Hospital systems in different countries: Mexico

Sent: Thursday, July 15, 2004 12:08 AM I have been wondering about Linda Nyquist, who had a health problem, so I was delighted to receive this message from her. I need not repeat that she knows Mexico very well: "Regarding the man about whom Dick Hancock wrote who chose to end his days in Colima rather than exhaust his estate seeking medical care in the United States. I can't say that I blame him, and I agree that some very competent physicians practice in Mexico. I chose to have some elective surgery in Monterrey, Mexico 2 years ago, and the medical attention and hospital could not have been better. There was no comparison to my recent and most unhappy experience here in Seattle; however, I do have one comment regarding end-of-life care in Mexico when one is suffering from conditions such as cancer, and that concerns the issue of pain control. In general, narcotic medication is not available, at least not generally. While some physicians may have access to it, it is hard to come by. The concept of hospice is not used, and the really good pain control that we have come to expect here is not used. Mexico uses analgesics (such as dipyrone, which is not used in the first world and is banned for causing blood dyscrasias) and limited morphine for post-surgery patients. Demerol is very restricted, and a doctor told me recently that it is banned in Mexico now, although I have not confirmed this. In general, terminal cancer patients suffer greatly. I always hope that people do not have to suffer. On my next trip down I'll be looking into this issue again. Perhaps some other WAISer has current information on the issue of pain control.

Dick Hancock didn't comment on the SSA system in Colima, which would have covered the country people not insured by IMSS (private sector workers) or ISSTE (government workers). IMSS now has an open enrollment period each year where even foreigners can pay a fee and receive services. And it is fairly reasonable. The ex-pat community in Guadalajara allegedly uses this option. IMSS usually has the best-equipped hospitals, but access can be problematic. Salubridad, or SSA, on the other hand, is the worst. People always like the private hospitals because of the personalized attention, but they often aren't well-equipped, with the exception of the ABC and other prestige hospitals in Mexico City, such as the Hospital Espanol.