Chapter 2. Measuring the administrative burdens of procedures in the Mexican Institute of Social Security
This chapter introduces administrative burdens triggered by procedures carried out in the IMSS. The first section shows the total aggregate administrative burdens by procedure version – in person, online and mobile application – and compares it to its total population. Furthermore, it includes the unitary and total administrative burdens organised by IMSS’ administrative area, with an emphasis on procedures that can be carried out through digital means. The chapter concludes with the Institute’s procedures that represent 81% of total administrative burdens.
Total administrative burdens
The total administrative burden is defined as the unitary administrative burden of the procedure multiplied by the number of times it was carried out during a given period (population). In turn, the unitary administrative burden of each procedure is the result of multiplying the handling time devoted by users by the value of the opportunity cost or salary of each type of user.
For the 84 procedures analysed,1 the total administrative burden, taking into consideration the population of procedures users, amounted to MXN 14 123 million. As seen in Figure 2.1, the largest share of the burdens (98%, equivalent to MXN 13 799 million), which the IMSS rights-holders and companies face, were originated by procedures carried out in the in person format. On the other hand, the administrative burden generated by digital procedures is barely 2%, equivalent to MXN 324.1 million.
Comparing the total burden with the number of applications submitted in 2017 (population) by submission mode, the procedures delivered through TICs generate a proportionally lower burden compared to the in person procedures; these results are an evidence of the benefits of digital procedures. Figure 2.2 shows that 2% of the total burden originated in the procedures carried out online, is generated by 17% of the total number of applications submitted in 2017. In addition, 0.2% of the total burden is produced by 2% of the requests made through the mobile application.
The information shown in Figure 2.2 suggests that the use of digital procedures is beneficial for users, since the administrative burden faced by users to perform procedures through these means is much lower, compared to the in person mode procedures. The information shown in Figure 2.3 confirms this conclusion: the average administrative burden of digital procedures is significantly lower. The in person mode generates, on average, MXN 94.4; on the other hand, the average administrative burden of the online process is MXN 9.5 and on mobile devices, MXN 8.7. On average, an in person procedure generates 10 times more administrative burden to the user than the on-line mode and 10.8 times more than the mobile application.
Note: The population of each procedure weights the average.
Figure 2.4 shows the total administrative burdens for each IMSS co-ordination, and Figure 2.5 shows the percentage contribution of each area. The following sections show, for each co-ordination, the unit burden for each procedure, as well as the population and the total administrative burden for each procedure.
It should be noted that the total burden per administrative co-ordination is only a reference for the procedures analysed, since, as already mentioned, the analysis does not include all existing procedures. Therefore, possibly other procedures whose cost was not calculated add significant burdens.
Considering this provision, the CAISPN is the administrative unit that accumulates the highest burdens with MXN 8 594 million, equivalent to 61% of the IMSS total burdens. In fact, the CAISPN and the CCEVD that accumulate MXN 11 675 million, represent 83% of the total burden. Figure 2.4 and Figure 2.5 show that while it is important to reduce burdens at the institutional level, the IMSS strategy to go on with administrative simplification should include the CAISPN and the CCEVD units. In any case, the final chapters will review the strategy of burdens reduction in procedures, which may include other co-ordinations.
Co-ordination of Affiliation
Total administrative burden by procedure
The Co-ordination of Affiliation (CA) is in charge of the initial contact between the IMSS and the companies and rights-holders, either to register them as employers or as new workers, or to assign rights-holders their Social Security Number (NSS). The CA has 48 procedures, only three of which were selected for this review: Employer’s Registration for an Individual or a Legal Person (IMSS-02-001-A and IMSS-02-001-C) and the Request for Assignation or Tracking of Social Security Number (IMSS-02-008).
The CA is the third co-ordination with the highest administrative burden of the IMSS, with 6.5% of the total burden. The three analysed procedures of this co-ordination shown in Figure 2.6 are among the ten procedures with the highest administrative burdens of the IMSS, and one of them is located within the four procedures that represent more than 80% of the total IMSS’s burden (see subsection below).
