Millions Of Americans Go To Mexico When They Need Healthcare
How much does healthcare cost in the USA? Let's put it this way: It's often cheaper to fly to another goddamned country, get treatment there, and fly back. It turns out that Americans do this all the time, and their preferred destination is their constantly insulted neighbor to the immediate south ...
Going To Mexico For Treatment Can Be Worth It -- Even If You're Already Insured
You probably already knew that healthcare is way more expensive in the USA than just about anywhere else. But you probably also know we got a big ol' health care overhaul this past decade that was supposed to fix things (among other effects, it reduced the number of uninsured Americans by a significant amount). And yet even today, Americans find it worthwhile to leave the country when they need treatment. Looking only at California, a million medical tourists a year went across the border both before Obamacare and after Obamacare. "If anything, we've gotten more business since Obamacare," says Jerry, who ferries medical tourists south in his shuttle bus. So what's going on here?
"American health insurance is really strange," says Dr. Juan, a Mexican dentist whose practice is a mile south of the border. "It can cover so much or so little." Some of the American patients who come to Dr. Juan don't have insurance, but most do, and they tell him it's still cheaper to pay out of pocket in Mexico than to throw it to insurance in the U.S. Plans still generally leave you with a deductible to pay, and deductibles keep growing. Unless you qualify for subsidies, your out-of-pocket costs probably went up under the Affordable Care Act.
So cheap care in Mexico can look like one hell of a good alternative. Costs overall are said to be 40-65 percent less than in America -- 70 percent or even more if we're talking about dental work. When you're facing a five-figure bill in the U.S., that means you can buy a plane ticket to Tijuana, book a hotel there, get healed, and then throw in another week of sightseeing and tequila on top of that, and you'll still end up spending less than if you'd gotten the work done at home.
You might even save time, since these hospitals don't make you wait for elective procedures. We should mention, though, that American wait times are hardly the worst in the world. "I get enough Americans complaining about waiting months," says Jerry. "Canadians have to wait years." So even some Canadians make the medical trip to Mexico, despite cost not really being an issue when you've got government healthcare. One recent Canuck passenger of Jerry's needed leg surgery so she could walk properly. "She told me that the wait in Canada was five years," he says. "I couldn't believe it." But she got fixed up five years sooner by heading south (or as we assume Canadians call it, "south-south").
Some Tourists Like Mexican Healthcare While Still Being Racist Against Mexicans
You might imagine there's something of an internal conflict for patients who screamed for a border wall to keep the filthy Mexicans out, only to themselves go south in their time of need. This is not representative of most people Jerry transports, but there are enough of them that he's come to expect it.
Someone might refer to the "beaner doctor" they're going to see. Or "wetback doctor," which comes off as very ignorant both in the that's racist sense and in that the speaker appears not to know what that slur literally means. "Wetback doctor would be working outside a Home Depot if it wasn't for us," said one passenger, according to Jerry, showing so many levels of misunderstanding that we don't even know where to start.
One large man got on the shuttle and announced to everyone, "I'm a Vietnam vet, and the VA can't do shit about what I have." It could be the first line of a moving tale of woe, but Jerry predicted merely by looking at him that the guy would be trouble. "He kept saying 'spic with a scalpel,'" he tells us, "in place of 'Mexican doctor' -- or, let's be real here, 'doctor.'" Jerry has light skin (plus a name tag that reads "Jerry"), so passengers seem to assume he's cool with hearing slurs, not realizing he's half-Mexican himself.
He usually doesn't say anything, though in the case of the large Vietnam vet, he did tell the guy he should consider keeping that shit to himself once he's off the bus.
It's Hilarious How Mistaken Patients' Idea Of Mexico Is
Jerry can generally guess how much a patient knows about Mexico based on where they're from. He'll get people from Texas or New Mexico or Arizona, and they know exactly what to expect from a major Mexican city, especially if they happen to be Latino. "And then we get people from way up north," says Jerry -- people who'd never visit Mexico but for this surgery of theirs. "They expect to see mariachi bands everywhere."
Now, we totally recommend you check out some mariachi music next time you're in Mexico, but not every place you go will look like a cheesy themed amusement park. Dr. Juan's office, for example, looks like a dentist's office anywhere else in the world, to the disappointment of many Americans with vague hopes of something exotic. A Mexican hospital is ... a hospital, with no special ethnic flourishes. "Some people expect taco stands inside," says Jerry. He's not kidding; one Canadian patient gleefully pointed at a brochure that said "taco bar on premise," thinking he could get pico and guac in the waiting room. Jerry had to explain that the brochure was for a hotel.
