Anonymous - 9-13-2005 at 11:19 AM
http://www.azcentral.com/news/articles/0911mexico-health11.h...
by Richard Marosi
Sept. 11, 2005
TIJUANA, Mexico - Thousands of Hispanics who live near the border are taking advantage of a benefit increasingly offered by their U.S. employers: less
expensive health care in Mexico.
About 160,000 California workers - farm laborers as well as working-class Hispanics employed at hotels, casinos, restaurants and local governments in
San Diego and Imperial counties - are getting their annual checkups and having surgeries through health networks south of the border, insurers say.
The arrangement is less expensive for employers and employees. In Mexico, health care costs are about 40 percent to 50 percent lower than in
California, freeing some employers to offer services that they couldn't afford otherwise.
"It's a win-win situation for me. I'm able to offer it to everybody, and my premiums went way down," said Mark Holloway, part owner of a department
store in Calexico, Calif.
He said he can sign up four employees, each at $100 monthly, for the same price as one employee in a U.S. plan.
Employees enjoy lower premiums and co-pays, typically $5, and the comfort and convenience of describing their aches and pains in Spanish to doctors
who, they say, tend to take more time with them.
"The rate is good, the service is good," said David Ouzan, a city councilman in Calexico, where he is among about one-third of the city's workers who
use dental and medical clinics in Mexicali, just across the border. "I myself have used dentists in Mexico."
Still, the trend has generated some misgivings among doctors and consumer advocates on this side of the border. Some worry about the quality of care
in Mexico and lack of regulatory control. Others say the cross-border plans represent a sad commentary on the limited access that immigrants and
working poor have to treatment in California.
They represent a "positive turn of events for cross-border health coverage . . . but are another reminder about how sick our health system is in the
U.S," said Dr. Robert K. Ross of the California Endowment, a health care philanthropy.
Mexico has long been a low-cost alternative for thousands of people, many of them uninsured, who price-hunt among clusters of storefront clinics and
small hospitals for treatment they can't afford in the states. And some cross-border health plans have operated since at least the 1950s, when
Imperial Valley farmers started offering coverage to migrant workers.
But the emergence in the past five years of cross-border HMOs, which must be licensed by the state of California, signals the growing acceptance of
Mexican doctor networks by mainstream employers and insurers in the United States.
Enrollees are typically Mexican citizens legally employed at U.S. companies, either living in Mexico or in the United States. Many earn only $5 to $7
per hour. But others are Mexican-Americans.
"Employers are really surprised a bit by the quality, the cleanliness," said Peter Duncan, a vice president at Blue Shield of California, whose
cross-border program is called Access Baja.
Still, some medical experts are concerned about what they describe as a wide variation in quality south of the border.
Although comparing the two systems, with their differing standards and philosophies, is difficult, doctors on both sides of the border say the Mexican
regulatory system is lax, and doctor training is not as rigorous as in the United States.
Tijuana's rapid population growth has fueled a miniboom in hospital construction, drawing some well-trained doctors from Mexico City and the United
States, say experts in both countries.
Part of what draws patients south of the border is the different medical culture. In California, some Hispanic patients say, medical care takes longer
to get and is not rendered with as personal a touch.
These enrollees, who have received health care in both countries, say the U.S. system is too bureaucratic and hurries them out the door.
"Over there (in San Diego), we wait for more than half an hour, and they just give us a Tylenol," said cross-border plan member Guadalupe Briseno who
accompanied her 15-year-old son to the Tijuana clinic of Dr. Teresa Figueroa Garcia.
Garcia, 52, a family practitioner, is one of about 73 doctors in Tijuana who is part of Access Baja. Garcia consults with patients in her office
before treating them in an adjoining examination room.
Garcia said she sees about seven patients daily. American doctors, by comparison, might see four times that, according to doctors on this side of the
border.