Gypsy Jan - 8-23-2012 at 02:56 PM
From The Huffington Post
Written by Matthew Dalstrom
"Rising health care costs, decreasing insurance coverage, and the great recession have made it increasingly difficult to afford health care. Retirees
are particularly vulnerable because many live on fixed incomes and require more medical services than younger adults. Furthermore, Medicare, the
primary insurer for Americans 65 and over, does not cover all the necessary medical procedures or expenses, and supplemental insurance plans can cost
in the thousands. The result is that many seniors have to forgo care, become medically noncompliant, and/or spend all their retirement savings.
Nevertheless, over the past few years, I have been researching a small, but growing number of retirees who are filling the gaps in their health
insurance coverage by traveling to Mexico.
Mexico, most famous for its breathtaking scenery, cultural charm, and more recently intense cartel violence has been slowly growing its private
medical system to attract not only tourists, but also patients. Over the past 30 years, Mexican medical providers have steadily moved their offices to
border towns creating mini-medical destinations for Americans. One of the most popular locations is Nuevo Progreso, located in northeast Mexico
between the cities of Reynosa and Matamoros. A small town by all accounts, with a tourist district of five blocks, Nuevo Progreso has bars,
restaurants, and stores selling cheap tourist items (like so many other towns). However, it also has over, 70 dental clinics, 60 pharmacies, and 10
doctors' offices that advertise cheaper prices, English-speaking employees, and high quality health care.
Just to the northeast of Nuevo Progresso is the Lower Rio Grande Valley that stretches from South Padre Island in the east to Laredo, Texas in the
west. The region is a very popular tourist destination for retirees known as winter Texans, snowbirds, and Q-Tips (because of their white hair and
shoes), looking to escape the cold winters up north. Beginning in October and lasting until March, they move into mobile home parks that dot the
landscape. For many, their arrival on the border marks the beginning of a medical vacation; not a hiatus from care, but a chance to use it. It is the
time when all of the prescriptions, dental fillings, and surgeries that were postponed over the course of the year because of costs and insurance
limitations in the U.S. are finally addressed.
By far the most popular type of medical care sought by winter Texans in Mexico is pharmaceuticals. Pharmaceuticals are significantly cheaper across
the border and in many cases do not require a prescription. For example, Spiriva can cost $25, the Z-Pack $5, and a month's supply of Lipitor less
than $30. The low prices are appealing to all, but they are definitely a life-line for those in the Medicare "donut hole." Many of the people who I
interviewed mentioned that they "had to," or "could not afford medications in the U.S." However, others were concerned about the quality of those
medications.
Aware of this, pharmacies actively compete for customers through low costs, large selections of medication, information about Mexican generic
equivalents, and English-speaking employees. Seniors take advantage of the situation and frequently purchase a year's supply for themselves, and in
some cases their friends and family. However, US Customs limits the importation of medications to a 90-day supply, so they either take multiple trips
or hope that they are not stopped at the border. In situations where the medication cannot legally be imported such as schedule I and II controlled
substances, the less discerning pharmacies will re-label the medication to appear legal.
Dental clinics are also very popular for retirees because Medicare does not cover preventive dental coverage. Similarly to pharmacies, dental clinics
in Mexico attract customers primarily because of their prices ($25-35 for cleaning, $10 for x-rays), and also because of the amenities that come with
the visit such as English-speaking staff and a transparent price list. In addition, some dentists offer massaging dental chairs and coupons to local
bars and restaurants. It is not uncommon for seniors to wait the entire year to see a dentist in Mexico because it can be thousands of dollars less
than in the U.S.
On occasion seniors will also get orthopedic, bariatric, cosmetic, and Lasik eye surgery performed in Mexico because either Medicare will not cover
it, or because the deductible and/or co-pay is more expensive compared to Mexico. While less common, these types of surgeries are not preformed in
Nuevo Progreso, but in the larger cities of Reynosa, Ciudad Juarez, and Monterrey where there are large private hospitals.
Through accessing medical care in Mexico, seniors can save thousands of dollars and improve their overall health because they can afford to access
medical care. Nevertheless, there are inherent health risks from both the care they get in Mexico, and also from neglecting care in the U.S. While in
Mexico, seniors may be given incorrect or counterfeit medication, suffer malpractice, be arrested for importing medications, or be victims of cartel
related violence. While those problems could happen in the U.S. (although much less likely), postponing or rationing medical care, because of the high
costs has its own set of health consequences. These are the choices that many seniors are faced with, and for many the risks of seeking care in Mexico
are less than forgoing it in the U.S. While the U.S. Department of Health and Human Services has continuously warned people about the risks, the
message seems ineffective to those who see Mexico as the only viable option to a medical system that threatens their economic existence. Therefore, it
stands to reason that as long as the cost of medical care in the U.S. erodes the safety net of retirement that retirees will risk their safety and
health in an attempt to balance financial security with heath security."
Matthew Dalstrom is an Assistant Professor of Anthropology at Rockford College. He received his degree in cultural anthropology from UW-Milwaukee in
2010. Since 2007, he has been working on health disparities and access along the U.S./Mexico border and has published several articles on the topic.
He can be contacted at mdalstrom@rockford.edu
Follow American Anthropological Association on Twitter: www.twitter.com/AmericanAnthro
durrelllrobert - 8-23-2012 at 04:25 PM
Nuevo Progreso is to Texas as Agadonas is to western AZ and CA
EnsenadaDr - 8-23-2012 at 05:03 PM
What can I say? All of it is true!!
Pescador - 8-23-2012 at 07:57 PM
The South of the Border Medical care can only increase in the very near future. As part of the Affordable Health Care Act (Obamacare) Medicare
reimbursement levels will drop to the same level as Medicaid levels. One of the big issues now is the fact that numerous hospitals and doctors
offices are unable to meet their operating costs under present Medicare levels and have started dropping out of the system. When the reimbursement
drops to Medicaid level, even more will be forced to drop out and no longer offer services. So people who are living in areas that do not have a
large number of choices will find that the availability of doctors and services will be seriously lacking. The very people that these programs were
designed to help, namely the old and poor, will find themselves in a much more limited availability of medical professionals who will provide the
care. So good for the people who can go across the border but it is going to get harder for those who can not do that.
[Edited on 8-24-2012 by Pescador]