Saturday, January 14, 2012

tossing my pills


I hate my rants.


My usual rule is that if I do not have the semblance of an answer to the complaints I raise, I should just keep my mouth (or pen) shut.  It is one reason I do not blog much about politics.


But I cannot help myself when it comes to American medicine.


Within a few days of arriving in Oregon, I ran out of my blood pressure medicine.  In Melaque, I would have simply walked to the pharmacy with my empty prescription box, and the pharmacist would have sold me a refill.


Not so in The States.  I thought I might have had one refill on my last prescription.  I did.  But it was over a year old.  And the doctor’s office would not authorize it without setting an appointment to see a doctor.


So I did.  A few days later, I stopped by the doctor’s office at the appointed time.  She took my blood pressure and wrote out a new prescription.  I paid $140 for 5 minutes of her time -- and I was on my way.


Let me stop right there.  That was $140 in legal tender American dollars.


For those of you who see American medical bills on a regular basis, $140 may not sound like much.  But I was astounded.


This is what happens in Melaque.  When I need to see my doctor, I walk over to her office.  No appointment required.  She will sit and chat with me about all sorts of topics for about half an hour.  She will then take my blood pressure and we will laugh about the effects of Mexican food and how good life is.


When I leave, I give her $200 (Mx) -- about $14.60 (US).  And, if I need to see her again on the same topic, there is no additional charge.


I really do not understand it.  What has happened to increase the cost of medical care in The States?  I know everybody has an opinion --– depending on their respective ideologies.  But we are not talking about expensive treatment here.  This was a visit to renew a prescription.


I have read article after article trying to explain health care costs.  But they make no more sense to me than the equally baffling outrageous increase in college tuition.


But none of the articles even come close to explaining to me why my Mexican doctor, who lives in a nice home a block from the beach, can perform the same medical procedures for me while donating a large portion of her time to the local Indian school, and then charge me only $14.60.


I guess I don’t need to understand.  I just need to enjoy the benefit of low medical costs while I am in Mexico. 


Where even cremation is cheaper than it is in Oregon.

25 comments:

Felipe Zapata said...

What has happened to increase the cost of medical care in The States?

This is very simple: lawyers.

Mexican doctors don't have to pay gazillions of dollars annually for malpractice insurance. If a medical procedure goes wrong in Mexico, the patients don't file a lawsuit. 

They blame the Virgin Mary, and that's the end of it.  Life happens.

Marc Olson said...

I've had much the same experience. 

I've said it before and will say it again...one of my biggest concerns about traveling to the USA is that I will get sick or have an accident there. I would much rather be under a doctor's care or in therapy in Mexico, where care costs much less, is easily accessible, more friendly and personalized.

Francisco said...

Steve,
I don't consider your post today a rant at all.   That rate ( $1680.00 per hr.) would be justifiable for brain surgery, getting a prescription, insane.  I'm afraid it comes down to greed.  Medical/Dental school is extemely expensive.  So are mansions, yachts, Maseratti's, and medical insurance as Senor Z pointed out.
  As of Jan. 1st. my health insur. increased 40%.  Who gets a 40% raise? I never did in 36 yrs. no one I knew did either.   Mexico health care is superior in most ways
Saludos,
Francisco

Kathe said...

I recently had a similar experience. I had a cold that I caught in the US and was concerned that it was becoming bronchitis. Since I had no doctor in the city where I was visiting, I went to Urgent Care. BIG mistake! I walked out with a prescription for antibiotics after a 5 minute chat with a Physicians' Assistant. He did listen to my lung sounds and a nurse did take my temperature and BP.

I was told that the bill could not be paid there and a bill would be sent to my friend's house. It was. $337.

For what it's worth, I have written a letter of protest...

John Calypso said...

The U.S. medical system has gone stark raving mad. When I have asked about $5 aspirins and other ridiculous fees - I have been told that the actual value must include the many aspects of 'overhead'. What does that mean. The cost of any item or service should relate specifically to that PERIOD.

Joanne said...

Steve, the bigger question is why you would have run out of meds within a few days arrival in the US.  Even with a refill left on your old prescription it just makes more sense to load up with what you need before leaving Mexico.  Of course, next time you will not make that mistake.  Saludos!

Steve Cotton said...

Lawyers are one element.  But they are not the sole cause.  I fully agree that medical malpractice suits have exceeded reasonability.  But those suits are also symptomatic of the American mania of blaming someone else for their problems.  There was a reason that the common law placed a heavy burden on people to be responsible for themselves.

