The health care workers' union is ready to strike on Sunday potentially creating a crisis situation in hospitals across the nation if a deal on retirement rules isn't reached soon. The Social Security Medical Institute (IMSS) and the union representing 400,000 health care workers have been engaged in negotiations for more than a year over legislation that would curb health workers' retirement benefits. When talks broke down earlier this month, IMSS Director Santiago Levy resigned. President Vicente Fox immediately named Fernando Flores to replace him. Although negotiations have resumed, there has been no sign of progress. If an agreement isn't reached, the strike is scheduled to begin when the clock strikes 12 on Saturday. 

If a strike occurs, 4,000 hospitals and clinics could be affected nationwide. On a daily basis, IMSS sees an average of 388,000 patients, and performs 3,000 surgeries and 1,400 births. After a brief meeting Thursday between union and IMSS representatives, union leaders returned to a closed-door session with 900 member delegates to discuss their options. The session continued until late into the night. Strikes have been threatened since last year. In July of 2004, the Chamber of Deputies approved a package to scale back the workers' retirement benefits. While the measure was approved in the Senate and then signed by Fox, in August the health care workers' union challenged the reforms in court. A verdict has not yet been reached.

IMSS has argued that the pension and wage burden stipulated by the union contract is unsustainable. "This is a problem that has been dragging on for years, and as time passes it keeps getting worse," said Oliverio Duque, coordinator of public information at IMSS, regarding workers' retirement package. He said the reforms being discussed include extending the retirement age and increasing the number of years future employees must work in order to retire. Under current rules, women can retire after 27 years of service and men after 28, regardless of age. Francisco Gasca, now retired, worked as an auditor at IMSS for 33 years. He doubts that the only financial liability for the institute is its obligations toward workers. "The truth is that high-level managers earn wages beyond the stratosphere," he said. "The workers' pensions would not be such a problem if they didn't spend so much at the top." According to Duque, management wages are adjusted to meet federal guidelines. While worker benefits have deteriorated throughout Mexico in recent years, Raúl Trejo Delarbre, a sociologist at the National Autonomous University (UNAM), said that government affiliated employees, such as those at IMSS and the state-run oil and electricity companies, still enjoy generous benefits. However, Trejo also said that the overall budget for healthcare delivery at IMSS "is inadequate. 

There are a lot of deficiencies in patient care." Part of the problem is that the country hasn't decided on a health care model. "In Canada and Europe, they pay a very high premium, and the (government sponsored) health care is high quality. In Mexico we pay lower premiums, and the result is that the quality of care is also lower," he said. "As a society, we haven't been willing to commit the resources needed for superior care." In order to meet budget guidelines, IMSS has had a freeze on hiring since last year, according to information obtained by EL UNIVERSAL. Seventeen-thousand positions have not been filled, which the union argues, negatively impacts patient care.

IMSS management has denied implementing a hiring freeze. Adriana Díaz Moreno, who has worked as a radiology technician for 22 years at IMSS, complains about under-staffing and an increase in the use of temporary workers. Díaz said that the institute wants to take away benefits won by the union through years of struggle. But she also says that the union hasn't been very effective in communicating with the work force about the current negotiations. The prospect of a strike makes her nervous. "I'm a single mother, I can't afford to go without a paycheck for more than two weeks," she said. "Very few workers have the money saved up to withstand a strike." IMSS is financed 25 percent by federal funds, with the remainder of the budget coming from employer contributions. The Mexican constitution requires that all businesses pay into the fund to provide health coverage for their employees.