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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Why Seguro Popular is better than IMSS for a expat
IMHO, there is no comparison between the US and Mexican health care system. The US has more resources, newer equipment, and higher expectations of
doctors on their medical boards. Which leads me to an interesting fact that I had just been talking about yesterday to someone. They brought again to
my attention that IMSS has a sindicato or a union. In addition, the Seguro Popular health care facilities have much nicer facilities than IMSS. The
reason is that because of the Union, the workers at IMSS get more of a cut of the money provided by the Mexican government, therefore less of the
money goes to the patients and equipment. IMSS is known for the "great" pay...from what this person told me a nurse at IMSS gets paid $5000 every
quincena, or every 15 days. Right now that amounts to less than $200 a week. Which is considered great pay for a nurse in Mexico. IMSS's faciities
are run down, the equipment outdated, and are not kept as clean as they should be. In constrast, for example, Hospital General Ensenada (which is
Seguro Popular) just got a brand new state of the art Mammogram machine, which cost them over $250,000 American. So who should benefit, the workers
or the patients? It seems there is no regulation with a workers' union at IMSS.
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chuckie
Elite Nomad
Posts: 6082
Registered: 2-20-2012
Location: Kansas Prairies
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Mood: Weary
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This is good stuff..I will be a full timer, after I close out some property in July, and will enroll when I get back....Thanks
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DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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I'm about to offer some strange sounding advice to folks that live south of the border.
If you have USA health care or not, you might want to consider asking for an Rx for strong narcotic pain relievers "just in case". Fill the
prescription in the states. Even though México manufactures a spectrum of narcotic pain medication, it is virtually impossible to obtain. For
instance, with a 2nd and greater herniation of a lumbar disc, the for a badly broken arm that required a total of eight hours in surgery, the
strongest pain reliever I found, after long, hard and thorough searching is called TYLEX. Simple codeine, with paracetamol, also known as
acetaminophen north of the border. More effective was simple OTC Tramadol. But what I needed for almost a YEAR of recovery from the herniation was
Oxycodone, and oral time release morphine. I was on a walker for six months, a crutch for six months and am now able to hobble around a bit. But I am
still on Tramadol, Nimesulide, and Tylenol, full time. I am hording a pair of strong oxycodone tablets "just in case". A cortisone injection in the
states proved to be ineffective. The neurosurgeon declared "Let's Operate" I replied "Let's say we did but not do it". Very strong pain relievers
would have made my life bearable getting back to the states. BTW, the disc herniation seemingly was a hundred times more painful than the broken arm.
A Lot To See And A Lot To Do
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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David, I want to say that this is EXCELLENT advice. I had 2 good friends come down here for Plastic Surgery and told them to ask their Drs. in the
states for some pain killers. They don't give any pain medications except anti-inflammatories for pain, even after major surgery. I have seen them
give Tafil, which is something like a strong muscle relaxer, but very infrequently. I have worked in all of the hospitals in Ensenada, and the only
Dr. that I ever come in contact with that has the full gamut of narcotics and anti-anxiety medications is Dr. Esquer in Maneadero. He has a license
for these medications, and I refer all of my chronic pain management patients to him, because Seguro Popular just has anti-inflammatories and
Metamizol which works for about 90% of the patients, but the other 10% need to be referred elsewhere.
[Edited on 6-17-2012 by EnsenadaDr]
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DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
Member Is Offline
Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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The sad part is the proveedores deny they carry narcotic analgesics and furthermore "there is no mechanism in place for them to secure opioid Rx
medications". Mexico Sector Salud seems to classify such medications as "Schedule 1"
I had to purchase oral medications from an outside source (nearby farmácia), and those that are located near a hospital charge full retail price
"Precio Maximo al Publico". Seguro Popular in La Paz would administer no medication that was not intravenous, even NSAIDS. A direct jolt of Ketorolaco
on an empty stomach is a little hard to take. Really sad when a COX 2 inhibitor like Nimesulide was available at Farmacias Similares for 30 pesos for
10 tablets, worked better as an anti-inflammatory and did not try to destroy my gastric region. Sector Salud and COFEPRIS seems riddled with
incompetence, and cronyism.
"No Cost Medical Care" for tourists can be explained best by the following:
"Medical personnel and facilities are required under federal law to treat a patient in need of emergency care until such time as they are stabilized".
