However, those unaffiliated have to pay out of pocket to attend Ministry of Health services or private health facilities, which provide a third
of the hospital beds in the country. Over half of private facilities are located in Mexico City [25]. In general, affiliates to one scheme do not
have access to others [26]. Mexico has among the lowest public spending on health care of OECD countries. In 2010, total health spending
accounted for 6.3% of GDP of which 53% is financed from private expenditures [27]. Furthermore, according to an OECD study, the Mexican
health system is among the least efficient. Reasons for this include inequitable health insurance coverage among lower income groups,