For the roughly seven in 10 Mexicans who rely on public hospitals, a long wait is not a story about the other side of a broken medical system. It is the system.
When Lucca Peguero Gómez Vidrio, a 14-year-old student, had a urinary problem about a year ago, he went to Hospital San Javier, a private hospital in Guadalajara. He was told the same day: nothing serious, fairly common. "The physicians attended to me very quickly," he said. In public hospitals, though, he added, "people have to wait for months for operations they need urgently."
"Patient care is terrible," said Alejandro Orozco González, a 15-year-old who broke a finger and was treated in a public hospital two years ago. "Even if you have a very serious and urgent problem, you have to wait behind hundreds of people. There are also very few workers because the government hasn't been investing much in public health lately. I think most Mexicans would agree with my opinion." Private care, in his experience, was a different world: "excellent, because there are many staff and fewer patients."
Mexico runs two healthcare systems in parallel. Public insurance—chiefly IMSS and ISSSTE—provides care at little or no cost. Private care is paid out of pocket or through private insurance, in exchange for speed. According to a study by the Mexican Institution of Public Health, public patients needing surgery wait around 14 weeks on average, while private patients can often see a specialist within days and schedule surgery within a couple of weeks.
Counterintuitively, most Mexican hospitals are private. As of 2024, of nearly 4,000 hospitals nationwide, about 64 percent were private and 36 percent public, according to a Commonwealth Fund country profile.
But hospital counts are misleading. Public hospitals still deliver 70 to 80 percent of all health care nationally, because they carry the bulk of the population; only 25 to 30 percent of Mexicans use private facilities, paid for through insurance or out of pocket. Private insurance covers just under 15 percent of the population, often higher earners who already have public coverage and receive private insurance as a job benefit.
That tension between free and fast played out for Marisol Rojas, a 39-year-old enrollee in public healthcare insurance. Rojas had to wait about 40 minutes in an emergency room in September 2025, just for staff to begin the intake process. The whole process of care was, needless to say, “painful and unnecessarily long and complicated.”
On paper, public care is a bargain. A finger splint that runs $30 to $150 privately, or a pneumonia consultation that costs about $100 with a private specialist, is free through IMSS or ISSSTE. The tradeoff is the wait, and often the quality.
Free care in Mexico is no help to those the system never reaches. In 2025, about 22.4 percent of Mexicans—roughly 30 million people—had no public financial protection to use public services free of charge, and likely no private insurance either, according to the Commonwealth Fund.
Part of the strain traces to how little Mexico spends. It devotes about 5.5 percent of its GDP to health, or roughly $1,368 per person adjusted for purchasing power, against 8.68 percent of GDP and about $5,084 per person in South Korea, according to World Bank data.
The workforce is thin, too. Mexico has about 2.6 physicians per 1,000 people, well below the OECD average of 3.4 physicians per 1,000, roughly a quarter below the OECD norm, according to the WHO. And those doctors are not spread evenly: density ranges from 2.14 per 1,000 in the Baja California to 5.64 in Mexico City, pointing to a geographic inequality layered on top of the economic one.
Javier De La Cabada Bauche, an internist and infectious-disease specialist at Hospital Angeles Andares, framed the problem structurally. A health system's effectiveness, he said, "depends on access to resources when the population needs the service,” enough trained staff and infrastructure to care for people "from infancy to death." In Mexico, "since it's a national system with budget cuts, this creates a deficit in personnel as well as in infrastructure," and "the patient with fewer resources is always the most affected."
Expanding public care increases access, De La Cabada Bauche said, but not necessarily quality: "you can end up with many primary care centers without the resources to implement prevention and chronic disease treatment programs." The root cause, in his view, is money and how it is collected: "Budget diversion, cuts to the national budget, and the low rate of people who pay taxes." Reform the tax system and raise the budget, he added, and public care could improve.