Health & Safety in Mexico
By Robert H. Page, MD and Curtis P. Page, MD
August 15, 2008 San Miguel de Allende

The Mexican solution to US healthcare woes

The United States’ healthcare crisis has become a huge issue in the 2008 presidential campaign. Democratic candidates are proposing more inclusive proposals to resolve the gaps in coverage, inefficiencies and costs that North Americans face. Today, the US has 45 million uninsured and 25 million underinsured individuals. The problems of the US healthcare system are highlighted in Michael Moore's latest documentary, Sicko, which compares the headaches and bureaucracies of private healthcare management organizations (HMOs) to the universal healthcare regimes in Canada, France, Great Britain and Cuba.

North Americans clamor for changes in the US healthcare system, but solutions provided by politicians and bureaucrats are unlikely to bear fruit for years. In the meantime, until hospitals can provide affordable medical procedures, many individuals have opted to find quality care at a fraction of the cost in Thailand, India, Singapore and Malaysia. Another growing destination in what has become known as medical tourism is the US’s southern neighbor—Mexico.

Going to another country for healthcare when the US has some of the best medical facilities in the world may appear perplexing, especially if it comes from a country most North American’s associate more with bursting borders and unremitting poverty than with advanced technology and education. But for years, many North Americans living along the US-Mexico border have been going to Mexico for inexpensive dental care and pharmaceuticals. More and more North Americans are coming to realize that Mexico has hospitals and doctors on par with the best in the world. The well-known Cross Border Health Insurance exists along the border states of California, Texas and Arizona. Researchers from the LBJ School of Public Policy at the University of Texas at Austin who studied the program discovered that Mexicans and North Americans have become comfortable receiving their health care in Mexico and can get that care for less than half the cost of similar procedures in the US. Mexican medical care is more affordable, in part, 
because salaries for Mexican hospital staff are less than what they are paid in the US, and institutions do not have to take out huge insurance policies to protect themselves from lawsuits. More importantly, the Mexican system does not suffer from exorbitant costs associated with HMOs. In the US, about half of what is paid out for medical fees goes to cover the administrative costs of insurance providers.

The majority of people’s experiences in Mexico have been very positive. They return for other procedures and inform friends about the possibilities. One example is Mark Sawko from Phoenix who required a total knee operation but was denied by his HMO. The operation would have cost him over US$40,000 in the US out-of-pocket. But instead he paid $12,500 to have the operation done in Puerto Vallarta. Hysterectomies cost $40,000 in the US, but only $3,800 in Hermosillo. Arthroscopic surgery: $20,000 in the US, and only $4,000 in Mexico. Given the cost difference, even major self-insured employers in the US that pay the bills of their employees are looking at medical tourism to Mexico in order to save vast amounts of money spent on healthcare costs. 

The biggest concern when receiving medical care abroad is quality. Indeed, there are strong warnings from the heads of dental colleges who recommend against dental procedures overseas. And there are grave reservations from physicians around the country warning that if there are complications, there would be no one to care for the patients on their return to the US. Rather, your physician would be an airplane ride away if you suffer any delayed complications. Many in the medical field caution patients to consider more than just price when deciding to have an operation in another country. 

Medical facilities in Mexico are some of the finest in the world. The infrastructure for medical tourists includes hotels, transportation, restaurants and airlines. Language and the culture of Mexican healthcare providers are very familiar to North Americans since our countries are so close geographically. But equally important is that our peoples understand each other. In fact, most Mexican hospitals employ English-speaking nurses and staff since they are already familiar with taking care of the millions of US and Canadian expatriates who live there permanently. In addition, many of the Mexican physicians have received their postgraduate medical training in the US or Canada and are familiar with North American customs and expectations. 

People who are not well-traveled outside the US may have extreme reservations about seeking healthcare in a developing country. Just leaving the familiarity of the family physician, the close network of doctors in our communities and the local hospital in which our families have received care for years may prove daunting. But having surgery in the US often places a heavy financial burden on these patients and their families for years afterward. Others who have had the opportunity to become medical tourists provide wonderful testimonials of outstanding healthcare. The biggest obstacle encountered by people who have never received surgery abroad and would like to save a fortune is the need for reliable and accurate information. This is where medical tourism brokers come in. Having spent years living, working and traveling in Mexico as medical practitioners, MedToGo International provides the trust, familiarity and quality of service to insure you receive care from Mexico’s top physicians and in the best institu
tions, as well as to arrange for transportation, hotels and recovery. 

