House by House, a step in the right direction

Many of those with access to medical services, especially private ones, tend to belittle and even mock programs like Salud Casa por Casa (House-to-House Health). They're right, if they're measured by the standards of a private hospital or even a well-equipped doctor's office. But if they're understood for what they are—a public policy of support and dignity for those without—the judgment is different. You can criticize the design, but you can't ignore the void they seek to fill.

The program, promoted by President Claudia Sheinbaum, represents a real difference in public healthcare. Never before has a Mexican government designed a national strategy to bring doctors, nurses, and medications directly to the homes of elderly or disabled people. There were precedents in the 1970s with the IMSS-Coplamar in rural areas and more recently in some municipalities in Mexico City, but never with this scale, coverage, or preventive ambition.

Before this program, more than 50 million people lacked social security. Free medical care was an empty promise for those who lived far from a clinic or couldn't afford the trip. The failure of Seguro Popular and INSABI only worsened the backlog. In this context, medical brigades beginning to visit homes and collect medical records has undeniable value.

As of July 1, the program has surveyed more than 9 million people and provided more than 800,686 home visits with complete medical records. It operates in all 32 states, although with uneven progress. In Michoacán, for example, more than 52,000 visits have been made; in Nayarit, 12,000. Most states have not published clear figures, making it difficult to measure actual coverage.

The model has a preventive approach: detecting diseases before they become complicated, addressing serious cases, and reducing unnecessary hospitalizations. It also acts as an epidemiological surveillance system: it was thanks to it that the measles outbreak in Chihuahua was detected. Furthermore, it allows for continuous care for those unable to access a medical unit. But it faces serious obstacles.

The staff is overburdened: each nurse handles up to ten visits per day, often without the necessary supplies. Not all of them have training in home care or geriatrics. And referring a seriously ill patient to a hospital is of little use if that hospital is overcrowded or undersupplied.

There's also a shortage of resources. The 7 billion peso budget for 2025 could fall short if it's intended to regularly serve 14 million people. And the integration with the Farmacias del Bienestar (Wellness Pharmacies), which should guarantee medication, is still not complete.

Logistics is another issue. There are areas without passable roads, others where insecurity prevents brigades from entering, and not all addresses on the Welfare registry are up to date.

House-to-House Healthcare is a serious intervention that seeks to correct decades of neglect. But it is far from sufficient. Its success will depend on its ability to sustain itself over time, adapt to obstacles, and articulate with a still-broken hospital system. For now—and only for now—it represents a step in the right direction.

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