"Where is medical care on your list of factors?"
During the past two weeks, I have received several comments and email from people who were convinced that I had left out the most important factor for retirement: medical services.
I did not forget it. It is simply one of those factors that does not register very high on my list of concerns. If my employer did not provide "free" health insurance, I would not buy it for myself. In the United States that would be a somewhat risky proposition -- if only because of the high cost of medical bills if I guess wrong.
There are many reasons why medical care in the United States is so expensive. And because there are so many reasons, most of the fast fixes that politicians propose will simply not work. As a result, the medical community and the public are caught in a mutual suicide pact that is simply unsustainable.
Most people who ask me about medical care in Mexico are only slightly veiling the subtext of their question. The real question is: don't you fear for your life in a Mexican hospital?
The quick answer is no -- because the question is based on a false premise. Mexico does suffer a lack of rural health care -- just like in the United States. The more remote, the less care.
But almost every population center has a core of highly-trained physicians and modern hospitals to provide excellent medical care. And that is where most Americans get worried. If the care is excellent, it must also be expensive.
That is merely the automatic reflex that health insurance companies have taught us to believe. When I grew up in rural Oregon without health insurance, affordable health care was just miles away. Not any more. The moment that the patient ceased to be the consumer, the system was doomed to end up where it now is.
Even though some Americans label Mexico as a socialist country (even I have fallen into the trap), it is far more free market-oriented than my paternalistic home state of Oregon. Health care works in Mexico because patients are customers.
If you pick up any book on Mexico, you can read about any number of foreigners who have suffered some major medical crisis with attendant hospitalization, who have paid the full bill and cash and who have spent little more than a cruise in the Caribbean. Health insurance and "single payer" governmental health schemes have not yet caused medical expenses in Mexico to sky rocket.
Mexico also has a system designed to provide basic medical care for Mexican workers: Mexican Institute of Social Security (Instituto Mexicano de Seguro Social -- or, as it is often abbreviated: IMSS). The system was not designed for foreigners, but anyone with a valid FM-3 or FM-2 visa can sign up for a very small annual premium.
The care is similar to that provided by public medicine throughout the world. The doctors often work for IMSS part-time, and part-time in their private practices. But, like every public health system, services are rationed through the age-old method of sitting and waiting. Many foreigners buy IMSS coverage as catastrophic insurance and then pay out of their pockets for day-to-day services.
That gives you an idea why medical care is not a big issue for me.
Now I need to come clean with a full disclosure. When I move to Mexico, I will not be running naked -- in an insurance sense. As a retired federal officer, I am entitled to medical insurance (TRICARE) that will reimburse me for some of my costs. And even though Medicare does not currently cover retirees in Mexico (and I will buy a large sombrero to enjoy for la cena if Congress ever approves that drain on a hemorrhaging system), if I register for Medicare and purchase Medicare B, TRICARE for Life will continue to reimburse some of my expenses.
I have friends my age (pre-65) who have purchased health insurance in the States and in Mexico. They are healthier than I am, but they fear the unexpected. I simply do not have those fears.
And I guess that is the moral: if you feel you need to give more money to the insurance industry to buy yourself some piece of mind, Mexico is a place that gives you the freedom to do that. But it also gives you a fighting chance to be able to rely on your own resources and still meet your medical needs.
I will call to the stand, one of my blogger colleagues, Theresa of ¿What do I do all day? originally posted on Moving Kids to Mexico:
We decided to be self-insured. With the price of health care in Merida compared to California, we spend what would be our co-pays and see specialists without having to ask permission. Some of our friends have IMSS insurance, which is the national health care. It goes by age, but even the most expensive premium (for age 60 and above) is around $300 USD per year. But even without health insurance, a general practitioner costs around $150 MXP and a specialist at the state-of-the- art Star Medica costs $500 MXP. And this is not a 15-minute visit; it's as long as you need. Our neighbor was in the hospital for a week, he had emergency surgery for a bowel obstruction, he was in a private room in Clinica Merida which until Star Medica was built was the #1 hospital here. His total bill for everything was $70,000 MXP including a couple of days in ICU. The private room was $900 MXP. Really, I have known people to go into the hospital and their co-pay was more than the approximately $7,000 USD our neighbor paid, and they certainly didn't get the same level of care. If he had gone to the IMSS hospital he wouldn't have had a private room, but he would have had the same doctors and not paid a thing! Merida is where they send everyone from the peninsula and even from Belize and further south. So unless you are living in a pueblito, don't sweat the health care. It's a bargain.