More Medical Mexico

After I posted an entry a few weeks ago about the relative superiority of wellness and treatment opportunities in Mexico over the U.S., I received an email from an acquaintance who lives near Lake Chapala, and for whom this issue is among the primary motivations for his being there after sampling several location south of the U.S. border. I thought I would post a few of his comments here to temper my rather unqualified endorsement of Mexican healthcare...

"I wanted to offer a few thoughts prompted by your blog post on health care here vs. N.O.B. The first is that there's no question that access is infinitely better, and you almost invariably make your appointments directly with the doctor rather than being pawned off on a series of nurses, P.A.'s etc. before finally being granted 10 minutes with the harried doc as you describe in the U.S. 

On the downside, it's much more of a caveat emtpor situation than most gringos realize, by which I mean that you have no recourse in the case of doctor incompetence or error. More important, you need to know that there are many labs and clinics that lack what would be considered basic or modern diagnotistc equipment in the U.S., so it behooves one to know where to get an x-ray on machines made in the past few decades, which labs do tests without offering kick-backs to the referring doctor (there's only one at Lakeside!), etc. Still on balance the care here is far better, and of course infinitely cheaper. It's a good thing, because realistically if you live here as a gringo your best option is to self-insure, since IMSS is very close to going under, Seguro Popular is a mess and private insurance rates are sky-high due to the very small % of the population that can even think about participating."

I had meant to comment in my original post about the 'no recourse' issue.  Mexico in general seems to be almost entirely unencumbered by tort law - if you trip and break your ankle due to a sidewalk defect or gash your head on an A/C cage or metal awning protruding into a pedestrian right of way at (giant gringo) forehead level, you are on your own.  Apparently in the practice of medicine it is similarly not customary to follow up poor outcomes which might arguably be due to improper or inadequate care  with a trip to an attorney's office in pursuit of compensation.  I guess in balance I am in favor of this arrangement, as I imagine it is one of the primary reasons the cost is so low, and there is a reduced number of diagnostic and treatment options prescribed out of legal defensiveness.   I also have confidence that with reference checking most doctors can be trusted to perform to the best of their ability and meet contemporary standards of competency and best-practices.  Hope I am correct if I should need or want to try this out.  It's always possible for an error to occur, and the cost of making that the equivalent of bagging a Lotto jackpot is un-affordable care for many.

On the lab issue, I have always been amused that anyone can apparently walk into a retail lab and order their own blood work, urinalysis, ultrasound, or even x-rays without the benefit of a doctor's order.