The American Healthcare System and Your Bankruptcy
What do you really know about Mexican healthcare?
In spite of my good health, I lived in fear in the U.S.
Like distant hoof beats thundering on the horizon, I would hear that perfectly healthy friends my age in Denver were paying over $600 a month for health insurance. One friend, who broke her elbow, is paying off $8,000 in related costs in addition to the $600 a month premium. Then there are those deductibles before the insurers will pay a dime, often at $5,000 a year.
What good is health insurance if you get sick just thinking about it?
In spite of the coverage, how many of us have any confidence that their insurer would cover the cost of one of those $100,000 a year cancer drugs if we needed it one day?
My friends are the healthy ones. There are thousands of worse stories out there in our republic. Stories of financial ruin even among those who had health insurance when when they got sick.
More than one half of all bankruptcies are caused by medical debt. Three quarters of those filing for bankruptcy have medical insurance when they become ill or injured. Loans to cover healthcare costs are not uncommon, meaning some are paying high insurance premiums and loan payments to stay alive.
Sooner or later, we all get sick. Unless you have a million put away or are one of the disappearing breed of people whose health care is covered as part of a pension plan, whether or not health care expenditures will leave you destitute in your old age has become largely a crap-shoot.
The U.S has the most expensive healthcare system in the world, and only to be ranked dead last among high-income nations, according to Newsweek. Experts believe that a healthy couple age 65 will need between $245,000 and $266,000 for health care costs to cover what will not be covered by Medicare. In an odd paradox, the healthier you are, the more money you need to have saved because you will live longer, have health care expenses longer, and be more likely to have more expensive end-of-life care.
U.S policies are not based on health, but rather profit. As the online magazine Salon puts it in an excellent article, “America’s Broken Healthcare Has Fallen Off the Radar,” healthcare has become a commodity, sickness seen largely as a source of profit.”
In that same article, Carl Boggs, professor at National University in his book, “Drugs, Power, and Politics: Narco Wars, Big Pharma, And The Subversion of Democracy” puts it even more powerfully:
“The practice of medicine in the United States since World War II cannot be understood without discussing the rapid growth of a labyrinthine corporate network — hospitals, clinics, institutes, universities — combined with an even larger ensemble of business interests: Big Pharma, insurance companies, finance, energy, food, agriculture, and the chemical industry. This corporate empire amounts to the most costly, bureaucratic, and commodified medical system ever created — a system in which failure and iatrogenesis are built into its very modus operandi…
While people suffering from chronic illnesses can spend tens of thousands of dollars for drugs and hundreds of thousands more for hospital stays of a few weeks, CEOs and hospital executives, Big Pharma and insurance firms make huge profits and salaries…amassing] private fortunes from human misfortune and suffering…
With trillions of dollars spent by a public inundated with advertising, fearful of alternatives, and anxious to find ready fixes, life expectancy in the United States ranks fiftieth among nations — and overall health indicators are no more flattering, placing it near the bottom of industrialized countries.
Journalist Conor Lynch goes on to conclude that without a broad progressive movement that confronts the entire corporate state, healthcare will remain one of the many sectors corrupted by stock options and returns.
As cases in point, drugs are two to six times more expensive on average in the U.S. than other countries, the most expensive in the world. The same impressive statistic is achieved in medical devices; hip and knee replacements and implants. According to The Economist, these high prices are unlikely to change.
Pharmaceutical companies spend more on lobbying than any other industry, a quarter of a billion in 2015 alone.
R&D doesn’t begin to explain the level of profit these companies are making. At least reforms in transparency, where hospitals would have to make their prices public and motivate people to compare (and rebel) are finally beginning to gain traction in progressive states. This won’t do anything about the gouging.
I am still investigating healthcare options in Mexico. High quality health insurance with a private Mexican insurer will cost me about $200 a month if I buy in before I'm 62.
International health insurance companies also sell excellent expat policies. The last quote I received for an expat policy where I could be treated anywhere except the U.S. was about $450 a month and a very comprehensive program which even included experimental drug program eligibilty.
Most drugs are cheaper, even much cheaper in Mexico. A visits with a pecialist costs a fraction of what you pay in the United States. Many doctors here received their training in the U.S. Many hospitals, particularly in major cities, are excellent. Routine tests cost a fraction of what they do in the States.
Most expats I talk to are very happy with their level of care here, and some have very serious health issues.
Online forums feature many expats who feel they receive better care here than at home. I hear stories from expats about how their Mexican doctors have out-performed their American doctors to a degree that they feel safer in Mexico.
My own experience has been less (much less) than positive. Medicine in Mexico has a dark side when you're an American expat. While Mexico is not a dishonest culture, I would venture to say it can be an opportunistic one. My guess is that if a person is covered by insurance rather than paying out-of-pocket, has less the danger of being overcharged by virtue of being American.
In general, I would say that if your treatment calls for more sophisticated, expensive technology, carefully examine the how a Mexican hospital will treat you versus an American one.
The Mexican government's healthcare system and how they bill for it make sense, although their system is different in some ways. For example, for hospital stays, you may need to have a relative or friend bring your meals and take care of your personal needs. When you consider Mexicans' extended family networks, this makes perfect sense. Private insurance offers nursing care. Insurance deductibles are calcated on health event, rather than calendar year.
Until I decide on a plan in Mexico, I will continue to hear the hoof beats. But at least I'm here now, close to determining how Mexico will fit into my game plan, and planning it while I'm healthy. I’m not standing stone-still on American soil waiting to be mowed down.
How much America's most expensive drugs cost in Mexico - Ventanas Mexico
"The Dicey Retirement Gamble Americans Are Making" by Next Avenue
Monica Paxon's "The English Speaker's Guide to Medical Care in Mexico" will give you a good idea of what to expect, and how much less medical care will cost in Mexico.
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About the author:
Kerry Baker is a partner with Ventanas Mexico which provides insight and resources to those considering expat life in Mexico including "If Only I Had a Place" a guide to renting in Mexico for the aspiring expat. More than a how-to, this book is a fluid system to rent well year after year.
She is also author of the "Interactive Guide to Learning Spanish Free Online," a curation of the best Spanish language tools on the web. Get started learning Spanish for the health of your brain and for coming to Mexico.