American Insurance Sends Patients to....Tijuana??

The cost of health care is a constant refrain these days. Just take a look at the wide variety of studies, news articles, and blog posts that are generated on the topic daily. Hardly surprising in an era where, as George C. Halvorson points out in his book Health Care Reform Now!, there are over 9,000 billing codes for procedures but not one for a cure.

Many solutions have been proposed, although the one embraced by a growing group of providers is novel: ship the patients to Mexico for treatment to cut costs.

Bloomberg's Thomas Black brings us the details as he reports from Monterrey, Mexico:

Yielding to pressure from employers, health insurers such as Health Net, Aetna Inc. and Blue Cross Blue Shield of South Carolina are offering cost savings to policy holders who take their ailing backs, hips and knees to foreign countries for non- emergency medical treatment. Mexico has emerged as a favored place for American medical tourists because of its proximity and U.S. insurer incentives.

Black reports about 180,000 Americans make a run for the border when they need health care each year, and spent approximately $2 billion with foreign providers last year while doing so. Why is this happening? Cost is the main factor, although Black's article reports some people stating they received better quality care in Mexico than in the United States.

A hip replacement in Mexico or Thailand costs $12,000 compared with $43,000 to $63,000 in the U.S., according to a study by Christus Health published last year. Angioplasty, in which a surgeon uses a tiny balloon to open a blocked coronary artery, costs $10,000 in Mexico, compared with $57,000 to $82,000 at an American hospital.

So that addresses the cost factor, how about that quality of care? Let's take a look at the case of Antonia Siguenza, who needed treatment for a cyst.

[In the U.S.] Her portion of the bill was $800, she said. When the incision failed to heal after several months and her U.S. doctor advised her to give it more time, she drove two and a half hours to get another opinion in Tijuana and elected to have a second procedure there.

Her cyst cleared up a few weeks after the surgery, she said.

Ana Andrade, vice president of Latino programs at Health Net says that approximately 20,000 customers have the Mexican coverage plan and also that they save roughly 40% on premiums by doing so.

While the pricing is vastly better across the border there are justifiable quality of care concerns. Follow-up care can be complicated to near impossibility, safety of the blood supply is sometimes suspect, and possible lack of legal options in the face of malpractice are valid concerns.

Black's article contains two pages of analysis as well as brief interviews with both patients and providers on this subject. He demonstrates the impact our inflated and inflating health care costs are having by demonstrating how many are opting to go outside of the American system because of finances.

SOURCE: "Mexico Gets Medical Tourists as Health Net Sends U.S. Patients " 03/26/08
photo courtesy of omar omar, used under this Creative Commons license