Other passengers complain to Jerry when a hospital lobby has English magazines set out by staff trying to cater to Americans. These patients want Spanish magazines so they can "see the culture" (even if they can't read said magazines, since they don't know Spanish). Some elderly patients, whose entire knowledge of Mexico appears to come from Westerns and footage of illegal border crossings, complain about never seeing the "real" Mexico, because the city they visit has sidewalks and paved roads.
Patients Make Whole Vacations Out Of Hospital Visits
Some medical tourists do take the opportunity to spend a little more time in the country they're visiting. Jerry will be taking some busload to the hospital, and he'll notice that hardly any of the talk behind him is about anything medical. Instead, passengers talk about relaxing by the pool later, or going horseback riding. "It sometimes feels like I'm taking them to a resort," he says. The medical procedure is simply one day of a week-long vacation.
Good for them, but that's the most surreal part of this whole thing. Medical costs force Americans into bankruptcy, leave others dead, and made these particular patients leave their country in search of treatment they can afford, but it can also be an excuse to spend a few days working on your tan. "An American said it was like being given a five-hour sales pitch on a timeshare for two nights free," says Jerry. "The surgery is like the lecture, and the rest of the trip makes up for it." And why not? They're still saving money, even with all the extra stuff included. We'll say it again: This is nuts.
And the towns they visit happily cater to this specific kind of traveler. Shuttles like Jerry's are one part of the medical tourism industry, because no one wants to drive right after surgery (or bring their car to a country they've heard is full of crime). Clinics advertise these shuttles, which pick you up at an American airport or other spot north of the border and take you directly to an eager doctor swinging a stethoscope.
Many of these are standalone clinics, but others grab the all-inclusive / office park model to dive into the "tourism" part of medical tourism. "There will be restaurants, shops, spas," says Jerry. The restaurants have rice and other soft foods, perfect for dental patients still sore from Dr. Juan's probing. Pamphlets direct you to the spa from within the hospital itself. And when you walk out of an eye clinic, you'll see hawkers selling something perfect for patients with dilating pupils as well as tourists of all kinds: sunglasses! Which might be genuine Ray-Bans, if you don't look at the logo too carefully.
Even Medical Tourists Mistrust Foreign Doctors
Expensive means good, we've been taught. Cheap means bad. Cheap knockoffs are sure to be inferior, with cheap Mexican knockoffs definitely not an exception. So some Americans view lost-cost Mexican healthcare with the skepticism of, say, that tourist being handed $5 Ray-Bans.
Dr. Juan's patients think they know more about mouths than he does, and insist on describing how their own dentists back home do things. Or they'll ask if he knows what Novocain is. "Not if I'm going to use it," he clarifies for us, "but if I know what it is." (He does know what Novocain is. He also knows they probably mean lidocaine, because most dentists haven't used Novocain for decades.)
His favorite line came from a patronizing New Yorker, who advised him before a procedure, "Be sure to use surgical gloves." Other patients are surprised he has state-of-the-art equipment. One was surprised to see solid brick buildings.
Those attitudes seem ridiculous to Dr. Juan, but patient advocates do suggest that you research any foreign clinic and even check it out personally before agreeing to be treated. Sure, good doctors in Mexico may be as skilled as their counterparts in America, but that doesn't mean you can trust just any building in a border village or resort town that swears it's a hospital. Maybe you'll find yourself operated on by a cosmetologist instead of a surgeon and needlessly end up dead. Or maybe the mistake will be less major, but you won't have American courts protecting you afterward or getting you compensation. Medical tourism comes with risks. It's a messy workaround that shouldn't be necessary, not some awesome hack that beats the system.
Every so often, a patient of Dr. Juan's will get up from the chair, still in severe pain, and leave. "Sorry," they say, leaving their nonrefundable payment behind. "I can't do this." And at least once a month, Jerry takes some passenger like that back to the U.S., their procedure abandoned. One memorable guy made it as far as having his leg shaved in surgical prep before getting out of there, spooked at the last minute by hearing the doctors speaking Spanish. On the shuttle north, the other passengers talked about how well their own operations had gone, so after they crossed the border, he phoned the hospital, asking if he could do the surgery after all. They told him it was too late -- to go forward with it, he'd have to pay the fee a second time.
Maybe he ended up doing that. Even paying twice, it would still be a bargain.
Evan V. Symon is a writer, interview finder and journalist for the Personal Experiences section at Cracked. Have an awesome job/experience you'd like to see up here? Then hit us up in the forums.
Interested in making a trip to Mexico? Check out Fodor's Guide to San Diego and Tijuana.
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For more, check out A Zero B.S. Guide To American Healthcare and 5 Huge Problems Nobody Told You About American Healthcare.
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