privately employed. The country has adopted a pluralistic approach to its healthcare industry, allowing both public and private healthcare providers' participation. The three components that make up the industry are: the social security institute, government services for those uninsured and the private sector that literally means out-of-pocket investment in exchange of coverage.
In accordance with the Secretariat of Health, the government services provide free healthcare assistance to all in the rural areas. For the entire country, emergency, vaccination and oral rehydration are provided free of charge. In the 10 years that span from 1985 to 1995, 41% more public hospitals have been built. Private hospitals here tend to be small and expensive. Majority of them don't have space to accommodate 14 beds and half of them have no more than 5 beds.
Despite all the new hospitals and modern facilities, more than 1 in 10 Mexicans are not able to access health care services. The primary reason is finance -- medication and treatment related expenses are high in relation to the average income in Mexico and most Mexicans do not have sufficient savings. The other reason could be geography related, which is especially true for rural areas that may be too far from the city or transportation to get to the medical facilities. One other factor here is that there could be mistrust or poor service that could discourage patients looking for help. The cost of not being able to access health care services is high and represents some of the major challenges for the Mexican health authority.
Legislation wise, Article 4 of the Constitution guarantees that all Mexican citizens are entitled to free or subsidized healthcare. Public medical help is either fully or partially subsidized by government funding, subject to the patient's employment status.
Additionally, citizens who are employed in the private sector can further qualify for the health care program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (English: Mexican Social Security Institute). The fund is financed by employee, its private employer, and the federal government.
This IMSS does not cater for the public sector servants. Those who work in the public sector look to the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (English: Institute for Social Security and Services for State Workers), which takes care of the healthcare needs of government employees. All government employees are grouped here, regardless of local, state or federal level.
Mexico still ranks low in term of health status and health care availability among the OECD countries. From healthcare expenditure perspective, at US$675 per capita, this number is only 25% of OECD average.