Total administrative burden by version
The CA procedures are available on digital versions. The IMSS-02-008 procedure can be done in person (at the window), online (IMSS Digital Services) or through the IMSS mobile application (IMSS Digital); procedures IMSS-02-001 A and C can be carried out in person or online.
Figure 2.7 shows the impact of penetration in the use of digital platforms on each CA process burden, and Table 2.1 includes the data on total administrative burdens and population for CA procedures. 86.2% of the applications (population) of CA procedures are submitted by digital means (online plus mobile application), which represent only 13.8% of the total burden of the co-ordination.
Table 2.1 shows that the online version of IMSS-02-001-A procedure has a population that accounts for 50.4% of this procedure population and the respective burden only represents 9.2%, which is another evidence of the benefits digital procedures offer users.
It also highlights that IMSS-02-008 procedure is intensively used in digital formats: 83.5% of the requests are submitted online and 3.1% through the mobile application. The total burden for each of these modes is 16.6% online and 1% through the mobile application. These data suggest that the benefits of simplifying and digitising CA procedures for users are clear.
Co-ordination of Comprehensive Health Care at the First Level
Total administrative burden by procedure
The Co-ordination of Comprehensive Health Care at the First Level (CAISPN) is responsible for the attention to rights-holders in their first contact with the IMSS regarding health issues. In this exercise, the administrative burden of four procedures was measured: Medical care in Family Medicine Units (FMU) (IMSS-03-011), Medical prescription of home oxygen (IMSS-03-014), Request for home medical care (IMSS-03-019) and Request for issuance of a death certificate (IMSS-03-020).
The CAISPN is the co-ordination with the highest administrative burden at the IMSS, with 60.8% of the total (see Figure 2.5), mainly due to the Medical Care in Family Medicine Units (FMU) procedure. This is the procedure with the highest burdens, since it accounts for 60.7% of the total burden of the procedures analysed, with MXN 8 573 million (see Figure 2.20) and 99.8% of the co-ordination burden (see Figure 2.8 and Table 2.2).
It was not possible to calculate the total administrative burden of IMSS-03-014 and IMSS-03-019 procedures, since there are no population records.
Total administrative burdens by version
The CAISPN has only one digitised procedure, the Medical Care in Family Medicine Units (FMU) (IMSS-03-011). It can be carried out through five different channels: In-person, In-person re-scheduled, Online, Mobile Application (App) and Telephone. During the estimation, it was identified that the appointment via telephone has the same cost as the online version.
Figure 2.9 shows that the largest share of administrative burdens for IMSS-03-011 procedure corresponds to the in person and in person re-scheduled versions (in which rights-holders are assigned a new appointment in the same medical consultation visit). Both amount to MXN 8 521 million. The number of requests related to this burden in 2017 constituted 94.5%, leaving 5.5% for digital modes and the telephone version.
Note: IMSS-03-011: Medical care in Family Medicine Units.
Table 2.2 shows the unitary burdens, the population that carries out the procedure and the total administrative burden, by each procedure version. Regarding IMSS-03-011 procedure, it is worth noting that the unitary burden of the in person re-scheduled mode is lower than the in person burden, since the user is already at the FMU and there are no administrative burdens for transfers. Likewise, the difference in unitary burden between the in person and the digital versions is significant. It also highlights that the use of digital options in this procedure is very rare. The intensification of efforts to promote digital versions of IMSS-03-011 procedure would result in reductions of administrative burdens for the user.
Finally, it was not possible to calculate the total burdens of IMSS-03-014 and IMSS-03-019 procedures due to lack of records on their population.
