Sheinbaum’s Health Proposals: Why We Should Take Them with a Grain of Salt

As Claudia Sheinbaum assumes the presidency of Mexico, her health agenda reflects a familiar refrain: continuity. Throughout her campaign and now in office, Sheinbaum has pledged to build on the previous administration’s healthcare policies, promising universal access, expanded infrastructure, and improved services for vulnerable populations. These are lofty goals, and on the surface, they may seem like the long-awaited solutions to Mexico’s longstanding healthcare challenges. However, a closer look reveals reasons to approach these promises with caution.

The cornerstone of Sheinbaum’s healthcare vision is the IMSS-Bienestar program, a continuation of an initiative introduced under her predecessor. Sheinbaum champions this as the key to delivering universal healthcare, asserting that it will eliminate barriers and provide comprehensive medical services to all. Yet, the track record of similar centralized systems raises doubts. Centralization has historically led to bureaucratic inefficiencies, slower response times, and a disconnect between local needs and national policy. By consolidating health services under a single entity, Sheinbaum risks repeating the mistakes of the past: overpromising and underdelivering. Universal healthcare is not achieved through blanket reforms but through meticulous planning, sustainable financing, and—critically—local adaptation. These are areas where the program’s framework remains worryingly vague.

Another hallmark of Sheinbaum’s health strategy is her commitment to increasing access to medications via her “Farmacias del Bienestar” ("Wellbeing" drugstores) program, slated for 2025. While the idea of distributing free medications sounds appealing, the proposed execution is riddled with concerns. The plan to co-locate these pharmacies with the Bank of Wellbeing (Banco del Bienestar) may seem practical on paper, but it overlooks the logistical reality that these branches are scarce and unevenly distributed across the country. Furthermore, the lack of trained personnel to manage these pharmacies raises serious safety issues. Medication distribution is not merely a logistical challenge; it requires trained professionals to ensure that patients receive the correct treatment. Without such safeguards, the program risks creating more harm than good.

Beyond access to services, Sheinbaum has also emphasized an ambitious expansion of healthcare for the elderly, involving thousands of newly hired health professionals conducting home visits. While well-intentioned, this initiative raises immediate red flags. The sheer scale of the program—20,000 professionals visiting households across the country—requires an operational infrastructure that Mexico’s health system currently lacks. More importantly, the capacity to effectively train, supervise, and deploy such a workforce is questionable. If history is any indicator, ambitious public health programs in Mexico often falter due to weak management, resulting in fragmented implementation and poor outcomes.

It is also worth noting Sheinbaum’s repeated commitment to continuing the policies of the previous administration. Continuity can be a double-edged sword. On the one hand, it avoids the disruption of starting from scratch. On the other, it perpetuates the inefficiencies and unfulfilled promises of the past. Under her predecessor, Mexico’s health system faced severe shortages of medications, substandard medical supplies, and an overburdened infrastructure. The fact that Sheinbaum’s proposals offer little in terms of innovation or substantial change should give us pause. Are we witnessing the birth of a more effective health system, or merely a repackaging of old ideas dressed up as reform?

In the end, Sheinbaum’s health policies are long on promises and short on concrete steps to ensure their success. The rhetoric of universal healthcare and expanded services is compelling, but without a clear, detailed plan for implementation, these promises may well remain aspirational. Mexico’s healthcare system is in dire need of reform, but reform requires more than political will—it requires a realistic assessment of the challenges ahead and a commitment to structural change. Until Sheinbaum’s administration provides a detailed roadmap for how it will turn these grand promises into reality, it is only prudent to approach her health policies with a healthy dose of skepticism.