Copyright© 2008 MedToGo, LLC.

Not for unauthorized publication or reproduction without the consent of MedToGo, LLC.

Robert H. Page, MD and Curtis P. Page, MD are authors of the MEXICO: Health and Safety Travel Guide and the Healthy Traveler Regional Series. For more information visit medtogo.com.

Sincerely Human
By Norman Araiza

Trouble in paradise

What is it that happens to many relationships after 20 or 30 years of marriage that make them less satisfying, enjoyable and fun? Well, the answer to that question is that most of them get flat, boring, predictable and stale. Certainly not all relationships are destined to this fate, but in my 35 years of working with relationships, couples who do not find some healthy intervention that addresses the critical issues of this time of their lives are left with but a shadow of their former relationship.

We come to San Miguel and fall in love with the city, the culture, the people. We decide that we have to live here unaware that in that decision, we have signed up to put our relationship through the most stressful of times. For a while, the intoxicating effect of San Miguel serves as a distraction and mitigates the serious adjustments we are going through. But in time the stressors take their toll and symptoms begin to show.

Unwittingly, most couples in the foreign community of San Miguel are going through the most stressful challenges of their entire lifetime. Not only are they adjusting to life in a foreign country, most not even speaking the native language, but many are dealing simultaneously with issues of post-menopause, andropause (male menopause) and the serious physical and psychological consequences of these transitional states. Add the problems of retirement to those difficulties and you have adjustment challenges that will shake the foundation of the strongest relationships.

How do couples cope when many have never lived in a foreign community, nor even given much thought to the adjustment problems of later life? They are used to working long hours away from home and only dreamt of the time when they could do anything they chose. Now, many couples feel the strain on their relationship from being together 24/7. For many, the economic realities of retirement and limited income add additional strain. Then there is the ongoing problem of too much time on their hands—the challenge of finding a project worth doing places additional strain.

We think of retirement as our golden years, when we can do what we like and sleep till noon, if we choose. But the reality is that many are bored and feel like fish out of water, struggling to find meaning in inactivity. It may be fine if you are an artist or have a passion in life that you can now pursue. But for those countless others whose main drive in life was to make a good living and raise a healthy family, retirement means accepting a new challenge that puts stress on their primary relationship because needs for esteem and to be of value, that earlier were met through work and satisfying their children‘s needs, now go unfulfilled. Adjustment problems commonly surface in symptoms such as depression, anxiety, insomnia, fibromyalgia, irritability and a host of other somatic complaints.

Some find meaningfulness in volunteering their time end energy in the many charitable activities our town has to offer. Others find temporary solace in alcohol or drugs, which does nothing to heal their troubled relationship. Unfortunately, when there is no other person on whom to vent the frustration, the person we value the most feels the brunt of our dissatisfaction. When our car begins to show symptoms that something is wrong, we think nothing of taking it to a mechanic for a tune-up. But when it comes to relationships, most couples recognize that a tune-up is needed, yet few couples make a decision to get it.

Learning to live successfully through these difficult life transitions often requires more than just a firm resolve to make the relationship better. In response to this need, I have designed a Relationship Survival Training workshop for post-menopausal, andropausal, retired couples adjusting to living in a foreign country.

In my former series on endangered relationships and toxicity within relationships, I wrote about the warning signs, the four choices that endangered relationships always have. Now I’m offering a three-week workshop that will meet twice weekly for two hours each session.

Workshop objectives include: improve communication, increase intimacy, build trust, increase satisfaction and improve physical pleasure. This workshop is not about sharing intimacies of your relationship with others; it is about respecting privacy and learning more effective ways of relating. As a result of this workshop, your relationship will improve, you will meet other committed couples and have fun doing it.

Norman Araiza, M.A., is an American-trained marriage counselor and psychotherapist enjoying a limited practice in San Miguel. He can be reached at 152-5454, email 2gatos10@cybermatsa.com.mx.