Co-ordination of Social Welfare
The Co-ordination of Social Welfare (CBS) is responsible for providing the rights-holders, as part of their social benefits, services aimed at promoting health, preventing diseases and accidents and contributing to the general increase of the population’s living standards. The most frequent procedure of the Co-ordination in 2017 was the Enrolment in Courses and Workshops on Institutional Social Benefits for IMSS pensioners (IMSS-04-001-B) with 131 470 applications (see Figure 2.10 and Table 2.3). Likewise, this is the most onerous procedure of the CBS, with MXN 18.2 million, which is equivalent to 75.1% of its total burden. The second most onerous procedure is the Enrolment in Courses and Workshops on Institutional Social Benefits for IMSS retirees (IMSS-04-001-A) with MXN 3.4 million, which is equivalent to 14.3% of the CBS’s burden.
The CBS is the second IMSS Co-ordination with less administrative burdens for the rights-holders (see Figure 2.5), however, currently, the Co-ordination does not have any digitised procedure, so the digitisation of some of its procedures may offer benefits for users.
Co-ordination of Vacation Facilities, Funeral Homes, Conventions Unit and Stores
The Co-ordination of Vacation Facilities, Funeral Homes, Conventions Unit and Stores (CCVVUCT) is responsible for the services the IMSS provides to the general public, such as funeral homes, vacation centres, the Convention Unit at the National Medical Centre Siglo XXI and the IMSS stores.
Three procedures were analysed for this report. The results are shown in Table 2.4 and Figure 2.11. The CCVVUCT has a total administrative burden of MXN 22.3 million. 95.2% of this burden derives from IMSS-05-003 procedure, with a population of 328 786.
Since these services are open to the public, users would greatly benefit from digitisation, mainly regarding IMSS-05-003 procedure,2 since there are digital platforms that offer similar services.
Co-ordination of Companies Classification and Validity of Rights
Total administrative burden by procedure
The Co-ordination of Companies Classification and Validity of Rights (CCEVD) addresses issues related to the IMSS services rights-holders can use or receive, as either consultation of validity of rights, issuance of a certificate of acknowledged weeks, or registration, data updating or de-registration from IMSS services. The CCEVD is the Co-ordination with the largest number of procedures and services considered for this review, accounting for 22 of the 87 procedures analysed.
The CCEVD procedures generate 21.8% of the IMSS total burden (see Figure 2.5 above). It has four of the ten IMSS procedures with the highest burdens: The Request for Validity Certificate of Rights of the rights-holder (IMSS-02-020-B), Request for Registration of the Son or Daughter at the FMU (IMSS-02- 066-J), Registration of Rights-holder or Pensioner at the FMU (IMSS-02-066-M), and Updating of son or daughter's data (IMSS-02-066-K), with 9.8%, 2.9%, 2.2% and 1.4% of the IMSS total burden, respectively (see Figure 2.20 towards the end of the chapter).
Figure 2.12 shows the total burden per procedure for this co-ordination, and Table 2.5 includes the population and burden data disaggregated by submission mode. The Unemployment Certificate and Authorization of Service in a Foreign District Upon Request of the Employer or Obligated Suspect (IMSS-02-019 modes A and B) were eliminated before 2016, so their total administrative burden is zero.
Total administrative burden by version
The CCEVD has 20 procedures that can be carried out online, including one that has a mobile application version (IMSS-02-025-A). 36.6% of the Co-ordination procedures are handled online, and account for only 1.7% of the total burden.
Figure 2.12 shows the five procedures with the highest total burdens of the CCEVD divided into their various versions.
The five CCEVD procedures with the highest burden are equivalent to 79% of the total burden of this Co-ordination’s procedures. However, the in person version constitutes 78%, while 1% corresponds to the online version. The average unitary cost of the in person version is MXN 192.4, while that of the online version is MXN 9.8, which means the former’s cost is 19.6 times the cost of the online version. The CCEVD has an area of opportunity to reduce administrative burdens significantly, by promoting the use of digital media.
Co-ordination of collection
Total administrative burden by procedure
The Co-ordination of Collection (CC) is responsible for collecting payments of social security contributions made by employers based on the IMSS business procedures. Three procedures were analysed for this report: Request for information on debit status (IMSS-02-096), Referenced Payments System (SIPARE) and Opinion on the fulfilment of fiscal obligations in the Social Security area (Opinion 32D).
