It’s not just the cost, it’s the care.
By James Murray for WOLF STREET:
An acquaintance of mine was walking around with a bandaged hand so I asked him what had happened. He was working and something slipped and he ended up with a nasty gash on the back of his hand. He went down to the local clinic and they put in 8 stitches. The total bill was $52.
Three years ago, I fell on a tile floor and broke my pelvis in 3 places. I was picked up by an ambulance, driven 40 miles to a private hospital where I spent 6 days and had a 5 hour surgery to repair the damage. They put in 3 pins, a plate, and 6 screws. The total bill was $22,000. I have no idea just how many stitches they put in, but the incision is 14″ long.
That was the total bill, no insurance.
However, I live in Mexico in a small town south of Guadalajara. I hate to even guess what the surgery would have cost me in the US.
When I came here a decade ago, people would disappear and the story would be that they went back to the US, because of health problems, to avail themselves of Medicaid/Medicare. However, now Americans are showing up here to get healthcare, especially dental, plastic surgery, and outpatient procedures. They can pay cash and still come out well ahead of paying deductibles in the US.
If you ask the medical profession in the US why there is such a difference in price, you generally get a “Well, Mexico is a 3rd-rate country with 3rd-rate medicine” answer. That is just not true. Medical care is as good in Mexico as in the US and in a lot of ways, better.
A large percentage of healthcare in Mexico is government run, either through IMSS or Seguro Popular. IMSS is for people under retirement age. Seguro Popular is for people over retirement age and the poor. In both instances, the government owns the facilities and employs the people working there.
IMSS is funded by employers. If you work in Mexico, your employer is required to pay for your IMSS. The payments are small and depend on age. For a young person, the premium can be under $100 per year, rising to about $300 per year at age 60. Anyone who lives permanently in Mexico can join IMSS for the same yearly rate that employers pay. There are some restrictions on the first two years of the policy. After that everything is covered and there is no deductible or copay.
Seguro Popular is free if you are over 60 years old. All you have to do is sign up and prove you live in Mexico. Seguro Popular has its own clinics and hospitals just like IMSS but if they lack something, they will send you to an IMSS hospital.
According to published figures, employers pay about 44% of the IMSS cost. The rest is covered by the government. Since Seguro Popular is “free.” I presume that the Mexican government funds 100% of that program.
There are also private hospitals and charity hospitals in Mexico. No matter who you are or your status, you can get healthcare in Mexico.
Most of the medical professionals who work for IMSS or Seguro Popular have a private practice as well. A friend of mine had to have a kidney removed. He was at IMSS the day of the surgery and the surgeon came in and said “Last chance, I can do it this morning or this afternoon.” When my friend asked the difference, the doctor said “This morning is free. This afternoon is next door at the private hospital and I charge $8000.” He went the IMSS route.
Most of the private hospitals are totally or largely owned by the doctors who work there and they are fiercely competitive on price, quality, and service. You can go to any private hospital in Mexico and ask for a price for a procedure and get a price, plus they will gladly give you a tour to point out their equipment and people. In Mexico, you are required by law to post prices of any procedure that is done in the hospital.
There is private insurance in Mexico but it is relatively expensive ($3,000-6,000 per person per year) and works totally different. When you are discharged from a private hospital, you are expected to pay when you leave. If you have insurance, the hospital calls the insurance rep and he shows up with a checkbook. Everyone looks over the bill, the insurance rep cuts a check for his portion, you pay the rest, and the bill is settled. Unlike the US where insurance companies make all kinds of discount deals, in Mexico, everyone pays the same.
One of the major differences I’ve observed is the amount of paperwork here is much lower. I had bypass surgery in the US and got a 42 page bill in the mail. It was just for the blood work over 6 days. When I had hip surgery in a private Mexican hospital, the bill was 2 pages. One listed the 6 doctors that saw me and the other page listed the hospital charges. Neither one was a full page.
The hospital did charge me a 3% service charge because I paid with a credit card and an extra $9.00 for the TV but other than that, the bill was exactly as the rate chart stated.
You see several differences between Mexico and the US with healthcare, especially with the payment system.
In the US, most people who have insurance think of costs in terms of insurance premiums, copays, deductibles, etc. If you have a $2,000 deductible, you know your costs going in. Insured patients rarely know or care about the actual costs.
