By Richard N. Baldwin T. /HispanicVista.com

From Mexico
July 25, 2009   

By Richard N. Baldwin T. /HispanicVista.com
On Health Care

     With all of the talk in the U.S. about government-sponsored health care and comparisons to other country's health plans going on, what is forgotten is what the country to the South (México) has for a national health plan.

     We keep hearing about the UK plan, which is a single payer (government only) plan that is now starting to ration health care as a cost control.  And, in reality, the waiting time to see a doctor has gotten excessively long with patients sometimes dead by the time their appointments come up. In addition, there is simple rationing. Cases are analyzed for "cost effectiveness". In other words, say you are at a certain age and you need a hip replacement so that you can walk. Some pea-brained bean counter says that your life expectancy does not justify the expenditure and a wheelchair is cheaper. And that is final. But it is a fact that President Obama talked about this very thing in his presentation to the public of his health plan proposal as an example of how to save money in health care.

     Canada's health system was set up in a like manner as the UK system. But there, people who could afford to go south to the U. S. simply did so. And with enough complaints from its citizens, Canada is slowly opening up the door for private medical practice in Canada. And yes, I could tell of some hair-raising experiences of Canadians with their health care under a strict single payer system.

     But my purpose here is to explain how México has addressed their health care. A good number of years ago, México established what is called a Social Security system (the IMSS). This is health care oriented and only recently has incorporated a modest national retirement program. A more inclusive retirement system is also available in the last few years that resembles a national 401K system. In that system, the prospective retiree gets options on various funds to invest in that are overlooked by the government.

     First of all, all workers (employees) with formal companies are covered in the IMSS health care system. The companies pay for this. More on the "formal" later. In addition, self employed and others not on company payrolls can participate as individuals. The yearly fee for the latter is only a few hundred dollars.

     This would include such people as farmers and those in informal small businesses.

     Emergency care, such as accidents, is treated free of charge for all subscribers. Those who are not subscribers are also treated and asked to pay for their services. Those who cannot pay are treated to the point that they can be transferred to government clinics. 

     The system treats as an institutional system. You don't pick your doctor; you are assigned one. And frankly, treatment requiring heavy diagnostic work is not the IMSS forte. But their trauma treatment is by all indications very good. When I was a plant manager in a die casting firm, we had an operator that was setting a die into a 200-ton capacity press. For some reason, the press closed while his hand was in the press. The only thing that prevented crushing his hand to paper thinness was the wrench that he was holding in his hand. As I helped carry the man to a car to take him to the IMSS trauma center close by, I looked at what was his hand and said to myself, "amputation". But in fact, in a few months he was back to work with a rebuilt hand that was missing only one finger and part of another. His only limitation was that he could not handle heavy parts any more.

     I was exposed to another little quirk in the IMSS system when my former father-in-law was confined in the hospital with what turned out to be his final bout with pneumonia. He required constant supervision in his condition and the family was told to provide someone to constantly watch over him by taking turns on shifts. One night, when one of his sons did not show up, they called his home and told his family that if he didn't show up promptly, they would send the police for him. The found him and sent him to the hospital quickly. 

     But besides the IMSS is a robust and viable private health system and private health insurance available. From my home close by is a dental clinic practicing with the latest techniques. A few years ago I had two extractions, a root canal and a new upper plate made. Cost: $600.00 USD. In another direction close by is a private internist giving high quality service. A number of years ago I came down with the flu and called in sick to work. Their response was to send a doctor to my home to check me over. Cost of a house call, $30.00 USD. And there are many private hospitals to choose from.

     "Prescription" drugs are very economical here also. About 40% lower for equal drugs by the same makers in the US. Two things hold the costs down: No written prescription is required for drugs with the exception of drugs that are opiate based and a few others. You, as an individual, can make your own choices and are responsible for them. And drug makers are not subject to the high costs of frivolous law suits here either.

     So, in México's case, a government health care system works along side of a viable private health care system. The government system provides a floor for as many of their citizens as is possible. The one problem is that so much of our population works in informal non-taxpaying occupations. This is not automatically covered by the IMSS. And this represents at least 30% of México's entire economy.

     This is a problem that México still has to solve, if only to broaden the tax base. It should be added that the major financing of the IMSS (along with the federal government) is the nationalized oil industry. Nice to export oil rather than have to import it.

     But examining what is being talked about in the US for health care seems to be set up to evolve to a single payer system, like Canada and the UK. And no real way to pay for it has been revealed.

     I am not suggesting that the Mexican health system would be good as it is for the U.S. But there may be some things to think about. And México is becoming a "tourist Medical" destination for many from the North.
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Richard N. Baldwin T., a HispanicVista.com (www.hispanicvista.com) contributing columnist, lives in Tlalnepantla, Edo de México. E-mail at: R1041643422@aol.com