Figure 2.14, Figure 2.15 and Table 2.6 introduce the results of the measurement process. The SIPARE is the procedure with the highest total burden of this Co-ordination. It is the system through which employers are assigned a capture line that is used to pay for IMSS social security contributions. It is worth mentioning that this is one of the three IMSS procedures with the highest burden, that amounts to MXN 876 million and accounts for 6.2% of the total IMSS burden.
Total administrative burden by version
The three CC procedures have a digital version. The SIPARE process starts online and allows employers to pay for their obligations either at the bank window or online. Currently, only 30% of payments are made online (population) and this represents 7% of the total cost of the procedure. IMSS-02-096 and Opinion 32D are the only IMSS procedures where 100% of the population is handled online (see Table 2.6 y Figure 2.15).
Co-ordination of Health Education
The Co-ordination of Health Education (CES) is responsible for issues related to educational services in the IMSS health area. Those physicians applying to enter as IMSS residents for a direct entry specialty, should initiate a Request for Mexican doctors to join the Mexican Institute of Social Security as interns Mode A) Candidates external to the IMSS for direct entry specialties (IMSS-03- 002-A). In 2017, the Institute received a total of 5 336 applications, so this procedure has the largest population and highest total burden of the CES, with MXN 14.1 million (see Table 2.7 and Figure 2.16). It should be noted that IMSS-03-001 and IMSS-03-004 procedures were eliminated in 2017.
Co-ordination of Economic Benefits
The Co-ordination of Economic Benefits (CPE) addresses the issues related to the economic benefits that workers and their beneficiaries are entitled to receive. Some of these are the following: pensions (retirement, old age, widowhood, disability, etc.), monetary aid (for marriage or funeral expenses), loans against a pension, pension settlements (to meet the assumptions of law or because of remarrying), or clarifications on pension payments.
Table 2.8 and Figure 2.17 show the results of the CPE administrative burden measurement. The CPE procedure with the highest burden is IMSS-01-002, which corresponds to the Request for a retirement, unemployment at an advanced age or at old age pension. It accounts for 28% of the CPE cost and is the second procedure with the largest population of the Co-ordination, with 323 990. The IMSS-01-015 procedure, Request for a loan against a pension under the 1973 Social Security Law regime, is the procedure with the largest population of the CPE, with 466 129, and is the second procedure with the highest administrative burden of the Co-ordination. It was not possible to locate IMSS-01-029-B procedure’s total burden because the CPE has no information on the population.
Upon completion of the analysis for this report, the CPE does not have any digitised procedures; however, the IMSS continues its simplification and digitisation efforts. Its short-term plan aims to, at least, have all its procedures available online in their initial stage and requiring only one visit to the window, to conclude the process.
Co-ordination of Occupational Health
The Co-ordination of Occupational Health (CST) is responsible for evaluating the disability or permanent disability conditions of workers or beneficiaries who have suffered an accident, and deciding when they can resume their activities. The CST operates three procedures: Appraisal and ruling on occupational risks (IMSS-03-008), Establishing disability status (IMSS-03-009) and Request for a ruling of disability for beneficiary son or daughter (IMSS-03-010).
Table 2.9 and Figure 2.18 show the results of the CST burden measurement process. IMSS-03-008 procedure is the most relevant of the Co-ordination, since through it workers can obtain a certificate of occupational disability, and with this, continue to receive their salary. It is one of the ten most onerous procedures, located in position 7, and it accounts for 1.4% of total IMSS burden. In 2017, the procedure was requested 709 465 times, amounting to total load of MXN 197.9 million, equivalent to 88% of the CST burden.
Co-ordination of Day-care Services for Comprehensive Child Development
Total administrative burden by procedure
The Co-ordination of Day-care Services for Comprehensive Child Development (CSGDII) is responsible for the process of admission of infants to the IMSS day-care centres. Four different profiles of rights-holders can make use of day-care services: female workers, widower workers, divorced workers and workers who have parental authority; all of them must be registered under the mandatory regime.