In Mexico, since most healthcare is cash based, people shop for price and reputation, both of which are easy to find. Also, education is cheap in Mexico, and there is an excess of medical professionals. Doctors with good reputations stay busy. Doctors with poor reputations end up driving taxis.
Most people in Mexico have either Seguro Popular or IMSS as their “catastrophe” backup and pay the little stuff out of pocket.
Drugs work differently here. You can buy almost all drugs without a prescription except antibiotics and narcotics. I pay less today for the same drugs I’ve been taking for years now than I paid a decade ago in the US with insurance. There is a maximum price on each box and everyone discounts 10-30%. The pills are all blister packed so they can’t be tampered with and they are the same manufacturers that sell in the US.
There’s a whole attitude difference between Mexico and the US when it comes to medicine. I’ve had major and minor surgery on both sides of the border, and I like the Mexico side better, not just the cost, the care.
When I had a minor hernia operation at a local clinic, the surgeon had an emergency, and I was late getting into surgery. It was pretty late when the last IV ran out, and the surgeon stopped by and said I could spend the night free if I wanted. I told him I hated hospitals. He wanted to know how I was getting home. I intended to call a friend, I said. He asked where I lived and said he would take me home.
He took me home (only a few blocks), made sure that I got inside ok, made sure that I had everything I needed close at hand, gave me his card with his home phone, office phone, and cell phone, and told me to call him anytime if I had questions or problems. By James Murray for WOLF STREET
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Thanks, Wolf, for giving us mucho informacion that is quite valuable. I had no idea how Mexico’s health system worked. It may be very valuable in the near future, when Paul Ryan puts MediCare on voucher system.
Medical tourism will really take off when Ryan switches to a voucher system.
US hospitals and doctors will wonder where all the patients are.
I have heard good things about the Costa Rica medical services, too.
I subscribe to market-ticker.org. They lay the blame for America’s high cost health care on failure to enforce anti-trust laws here. Our Hospitals and doctors do not compete on price and patients don’t force them to. I may move to Mexico.
Actually in a way I suspect it’s even worse than that, as one notion that is drilled into our heads from the day we are born is that more expensive equals better, so, with your life literally on the line, are you really going to go for the cheapest choice?
Don’t forget that the health care system operates under a ton of regulations and restrictions from the government, insurers and “professional” organizations. I’d like to know how much the privacy act, HIPAA, added to the average medical bill. I’ll bet it is substantial.
I personally know a Minnesota-Blue Shield executive who retired after working there twenty-something years. She was mid-level management. Her retirement was a $6 Million payout! She spent six months huddled with tax advisors, attempting to minimize the tax effects of how that six million was paid out.
The labels of “Communism!” and “Socialism” about certain ideas have certainly hurt society as a whole. And heck, the US Military is the biggest “socialistic” entity in the country. People never realize that!
You meant the ‘unprivacy’ privacy act did you not ?
I believe it’s referred to as the ‘No Medical Records Hacker Left Unchallenged Act’
Friend of mine is an MD. When I first used his services, an office visit was $35. Over three years it rose to $135. He had to expand the office, hire a new full time clerk to take care of paperwork, had so much charting and record nonsense to comply with he could see fewer patients per day, and his days were longer. His malpractice insurenac over that three years went from $600/year to $1200/month, and that was AFTER he eneded a number of “high risk” services, like in home elderly visits for his patients. Now those patients had to use government services to get to his office. He managed to hold off on many of those price increases until Uncle Stupid changed the rules, and ALL patients now fell under the same federal records guidelines. I always paid cash, at time of service. He could jeep minimal records on me. No more.
GOVERNMENT are the single largest cause of increased costs in medical care in the US. Paul Ryan does not “get it”.
Health care and insurance industry are exempt from many anti-trust laws thanks to the McCarran-Ferguson Act of 1945.
I live in Mexico, my experience is much the same. It’s often the case that you can see a specialist the same day just by walking in and waiting 20 minutes or so. There are some medications that cost 100 times as much in the US as MX. Most gringos I know, even those with money, just pay cash for medical stuff since it’s affordable. Doctors in MX mostly make a good living but it’s not a get rich quick racket.
U.S. healthcare defines the term “Criminal Racketeering”. Per capita, the U.S. pays 25 times (yes, 25X !!) the dollars paid in Cuba per capita per year.
Guess who’s infant mortality rate is WAY lower ( at 25x less money) ? Cuba
Guess which country has a longer life expectancy (at 25x less money)?