After which the patient is required to obtain medical service on their own. If they have health care coverage, fine. If they do not, they are expected
to prove they can pay for it while being treated. The no cost service is only for triage. This means a severely ill or injured patient can be
discharged if the triage facility feels confident the patient can make it to a "for pay" medical facility. Of course some hospitals have triage and
primary care combined.
A Lot To See And A Lot To Do
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Lee
Ultra Nomad
Posts: 3597
Registered: 10-2-2006
Location: High in the Colorado Rockies
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Es verdad, sad but true.
An accident ruptured a lumbar disc couple years back, Oxy I brought down helped, and MD in Cabo told me pain meds (narcotic) was not available. He
offered a spinal but I passed.
BYOM's or you'll be sorry.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Pain control
There is quite a need for strong pain medications for people with chronic neurological problems such as ruptured discs, cancer patients, and
post-op/fibromyalgia. Like I mentioned, this physician is the only one I have seen in all of the hospitals and clinics that writes medications freely
for these strong pain and anti-anxiety medications. They need to be more accessible for everyone suffering from these conditions. | Quote: | Originally posted by Lee
Es verdad, sad but true.
An accident ruptured a lumbar disc couple years back, Oxy I brought down helped, and MD in Cabo told me pain meds (narcotic) was not available. He
offered a spinal but I passed.
BYOM's or you'll be sorry. |
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Alm
Ultra Nomad
Posts: 2747
Registered: 5-10-2011
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What about private hospitals - same red tape there?
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DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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EnsenadaDr.
First of all, thank you for all your excellent information and advice.
Would you happen to have a telephone number for Dr. Esquer in Ensenada, B.C.?
Debido a los matices de idioma prefiero hablar Inglés para exámenes médicos asuntos.
I am assuming he has access to schedule 1 medications? I do carry a Scripps hospital MRI on CD ROM so medical staff can verify my diagnosis if
necessary. Also copies of USA Rx, and dispensed medication bottles.
A Lot To See And A Lot To Do
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Red Tape..
It appears that way as well. They are trained in Mexico to believe the only medications that are needed for pain are non-narcotics. I don't
understand it at all. | Quote: | Originally posted by Alm
What about private hospitals - same red tape there? |
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Dr. Raymundo
Dr. Raymundo Esquer Uriarte
(646)154-0018
| Quote: | Originally posted by DavidE
EnsenadaDr.
First of all, thank you for all your excellent information and advice.
Would you happen to have a telephone number for Dr. Esquer in Ensenada, B.C.?
Debido a los matices de idioma prefiero hablar Inglés para exámenes médicos asuntos.
I am assuming he has access to schedule 1 medications? I do carry a Scripps hospital MRI on CD ROM so medical staff can verify my diagnosis if
necessary. Also copies of USA Rx, and dispensed medication bottles. |
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MitchMan
Super Nomad
Posts: 1856
Registered: 3-9-2009
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No Comparison?
| Quote: | Originally posted by EnsenadaDr
IMHO, there is no comparison between the US and Mexican health care system. |
No Comparison, you say? My son starts medical school this August in a top ten USA medical shcool and he will have to go to med school for 4 years in
order to get his MD diploma and wil have to be in residency for another 4 years before he gets his license to practice. It is my understanding that
Mexican doctors only have to go to med school and get their MD diploma and can then get a license to practice medicine publicly without having to go
through a residency. If I am right about that, I cannot see that there is "no comparison"?
Also, just spoke to my Mexican public accountant last week and he said that you can practice public accounting as a licensed public accountant in
Mexico with only the 4 year accountant's college degree without having to pass a CPA exam and without doing the obligatory 2 year apprenticeship under
a licensed CPA with specific audit experience as is the case in the United States.
Also, to engage in real estate as a broker in the USA you have to have a 4 year college diploma , take about 8 college level classes in real estate,
and then pass a broker's exam to get the Real Estate broker's license in the USA. Or, take those 8 classes and then some and have two years
experience as a real estate salesman under a licensed real estate broker and pas s the Brokers exam. In Mexico, there are no requirements at all to
practice as a real estate broker...or real estate salesman for that matter.
I hope that I am wrong about all this. But, if I am right, the comparison doesn't match up.