Steve Cotton said...

Amen.  I also find that I tend to look out for myself more in Mexico than I did in The States.  Well, with the obvious exception of ziplines.

Steve Cotton said...

A nurse practitioner could have authorized the prescription.  That is what really annoyed me.

Steve Cotton said...

Protesting is the right thing to do.  But cash payers are such an anomaly in the health care system that it will most likely do no good.  On the other hand, I am certain that merely writing the letter was therapeutic.

Steve Cotton said...

If you want a real headache, just wait until federal "cost containment" measures start kicking in.  I predict the post office will look like a well-managed machine in comparison.  Richard Nixon's price and wage controls on steroids.

Steve Cotton said...

Interestingly, this is one area where the Mexican health system is not as good as the American system.  My prescription up here costs 10% of what it costs in Melaque.  It is simply an outlier.  The Mexican drug manufacturers do not make the drug in as small a dosage as I need.

Tancho said...

Between the lawyers, insurance companies and passing on lots of fees, add a touch of worrying malpractice it has become unaforable. But no problem, the government will fix it all for us.....yeah.
This is why you can live very comfortably in Mexico in non tourist areas for 1000 bucks a month and have money to spare.  You got off cheap Amigo, one of my employees needed some salve for poison ivy, couldn't get it because it needed a prescription, which I can buy over the counter down here, his doctor was away so he went to the emergency room, walked out 15 minutes later with the prescription and the total was 1244 dollars, which the insurance paid 800 dollars of...... And I am sure that there are worse stories abound.
Same thing goes with veterinarians....in Mexico they make house calls and follow up on the phone, And people make jokes about Mexico....

Laurie Matherne said...

Last week, I paid 20 dollars to see an eye doctor, upgrade my lenses, and have them fitted. And she took the time to explain all the special needs that my eyes presented. In the US? Add a zero. And that would be a conservative guess. 

Steve Cotton said...

And that is why I do not support the extension of Medicare to Mexico. 

Steve Cotton said...

My right ankle fracture would have fallen into the same financial analysis.  We give up some things diving south of the border -- or even further south of the border.  But there are far more blessings.

Steve Cotton said...

I have read quite a bit about the medical services industry during the past four years. If I feel certain about anything, it us that more government involvement will simply exacerbate the problems in the system. Both major parties are promising more government involvement. The only distinction is just how pervasive that involvement will be. As for me, I have a nice free market system in Mexico. And that is good enough for me.

Karen McGivney said...

Felipe is correct, lawyers actually torts, Joint Comission and the government. Cost is not the only problem. We have become so bound up by red tape it is also very hard to give good care. Having been an RN since 1993 I've seen a lot of change. I'm sorry you didn't know you CAN order medication on line from foreign countries and have it delivered by mail. Next time..

Kwallelno said...

Visiting with my brother-in-law the doctor a few years ago, we were talking about medical costs. He said the week at the beach cost $5000 a day in overhead for his share of his group's practice. $5000 a day before the man made a penny for himself.

Steve Cotton said...

Having been in private practice, I understand the overhead costs. Even so, something is amiss.

Kwallelno said...

No doubt of that!

mdoneil said...

When I practiced medicine in the US all the insurance I carried, malpractice, business - not counting policies covering my health or the health of my staff cost me just over four dollars. 

Four dollars an hour. 
Four dollars an hour every hour I was alive. 
I was getting away cheaper than friends who were surgeons. 

Now I am a consultant, no patients at all.   I'm probably down to four bucks a day and that now includes car insurance!

Steve Cotton said...

I worked with a program in Oregon that helped to subsidize medical malpractice insurance for rural physicians.  I have always been very sympathetic to those costs for all doctors.  And the premium cost does not come close to matching the psychological cost of having a former patient sue the physician.

I would not want to be responsible for managing a modern American medical office -- with the plethora of agencies that must be satisfied just to get through the day. 

But something at the heart of medicine and education has shifted.  Maybe it is because patients want to live forever and students want to obtain jobs for which they are singularly unqualified (to mix the two topics that continue to astound me).  Maybe our social expectations are the source of this derailment.

Bevfam4 said...

Good to know 'the end of the line' won't cause your family to go broke if you're fortunate enough to pass away in Mexico!

Steve Cotton said...

Another goo point. Just roll me into the ocean.