It’s a statistical tie. Now THAT’S Criminal Racketeering ,beyond belief.
I’m not surprised Mexico has a better healthcare system than the US. Our medical system is abysmal and getting scary to use. You never know what the bill will look like after going to the doctor. And if you’re lucky they won’t kill you.
One of the things I learned in Florida was that recent refugees from Cuba would return to Cuba for any operations they needed. First they got their immigrant status and then they would return for any operations. I think there was a waiting period for returning Cubans to get care in Cuba because it was always a long term stay, of many months, when they returned to Cuba.
I’ve come to the conclusion that to fix healthcare in America, you actually have to fix Americans. Most Americans have never needed healthcare outside the U.S. and have absolutely no idea how easy it is for most people in the rest of the world. Couple that with “America is the greatest country in the world” and they cannot imagine that a simple trip to the hospital for a broken arm shouldn’t cost $30,000, and a Tylenol shouldn’t cost $300.
There’s really nothing that can be done. It’s astonishing.
It’s been the decades-long policy of the AMA to restrict the number of doctors in the USA to as few as possible. The result is very visible: you go to a clinic, and if your doctor is not from South Asia (India, Iran, etc) then someone on the staff is from there. Are they good doctors? Usually, yes.
My father-in-law, successful millionaire, used to be asked all the time in social settings (years ago, he’s 90 now) “Tom, how do I make more money? I’m stuck at $250K a year, and nothing I do seems to increase that!” The AMA made it a policy to keep the number of doctors fewer, to increase the possibility of more income. Nowadays, doctors are harried, hurried, and haphazard, all because there are not enough doctors!
This is one of the most common falsehoods in the healthcare discussion. Listen up folks: the AMA has NO CONTROL OVER THE NUMBER OF DOCTORS in this country. In fact, the AMA has little control over anything, other than that it owns the copyright to the codes that are used for billing, and it collects enough royalties on that to make up for the loss of dues from the doctors leaving its ranks every year. The organization responsible for the number of doctors is the federal government, which regulates the number of residency positions available in this country. It doesn’t matter how many more medical schools we build, or how many medical students graduate–if there are no residency positions for them, they aren’t going to be able to practice. The government is also the entity that regulates the doctors, the hospitals, the facilities, the MRI machines, and everything else that makes American medicine so much more expensive. American tort law also adds a huge amount to the bill. The posters on this thread make it sound like nothing ever goes wrong in Mexico, but when it does, you’re out of luck. I like the Mexican system, and I wish we had it here. But you must realize that there are negative consequences as well as positive, and that the insurance companies and the trial lawyers will never allow it to happen.
Why are People so Surprised…..? The U.S. Health Care and Pharmaceutical Industries are in it for two reasons..Profit and MORE Profit…lolol God forbid they would ever CONSIDER the Patients…! aloha and thanks for reading
When you have surgery at a private hospital in MX the lead doctor quotes a price that covers everything, you pay him and he pays all the other doctors. One bill. Also, if you want to compare drug prices, check the websites of Farmacias Similares or Farmacias del Ahorro. These are the largest pharmacy chains in MX. Drug names must of course be translated into Spanish. Even Walmart has pharmacies in MX, some things are cheaper there. Pharmacies generally have a doctor on-site, cost for basic visit $3 or less. Many doctors speak English, but few pharmacy doctors do, in my experience. For many medical tests you can generally walk in, the bigger labs with multiple locations often have more up to date equipment. I had x rays, the equipment was relatively new, Jewish radiologist as well.
example of American medical fraud: MRI thru medical plan billed $3900 to insurance company, insurance pays $1870 to provider, patient pays $600. I called up several imaging groups in town and asked for a walk-in cash price, was told $600 by several vendors.
Time to renew my passport.
MRI in Saint-Petersburg Russia is about $60-70.00 if you come after 10 pm it is 25% off in some clinics. And I’m talking walk ins. Had it a couple times. 45 min and you are out with full doctors reading of your results.
Merlin you can go online and search cheap MRI and get great rates from firms looking to use downtime for their machines I needed one and found a few in midtown Manhattan at VERY reasonable rates
In Guadalajara, you can expect to pay about $200 for an MRI, cash price.