Table 2.10 and Figure 2.19 show the results of the CSGDII procedures burdens measurement process. All the procedures of this Co-ordination can be carried out in person at the IMSS day-care centres or be initiated online. IMSS-01-006-A procedure stands out, with a total population of 223 215, and accounting for 99.7% of the Co-ordination’s total burden, MXN 55.7 million. In contrast, the second highest total burden represents only 0.1%, MXN 90 111, and corresponds to IMSS-01-006-D procedure.
Total administrative burden by version
The four CSGDII procedures can be initiated online. This is the Co-ordination with the largest share of population performing the procedures online, with 50.3% (112 569). However, the unitary burden of the online version of the procedures is very similar to the in person mode. This is due to the fact that the citizen still has to carry out more than half of the procedure at the IMSS facilities (day-care centre and FMU). The procedures of this administrative area cannot be carried out in a completely remote fashion, since users must visit the day-care centre for an informative session.
Procedures with the highest administrative burden
The four procedures shown in Figure 2.20 account for 81% of the IMSS total administrative burden, which constitutes just over MXN 11.4 billion. The Medical Care in Family Medicine Units (FMU) (IMSS-03-011) is the procedure with the highest total burden: MXN 8 573 million and alone represents 61% of the IMSS total burden.
The procedures shown in Figure 2.20 are already digitised; however, the use of digital versions is still not frequent. Only 18% of these procedures were carried out through digital means in 2017. This suggests the potential impact of promoting the use of digital channels of these procedures on the potential total burden. Chapter 4 describes the potential impact of burden reduction under a more frequent use of the digital mode scenario in IMSS procedures.
Summary of the key messages in this chapter
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The unitary administrative burden of each procedure is the result of multiplying the handling time users dedicate to the procedure by the value of the opportunity cost or salary of each type of user.
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The total administrative burden is defined as the unitary administrative burden of the procedure multiplied by the number of times it was carried out during a given period (population).
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The total administrative burden of the 84 procedures analysed (there were no population records for three procedures) was MXN 14 123 million. 98% of these burdens were originated by procedures carried out in person and 2% were generated by digital procedures.
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The procedures carried out through TICs at the IMSS generate a proportionally lower burden compared to the in person procedures: 2% of the burdens derive from digital procedures, which involve 17% of the population of procedures users. In contrast, 83% of the population that conducts the procedures in person, face 98% of the IMSS procedures burden.
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The use of digital procedures is beneficial for users, since the administrative burden they face for carrying out procedures through this means is much lower. The average administrative burden of digital procedures is significantly lower. The in person procedures generate, on average, MXN 94.4; on the other hand, the average administrative burden of online procedures is MXN 9.5 and on mobile devices, MXN 8.7.
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On average, an in person procedure produces 10 times more administrative burden for the user than online mode and 10.8 times more than the mobile application.
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The procedures of two IMSS co-ordinations accumulate 83% of the charges generated: the CAISPN and the CCEVD.
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Four procedures concentrate 81% of the total IMSS burdens: IMSS-03-11, IMSS-02-020-B, SIPARE and IMSS-02-008, so that future efforts to reduce burdens at the IMSS should include them as a priority.
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Evidence shows that the unitary administrative burden of the IMSS online or mobile application modes of the IMSS co-ordinations analysed is significantly lower, with the exception of the CSGDII, in which the user still has to visit the offices several times despite starting the process online.
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In addition, with some exceptions, evidence shows that the use of digital procedures modes is not frequent among IMSS users.
Reference
SCM Network (n.d.), “International Standard Cost Model Manual, Measuring and reducing the administrative burdens for businesses”, Standard Cost Model Network, http://www.oecd.org/gov/regulatory-policy/34227698.pdf.
Notes
← 1. As mentioned in phase 3 of Annex 1.A, administrative burdens could not be estimated for three formalities out of the 87 selected for the review due to a lack of information on the population carrying out the procedure.
← 2. Reservations can be made for the Vacation Centres and the Convention Unit through the IMSS call centre.