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From Universal Coverage to Universal Quality

By Maureen Bisognano | Friday, August 2, 2013

Two weeks ago, I was in Mexico City for a Latin American Summit on quality improvement and population health. While there, I had the great pleasure of visiting the beautiful Mexican Ministry of Health building, an elegant stone structure constructed in 1925. What I loved most about the building was its symbolic message. Walking through the main entrance you have two options: on one side is a wing focused on clinical care; and on the other a wing devoted to prevention and public health. Nearly nine decades ago the building’s designers recognized the importance, and connection, of both clinical care and overall wellness! The message the design conveys is clear: we’ve got to do both well.


As I toured the Ministry of Health building I couldn’t help but wonder what the health of populations in Mexico and elsewhere would look like today if the holistic vision embodied by the architecture had taken hold and become rooted in our cultures.


Unfortunately, throughout most of the world today too many resources go to “sick care” rather than prevention and wellness. Tens of millions of men and women around the globe have fallen into lifestyles and habits that lead to poor health and disease. While in Mexico City, news came that Mexico has overtaken the United States in the incidence of obesity. These challenges are becoming increasingly common, highlighting the need for information sharing and two-way learning.

LEARN MORE: Leading Population Health Transformation, Feb. 22-24, 2017, in San Diego, California

At the same time, I was impressed by much of the work being done in Mexico and throughout Latin America to improve health. I spoke to more than 500 delegates (thousands more attended virtually) at the Latin American Summit, which was convened jointly by Mexico's Ministry of Health, the National Academy of Medicine of Mexico, and IHI. I was privileged to share some of IHI’s latest thinking on the importance of a broader understanding of care and health, and was able to hear about so much inspiring work being done around the globe.


One of the most encouraging signs coming out of this Summit was the remarkable progress many Latin American nations have made toward universal health coverage. The World Bank noted this impressive trend in a February article pointing out that Latin American countries are currently "leading the charge" in the direction of universal coverage.


In Mexico, for example, Seguro Popular (popular health insurance) has achieved universal coverage in less than 10 years, with more than 50 million previously uninsured citizens now covered – an amazing achievement.


Now the challenge for Mexico, as for so many countries, is to strive toward realizing the vision represented by the powerful symbolism in their health ministry building: integrate great clinical care with a broader and deeper understanding of health, prevention, and wellness to move from universal coverage to universal quality.

-Maureen Bisognano

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