Great piece of information. As a family physician with a libertarian bent I agree with what he says. Two problems in this country (there are more of course) are: first, the limited access to medical education and the restrictions on what health care professionals can do – e.g. nurses can treat a lot of conditions but are not legally allowed to and; second, the cancerous growth of the health insurance industry. Note, that Obamacare drove up health care cost by destroying the relationship between risks and premiums and by burdening the companies with more mandated benefits such as covering birth control. This in turn allowed health care providers such as hospitals and doctors to increase charges for at least some services because the insurance companies have to pay for them. ( as an aside, when I started practicing in the late Seventies, birth control pills cost up to $1 a month- now $50 a month and up retail)
Don’t have a simple answer except that health insurance’s role in the payment of medical care and the “managing of it” has to decrease.
There is most assuredly a very simple answer and it’s the right one–separate medicine and state. The day after all legislation for the medical industry is repealed, all this bs would go away. We would return to the situation when I was young, which was pretty much like the fellow in this article describes. You go to the doctor, he hands you the bill, you pay it out of pocket.
I said it was simple, not easy.
“A large percentage of healthcare in Mexico is government run, either through IMSS or Seguro Popular.”
What part of that did you miss Marty?
We have government-run health here in Canada, and it works great. The problem is when the “state” is in the pockets of the associations.
Please see my comment below about Canadian dental care.
The Oklahoma Surgery Center quotes all its prices upfront, for everything, and for cash. the cost if close to what one will pay for a co-pay under insurance.
As both a physician and a healthcare consumer, I am not surprised. The number of “middlemen” trying to make a profit off the system is tremendous – from the hospitals and surgery centers, to the insurance companies, drug companies, pharmacy “managers”…the list is long. Most physicians work very long hours and deal with a huge amount of beaurocracy to earn their living – which is good but for most not exhorbitant (typically about $120,000 – $150,000 a year for most primary care docs; many also come out of professional training with hundreds of thousands of dollars of debt.). There is no transparency in the system, and the insurance companies and hospitals deliberately make it difficult so comparison shopping and transparency are impossible. When I was in a larger practice, we employed 4 staff full time JUST to deal with the insurance companies. While there is a growing minority of physicians who believe in transparency and are up-front about cash pricing and services, the healthcare system as we know it today will not change until there is demand for it. The regulations also add a huge cost – mandated HIPAA compliance and EHRs themselves can add tens to hundreds of thousands of dollars a year in costs to a single practice. When there are so many players in the mix, all vying for profit with no real competition, this is what you get.
Exactly what I have been saying for years. There is no reason the medical community can’t just charge by the hour like every other profession. Get rid of the middle-men. You’ll be 99% of the way there.
I have had similar experiences in Peru and Russia. Low cost, open prescriptions, quick service, quality care and well-trained professionals.
Someone reputable (Trump?) should get a team to go to 20 other countries and write a report about people’s experiences with healthcare there and then publish it. Maybe we could learn from them?
We don’t need a “report” to learn how other countries provide medical care at a fraction of what it costs in the US. We know what the problem is.
In no other country in the world is the health care system the single source of profits for billion dollar industries like insurance, pharmaceuticals, hospital and surgery chains. (Picture a ladybug staggering along the ground carrying five or six cockroaches on her back.)
If you have lived outside the US for any period of time, you have received medical care through a single payer system. My experience was three years living in France. Excellent care in every way, streamlined and personalized. (Granted, speaking the language helps.) At the end of the day you owe some cash, in my experience never more than about $100.
So why are we stuck with our insane system? Subtract the huge profits of the healthcare industry from the US economy and you have your answer. Wall Street
Most physicians in Europe speak good English in my experience so the language barrier is minimal and even in 1971 when I used a hospital in rural Germany that was the case
Anecdotal accounts don’t amount for much when trying to raise awareness. Neither are they comprehensive. A good report would also show the trade-offs that other systems face, such as shortages of care and long waiting times. It might also allow us to see which countries have been most successful and are therefore the best examples.
“We” may know about it, but “We” = a small minority, mostly with very partial knowledge of systems elsewhere but strangely solidified opinions. If knowledge was widespread, the situation we are in couldn’t be supported by politicians who wanted to be re-elected.
Trump??? No, you want someone reputable.
Thank you for sharing this.
I lived in Canada for 8 years (miss it terribly) and had extensive experience with their medical system. The ease and lack of paperwork was jarring.
Unfortunately, the average American’s lack of travel and experiences outside the U.S. does not keep them from pontificating on other’s assumed pitfalls.