[Edited on 6-17-2012 by MitchMan]
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TMW
Select Nomad
Posts: 10659
Registered: 9-1-2003
Location: Bakersfield, CA
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MitchMan you need to read the rest of the paragraph you quoted from.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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I was saying, that the US preparation was better. I guess you didn't understand what I was saying. You graduate 4 years from medical school in
Mexico and then you have to do 2 years, 1 year Internship, the same as the US, and 1 year Social Service which would be equivalent to the second year
of residency in the United States. Then most Mexican Doctors go on to do 2 or 3 years of specialty, depending on what you want to do...family
medicine is 2 years and surgery is 3 years in Mexico. I believe that the US system is preparing doctors better in the US...I had a girlfriend that
took a 6 month course in the US and she got a real estate license.
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Pescador
Ultra Nomad
Posts: 3587
Registered: 10-17-2002
Location: Baja California Sur
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The issue you originally raised is Seguros Popular in comparison to IMSS. I would agree that you will probably get the better hospital by going to
the General Hospital but we do not need to go to far back to remember Ron Hoff's experiences and coverage when he and his wife were injured. They did
a pretty good job of taking care of her, but he ended up in a private hospital for care. In Mexico, the private care system is where most of the
better medicine is practiced and the doctors and facilities are good enough that they can command private payment. The exception to that rule are
some of the hospitals and clinics in Cabo that have been fraught with medical malpractice for years.
The big challenge is that I see expats getting coverage with Seguros Popular and then watching them assume that they have coverage that is somehow
comparable with coverage they might have had in the United States. It may be adequate for emergency, clinic, and some general treatments, but it must
be remembered that it is offered to everyone who applies so the services and medications are going to be stretched thin.
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DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
Member Is Offline
Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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I would to have gone to Monterrey, Guadalajara, or México, to get as good a surgeon as what I had to have for my wrist. The surgeon in La Paz guessed
the process would have cost three hundred thousand pesos, including rehab. Most expats IMHO with MediCare would be financially better off going back
to the states for a "biggie".
A Lot To See And A Lot To Do
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durrelllrobert
Elite Nomad
Posts: 7393
Registered: 11-22-2007
Location: Punta Banda BC
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Mood: thriving in Baja
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When I broke my arm 4 years ago I went to the Military Hospital here in Ensenada and the total cost including rehab was only around $600 US but I
understand that they no longer treat gringos.
Bob Durrell
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Alm
Ultra Nomad
Posts: 2747
Registered: 5-10-2011
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| Quote: | | Originally posted by DavidEMost expats IMHO with MediCare would be financially better off going back to the states for a "biggie".
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Yes. The only advantage of programs like SP is the near proximity to a half-decent public hospital when you don't have much time (and don't have any
insurance, otherwise private hospital is better). Not to everybody it's "near", though. Anything that can wait, is better be done North of the
border.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Private Hospital
I was told by an inside source that Ron Hoff had insurance because he was employed by the Mexican government. I don't know if this is true or not
true but the source was a very honest person and was there when all this was going on, and if you know anything about private hospitals in Mexico,
unless payment is guaranteed they will not accept you in the first place. I am totally in agreement with you, Pescador. If I had any serious injury
or illness I would go to the US for treatment if possible but Seguro Popular is an option if you don't want $20,000 American deducted from your credit
card immediately at a Private Mexican Hospital for a serious illness. | Quote: | Originally posted by Pescador
The issue you originally raised is Seguros Popular in comparison to IMSS. I would agree that you will probably get the better hospital by going to
the General Hospital but we do not need to go to far back to remember Ron Hoff's experiences and coverage when he and his wife were injured. They did
a pretty good job of taking care of her, but he ended up in a private hospital for care. In Mexico, the private care system is where most of the
better medicine is practiced and the doctors and facilities are good enough that they can command private payment. The exception to that rule are
some of the hospitals and clinics in Cabo that have been fraught with medical malpractice for years.
The big challenge is that I see expats getting coverage with Seguros Popular and then watching them assume that they have coverage that is somehow
comparable with coverage they might have had in the United States. It may be adequate for emergency, clinic, and some general treatments, but it must
be remembered that it is offered to everyone who applies so the services and medications are going to be stretched thin. |
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Military Hospital
Bob as you know I did my internship there, they will set a broken arm but as far as admitting you for a serious illness they do their best to put you
in another facility or if you are American, they encourage you to go to the States. | Quote: | Originally posted by durrelllrobert
When I broke my arm 4 years ago I went to the Military Hospital here in Ensenada and the total cost including rehab was only around $600 US but I
understand that they no longer treat gringos. |
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