Mexico Road Trip: Health Care and Socialism
Amazing, I remark, I never would have guessed that. I would have thought hypertension or something like that…
Diabetes is a killer, maimer and drain on our system, he adds, and we also have a high incidence of blindness.
Is is hereditary? I ask, the Latinos in the U.S. have a higher rate.
Certainly, he replies, but it’s also diet and appears also closely related to physical activity. The combination of factors creates such a deadly etiology that it often seems we are fighting a hopeless battle. That and the mental part – the fear…
What do you mean?
Many of our patients perceive it to be like cancer or a tumor…something terminal. They take it very hard and often come in when the symptoms are severe…and of course then once it’s onset there is no real cure…only treatments. We don’t do the implants like they do in the States…but I don’t think implants are very common there either.
Since medicine is subsidized here, I reply, you would think the government would be all over the prevention angle.
Ah, government’s are run by politicians and managers and numbers and budgets are what matter…I think it is similar in the U.S. But it’s also us…we are our own enemy here. We like our soft drinks and sweet bread and coffee while we live in a paradise of fruits and vegetables and fish. I have noticed there is a much lower incidence rate in the extreme rural areas where they have a better diet. So even if we know the cause and effect; we often won’t do anything about it…so we get a steady stream of blindness and foot amputations…I read the medical journals and the same happens in the U.S.
There’s that cause and effect again, I reply.
What’s that? he asks.
Oh nothing, just a little concept that has been bothering me for the last few months.
You haven’t changed that much, amigo, ideas always used to put a furrow in your brow, he laughs, and it looks like they still do.
But the medical system has always worked pretty well here, no? I ask.
For what we have to work with, the answer is yes…of course there are those with means that always get better care, just like in your country. Those that can afford the best specialists get better treatment…
I’ve never really understood the hospital system here, I reply, I’ve never had much need…
That’s because you have that guardian angel always looking down and protecting you, said Lazaro, I remember even sometimes when there were fights in the cantinas…the bottles always missed your head and hit somebody else, he laughs, but getting back to medicine, the poor here in Mexico actually have better care access than many poor in the U.S. do…it’s because you are all a bunch of capitalist pigs, he laughs, just look at you, Mr. Entrepreneur – I bet you drive some European sports car, no?
Actually not, I laugh, it’s a Honda that has taken a beating on this trip…sort of like me…and like me it doesn’t leak, at least very much. Yet.
Lazaro pulls out a napkin and takes out his pen, just like in the old days.
For those under social security here, we have the IMSS, he says, and by and large this is better care and based on whether an employer participates in the social security plan…
For those that don’t, there is the SSA, it has a slightly lower level of care and the patient has to pay for hospitalization, which can be expensive. But you have to remember here a surgery might cost 3,000 pesos and not $30,000 dollars. Then there is the ISSTE for government employees and of course the PEMEX hospitals for oil workers.
The cost of medicines has gone way up as the subsidies have been reduced…many patients that had access to the IMSS didn’t use it and instead used private practicioners, but since the cost of medicines has gone up, they are now going to IMSS. There is also a Seguro Popular, sort of like your Medicaid, that helps defray costs for the most indigent…but it is controversial and sometimes they won’t release a patient until the bill is paid…much like privatized medicine. There are holes in any subsidized system and as you must know medicine is usually a matter of how to pay for it…even though the government still subsidizes medicine. But it is still socialized medicine even though there are more copayments…and we doctors still subsidize it too…
What do you mean? I ask.
A new doctor has a very hard time finding a job, especially in urban areas…there are jobs in the rural areas but who wants to work there? Ride a horse from village to village, he laughs, I did it for two years and many doctors do…but as soon as we can we move back to the city. That’s why many doctors move to the U.S….
But it’s tough to get a license, no? I ask.
Sure, but many don’t work in medicine…they work in construction or something else…anything is better than starving as a doctor here. All that time and money wasted when they cross that river, no amigo? He looks at his watch, asks for the bill and stands up…
I’m already late for a department meeting, he says shaking his head, I wish we could talk. He pulls out a business card and jots down some numbers…Here’s my cell and e-mail. Let’s stay in touch…
Who’s the big shot now, I laugh, remember when I used to call you Che Junior?
Sure, he laughs, I remember drinking tequila and smoking those horrible Cuban cigars at your wife’s rancho…say, that reminds me, I didn’t tell you. I’ve gone to Cuba maybe a half dozen times and have been involved in some medical research there…you ought to go…you would find it fascinating.
Me? I’m not a leftist anymore, I laugh.
No seriously, amigo, you should go. Take a look for yourself…the people and system are interesting even if you don’t agree with it…I saw some Gringos there…call me on my cell and we’ll talk about it.
The bill comes and he plops down a 200 peso note. We shake hands and look each other in the eye and then he turns and leaves. He opens the door to a taxi and turns back to me…
Viva Che! he shouts laughing. And then he is gone.
Jack D. Deal