I guess it’s the “American Exceptionalism” that’s been beaten into their heads.
Brainwashed, is probably the correct term.
I drive into the DC capitol once a month now (grew up inside the beltway in an let’s just say, affluent neighborhood) and based on what I see going on there and even where I live outside the area I have to conclude there’s no way the US public can afford to blow the billions on what I see, it’s a huge burning urn of steaming funk here.
Wow, we’ve doubled the debt to $20T in less than a decade and we have no progress to show for it.
I worked in Canada for two years. During the first week of employment the administrative secretary called me into the office and asked if I had received my Care Card yet. “I’m a f—ing Yank, how many months do I have to be employed before I qualify?”
“You are in a civilized country now– we don’t allow people to be denied health care.” The application form was one page long and I received full 100% coverage immediately.
The US spends as much on administrative paperwork in its medical extortion system as most countries do on their entire health care system while delivering superior results.
And yes, dental care in BC is outside the system and every bit as expensive as in the US. My dentist was a type AAA first generation Indian who staffed her all-woman office with beautiful women which did help to ease the pain a bit. (I guess I’m allowed to make a comment like that now that we live in Trumplandia?)
Not “denied” per se, but it will take you 4-6 months to get an MRI in the western provinces. They ration care, and many Canadians will come to the US for urgent needs.
The reason healthcare insurance in US costs $1,000’s every month is our government is at war with the citizens. So the citizens elected someone outside the sphere and now the elites want to assassinate him.
Mexico is looking pretty good, no wonder Ford is moving there.
I went to India for a surgical procedure back in 2011. Total cost was about 75% less than the US. This included airfare and recovery time lodging.
The doctor and facility were top tier. World class. It’s been over 5 years post-op and I’m doing fine.
The real issue in the US is the cost. I priced my exact procedure in The UK and Europe. Bothworld renowned for this procedure. They were about 50% less than the US.
It’s no surprise that the premiums were starting to skyrocket here in the US. The ACA, with its ambitious coverage of pre existing and the uninsured would not change the costs and only cause everyone to have to pay more.
I live in Thailand and it’s the same … (literally) world class treatment with 3rd world costs .. and as an extra bonus you get to travel and broaden your mind about the rest of humanity.
As much as I love the USA, its health system is the pits. Here in the UK our NHS stumbles along, as it always has, delivering excellent care to all who choose to visit.
Can’t resist posting this link:
Here in the UK, my father is currently in hospital after a hip replacement. Following post-op complications he had to be transferred to the intensive care unit a larger nearby hospital and is currently receiving 24*7 nursing care. This is his itemized bill so far:
Hip replacement: £0.00
Ambulance transfer: £0.00
Drugs (total): £0.00
5 days in ICU: £0.00
At current exchange rates that’s $0.00
I am a Canadian who lived in California for about 10 years. I can attest to the fact that Canadian medical is, in almost every way, much better than US medical — even for the insured.
I live near the border, and have noticed that people come across the line quite often especially to give birth. It is just sooo much cheaper here, and the quality of care is usually much better.
Now when it comes to dentistry, Canada has a fairly similar system to the US system. The result? People fly to foreign countries to get their dental work done so that they can afford it. Its cheaper to take a free vacation than to get somewhat complex work done here.
Yes, B Fast, I noticed that too. The dental system in Canada is similar to what the medical system is in the U.S.
It is total crap (overpriced, and many of the other negative things that you can say about American medical care).
We have dental insurance and last year my son needed to have 4 wisdom teeth extracted. The insurance company took one month to approve the procedure, while my son was in pain. They paid for most of it, but it still cost almost $2k to extract 4 wisdom teeth, my portion was about $400, which is what I think they should have charged in the first place.
The insurance company dragging their feet when emergency service is needed is a common problem we have experienced. When people here say they fear rationed healthcare, I have no idea what they are talking about, because we already have it.
“Well, Mexico is a 3rd-rate country with 3rd-rate medicine” . Another thing they like to throw out is that traditional medicine like Chinese acupuncture, etc does not work. I used to think acupuncture is no better than snake oil, but 15 years ago I had a condition that no Western medicine could fix. It’s not fatal or anything, but let’s just say, the quality of life wasn’t great. On a friend’s recommendation, I went to this acupuncture doctor in South East Asia. One visit and I was fixed forever. No medicine to take, nothing. And the price was embarassingly cheap.
