mexico

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  • Cyrille Schwellnus

Abstract

Despite progress over the past two decades Mexico?s health and education indicators remain well below the average of the OECD and some of its Latin American emerging market peers. Health insurance coverage is incomplete, especially for low-income families, and access to health services is highly uneven. There are several separate vertically integrated insurance networks, which increases administrative costs and results in an inefficient use of facilities. In education, lower secondary schools enroll only two thirds of the relevant age group and the quality of education is low, as indicated by poor PISA scores. This reflects poor teaching quality, a consequence of non-transparent teacher selection processes until recently, and limited school autonomy in budgeting, instruction and personnel decisions. Accountability to the government and parents is also low as there is no national exit exam after secondary education and the existing evaluation schemes are fragmented. Recent health and education reforms have started to address these issues, but more needs to be done to increase the efficiency of spending by increasing the coverage of health insurance, reducing the fragmentation of the health system, increasing enrolment in lower secondary education, and improving the quality of teaching. Améliorer les performances : renforcer l'efficience des dépenses de santé et d'éducation au Mexique Malgré les progrès réalisés ces vingt dernières années, les indicateurs du Mexique dans les domaines de l’éducation et de la santé restent nettement inférieurs à la moyenne OCDE et aux indicateurs de certains pays émergents d’Amérique latine. La couverture par l’assurance-maladie est incomplète, en particulier pour les familles à bas revenu, et l’accès aux services de santé est très inégalitaire. Plusieurs systèmes d’assurance verticalement intégrés coexistent, ce qui accroît les coûts administratifs et empêche une utilisation efficiente des services. Dans le domaine de l’éducation, seuls deux tiers des enfants en âge d’être scolarisés dans le premier cycle de l’enseignement secondaire le sont effectivement et la qualité du système éducatif laisse à désirer, comme en témoignent les mauvais résultats obtenus dans le cadre de l’enquête PISA. Cette situation résulte d’une mauvaise qualité de l?enseignement, qui s’explique par le manque de transparence qui, jusqu’à une période récente, caractérisait les procédures de sélection des enseignants et par le manque d’autonomie des établissements scolaires sur les plans du budget, de l’enseignement et des décisions relatives au personnel. La responsabilité du système éducatif vis-à-vis du gouvernement et des parents est également limitée du fait qu’il n’y a pas d’examen de fin d’études au terme de la scolarité secondaire et que les systèmes d’évaluation existants sont fragmentés. Les réformes engagées récemment dans les domaines de la santé et de l’éducation ont commencé à remédier à ces faiblesses, mais des efforts supplémentaires s’imposent pour améliorer l’efficience des dépenses en étendant la couverture par l’assurance-maladie, en réduisant la fragmentation du système de santé, en augmentant le taux de scolarisation dans le premier cycle du secondaire et en améliorant la qualité de l’enseignement.

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File URL: http://dx.doi.org/10.1787/220731242856
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Bibliographic Info

Paper provided by OECD Publishing in its series OECD Economics Department Working Papers with number 732.

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Date of creation: 03 Nov 2009
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Handle: RePEc:oec:ecoaaa:732-en

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Keywords: data envelopment analysis; health policy; Mexico; education policy; politique d'éducation; analyse d'enveloppement des données; politique de santé; Mexique;

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Cited by:
  1. Sharon Hadad & Yossi Hadad & Tzahit Simon-Tuval, 2013. "Determinants of healthcare system’s efficiency in OECD countries," The European Journal of Health Economics, Springer, Springer, vol. 14(2), pages 253-265, April.

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