Same nice experience to you, Chinese acupuncture not make big profit pharmas company if you not take drug for all your live, this is the true, and this why brainwash pharmas pay for medical news pub.
In June my husband and I went to Saarbrücken, Germany to see a doctor about a chronic health condition that he has that is very painful. The doctor conducted a battery of clinical tests, he took his time examining my husband. The bill was €250 cash and we came away with more answers to our medical questions than before. What I noticed that was different (compared to US) was that the doctor relied more on his experience and basic, traditional, old school medicine; and less on expensive medical diagnostics, dangerous prescription drugs that are essentially a hit and miss game. Don’t get me wrong, we are happy with our doc here in the US, but sometimes it seems like doctors here don’t perform the clinical exams like they should, instead relying too much on high-priced medical diagnostic technology and drugs.
I am surprised no one mentioned malpractice insurance, yet. Reportedly, about 10% to every doctor’s bill. And the US is exceptional(ist) again in this regard.
Not in Texas or California. Tory reform has limited the payouts for malpractice so low that attorneys won’t even take a call about it.
Of course malpractice insurance has only gone up…
I have lived in Mexico over 7 years and can attest to all said here. I’ve had cataract surgery, friends have major heart procedures, and all have nothing, but good, to say.
One major difference here, never have I had more than 3 professionals attend to me. None of the U.S. style of numerous people sticking their heads into the room, and padding the bill.
Just this morning, I purchased my blood pressure meds, and paid about $15. 10 years ago, I paid over a hundred, back ‘home’. All this and I have the great facilities of Guadalajara, only minutes away. I can say the same for Puerto Vallarta, as I lived there 6 years. Finally, I have never felt rushed out the door, as every professional I have ever needed made me feel as though I was their most important patient.
I had (what would have been) $5,000 worth of dental work done in Mexico. The flight, hotel, restaurants and (2) days of dental work cost $2,400.
I am medically trained and have only worked in the UK. I have been a patient in the US. As a Carer I have been a party to varied medical care in the UK. I have great admiration for the healthcare assistants and domestic staff who really deliver a lot of the care and attention. The free at the point of access model as per the NHS in the UK is great in that it does not enslave us to healthcare debt. But it is now massively overstretched. And somewhat variable. And now driven by internal markets and is being privatised by stealth since the mid nineties if not before. Rationing is commonplace if not ubiquitous. Overall I would rather get old in the UK. Don’t really know much about European or Mexican healthcare. Key for all healthcare providers is embrace the patient centred care concept. Hope the Donald can improve the system.
When I lived in the US, I took 3 drugs, 2 brand names and one generic. I paid (with insurance) $5 for the generic and $25 for the 2 brand names.
I heard an ad from Wal Mart one day of 90 days of generics for $9, so I went to see. Sure enough, 90 days for $9. Then I asked about the other two drugs. One was $60 for 90 days, the other more expensive. I’d go to Wal Mart every 3 months and save $20. $20 is $20
When I came to MX and found out that you could buy almost anything over the counter with no prescription, it almost blew my mind. I expected to see dead people lying everywhere. At that time you could buy antibiotics also, but they stopped that about 5 years ago.
It took about a year before I lost the feeling that the cops were going to raid the pharmacy one day for selling drugs without a prescription.
Blood tests work the same way. I go down once a year with my old report, they take my money and my blood and email the result overnight.
As a US physician, I will tell you there is an incredible amount of waste in the system primarily involving compliance with meeting ever increasing regulatory requirements and getting insurance to pay for services rendered. Health insurance reform would go a long way toward lessening the cost of care delivery and giving me more time to spend doing clinical rather than administrative work.
I will also say that I’ve taken care of a number of bariatric, general and plastic surgery disasters from Mexican hospitals that’ve been flown back up to the states to deal with complications. Our system is expensive and inefficient, but you will be taken care of and you will have legal recourse in the event of a bad outcome. Caveat emptor.
I think these are good points but I’d just like to point out that another reason why American medical services and health insurance is expensive is the stratified pricing. US consumers pay on average around 4 times more or greater for the same drug as any other country, but the US also develops more drugs than any other country – so one reason why healthcare is cheaper everywhere else (besides the fact they don’t pay their doctors and nurses as much) is that the US is subsidizing the cost of prescription drugs for every other country.
If you look at the drugs that Mexican patients use, what proportion are developed and patented in Mexico? The US pharmaceutical industry, with all it’s flaws and greed, develops products that people everywhere use, but US consumers do not benefit from it. I think one part of the solution will have to be charging US patients less and patients in other countries slightly more for brand name drugs still on patent.
I’ll take the Canadian system over the US system … and I don’t understand why americans don’t make a better argument for single payer.
1. Single payer means that if you want to leave your company and start a business, you don’t have to worry about losing health care. Great for entrepreneurship.
2. Single payer means that doctors can spend time medicining (I know not a real word) and not insurance handling. That’s called efficiency.
3. Single payer means a more efficient use of expensive medical equipment. Not every doctors office needs an mri machine or whatever. Instead centrally located equipment gets used to its maximum. Also called efficiency.
4. Peace of mind (and not bankruptcy). I know I don’t have to worry if I or a member of my family gets sick. This is simply huge in my mind.
Yup, we pay more in taxes, but we get lots more too. Ultimately though it is the peace of mind that is worth the most. You get to make medical decisions based on medical need, not on financial ability – and that is the type of society I like living in … even if I end up with less personally.
Smth to consider for your Canadian single care system: city of San Francisco has more MRI machines than the whole of Canada.
Avearage Waiting time to get an MRI scan in Canada is 9 months.
Of course it costs nothing if you can wait that long
I am a physician in a small, Canadian city…. small means 30,000. If you need an urgent MRI wait is no more than a few days, it might be several months for non-urgent scans. Average wait times is a totally misleading number. Don’t equate average wait times with poor care.
Excellent article. If would be useful if you posted some good
Mexican hospitals that accept US patients. I’m burned out on all the insanity of US healthcare.
When I ask ‘how much’ they tell me, they won’t know until after the procedure or ‘we don’t do billin here’. I’m sick of it.
Does everyone speak english?
I had a special procedure done in the City Hospital of Brussels Belgium. We were assured that English would be no problem. As it turned out, the surgeon, his secretary and the anesthesiologist spoke English and that was it. Everybody else spoke French only. I fortunately brought a dictionary with me to help communicate with the staff. I got decent care none the less. But don’t count on “everybody speaking English” unless you are in country that speaks a Germanic language.
In Hanoi Vietnam I had two crowns and a root canal done and teeth cleaning for the grand total of $260. My Vietnamese friends thought I got ripped off because I went to a western-style dental clinic but I was more than happy.
The 2 biggest lobbies in America are health insurance and pharmaceuticals. Don’t expect any changes. They have more money than you and politicians are corrupt.
I am a retired American living in China. I can get a procedure done for the cost of the deductible on Medicare. Almost all medications are OTC and extremely cheap. I have a major hospital a few blocks from me that is affiliated with a medical school. First class healthcare. Americans don’t realize how badly they are being screwed because they don’t know much about the rest of the world.
Americans don’t realize how badly they are being screwed because they don’t know much about the rest of the world.
True in a lot more areas than just the medical system. But willful ignorance and the conceit of “‘Murkan exceptionalism” keeps them from making too many comparisons, and there are lot of interests that want to keep it that way.
We have lived and worked in Spain these last 35 years, self-employed. Current rates for social security contributions are about $290-$300 per month – that covers health for the whole family (husband, wife and all children) plus eventually a (small) pension. Medicine costs 10% of the retail cost if you’re still working, zero if retired. Hospital costs are zero, a visit to the doctor is zero and my experience of treatment is that it is pretty damn good – British and Dutch doctors I know tell me that Spanish medical people are as good as anywhere. What a bargain.
Years ago my then 7 year old son caught a nasty case of rotovirus while on vacation in Madrid. We ran to the emergency room and my wife fortunately speaks fluent Spanish. We were very worried about them taking our American insurance. The registration lady took all of our information. My son was in the hospital for 3 days being well taken care of.
We never received a bill. Including our insurance company. Wonderful to be able to live like that.
My list of bad experiences with our healthcare system are numerous. When the “debate” over the ACA exploded back in 2011, I posted my stories on numerous discussion forums and comment sections like this one. I would routinely receive responses that included calling me un-American and a pinko communist.
There was a recent Reddit thread about the topic (thousands of comments), someone posted “you can have your government healthcare, I’ll keep my liberty.” I asked how his liberty will pay his emergency room bill. He replied by telling me to move to North Korea. I still see that retort thrown in discussions about this topic, am still scratching my head over what that even means.
Back in 2007 I had a suspicious mole removed from my back which was *supposed* to be covered by BC/BS (was paying $400/month with MA’s Romneycare). I ended up getting a bill because it was deemed two procedures, and BC/BS doesn’t pay for two medical procedures in one day. After a few irate phone calls I learned that the first procedure was the removal of the mole, and the 2nd procedure was the stitching of it. Like I had the option to have the stitching done on a different day???
I shared this story again on some dumb internet discussion group which quickly devolved into the aforementioned name-calling. I pointed out that that same year the CEO of BS/BC got an $8 million bonus, “so they can afford to pay him an $8M bonus but can’t afford to cover a simple mole removal?” Someone replied to me with a thousand word lecture about how that CEO legitimately earned his bonus just like some big named baseball player (can’t recall the name) and who am I to begrudge that baseball player…I just shook my head.
I also had a CT scan a few years back, also “covered,” and I got a bill for $750. The final straw came last year when I had a colonoscopy, I was assured it was “covered” by my insurance. Yep, I got a bill. $1,300. All because I had a previous diagnosis of diverticulitis (of course, nobody told me this beforehand, and I’d have never had the procedure if I had known I’d get a four-figure bill, which particularly stung since my contract job ended and I once again was unemployed).
I fought it for nearly a year, but they sold the debt to a private creditor who I learned could take me to court and I could go to jail (debtor’s prison) for nonpayment. I have since sworn to never see a doctor in this country again. I’m currently searching for a teaching job overseas (after four years mostly unemployed, I gave up and got a tefl certificate), not yet sure where I’ll end up (am considering Thailand)…
Go to Vietnam better money and easier to get a job . Not sure how old you are but youth helps .
Asian teaching programs are just horrible. I have a M.A. in Applied English Linguistics ans 8 years experience as a Teacher of English as a Foreign Language but not of that matters in the least, they just want a warm Western body to prop in front of the students. You are forced to use rigid, antiquated, student hostile methods with unmotivated students who don’t learn the language however many years of classes they take. A better bet is to teach private students who are taking English for their own interest and paying for their own lessons. These are highly motivated to learn and can generally learn decent conversational English in about 6 months.
Nothing about your comment surprises me. I will also add that most state medical boards are in the pockets of the American Medical Association, and you will not get anywhere complaining to them. The medical industry in America is scary to me. They will kill you for money and yes I really, really, really believe that.
I am very impressed with the comments as regards the medical system in Mexico and I want to thank everyone for sharing. For those of you living in Mexico, can you suggest some places where one could consider relocating to, which would not be severely overpriced as are the hot-spots in Mexico. As a Canadian, I am getting tired of our cold winters and am seeking warmer climates where there is a good medical system and a safe area that is not crime ridden. Thanking in advance everyone for sharing.
Merida, Yucatan, Frank
I have a relative who has lived in Mexico for several decades. I forwarded this post to him and here was his reply:
I think that the article is pretty accurate. The health care in Mexico as good as in the US and in many ways better. Doctors still do house calls and give a lot more personal attention. The important thing is to make sure you have a good private doctor (there are a lot of bad ones) and don’t have anything to do with the government health care system. I have never known anyone who had private health insurance. You just pay the doctors and private hospitals in cash. The costs are a fraction of what they would be in the US. I had 3 major surgeries [several years ago]. The care was excellent and the costs were very reasonable. I would without a doubt choose Mexico or Spain over the US for medical care. Thank God I never had to buy Obamacare.
Supply and demand is the name of the game. Flooding the system with money raises prices.
If the most the average person could or would pay for a heart transplant was $5,000, guess how much a heart transplant would cost. Conceivably a bit more than that because they’d want to pad the bill in the hopes an individual could pay more, but in the end, $5,000 is what they’d bank on and what they’d take.
Now add third parties to the mix, paying with Other People’s Money; lawyers; and the government, the representatives of which are representing lobbyists with cash in the hopes of extending their career on the public teat instead of their constituents, and it costs in excess of half-a-million.
I don’t know what the ramifications of single payer are overseas. Perhaps it’s those self-serving politicians I mentioned, but here, government control of medicine would be essentially weaponized, used to reward friends of whoever held power at the time and punish their enemies. Smashing the size and power of govt would seem to mitigate a lot of ills.