Hospital systems in different countries: Mexico

Sent: Wednesday, July 14, 2004 11:00 PM Dick Hancock writes: "I have a comment about the Mexican social health program (IMSS) derived mainly frrom 20 years (1967-85) operating a study abroad center, Hacienda El Cóbano, in Colima, Mexico. We had people injured during our years there, and the Mexican health service always gave them competent first aid without charge; in terms of fixing simple fractures, etc., they were the best. However, I did note that people who could afford it sought medical attention in the private sector. We had a contingent from the University of Oklahoma medical school visit the Colima medical services. They were particularly impressed with the rationality of the system. Colima had class B and C hospitals that could adequately attend to the normal run of medical problems; difficult cases were sent to one of the Class A Hospitals in Guadalajara. This is in contrast to the system in the United States, where it seems that every hospital is not content to refer difficult cases to a larger hospital but wants to be able to have all of the latest technology in its own plant regardless of the practicality of offering all these services locally. As one of the OU medics stated, "Their system seems very efficient, but we didn't poll the patients." Also, it should be remembered that being employed was a qualification for receiving treatment other than first aid. This left out most of the nation's rural population.

I think that the IMSS kept costs down in the private health sector; most public health doctors also had a private practice. I recall a wealthy American from Massachusets who retired and lived at our municipal seat was diagnosed with incurable cancer. He told me that, after talking with the best doctors in Massachusetts, he elected to die in Colima because to have received medical attention for his final months of life in Massachusetts would have exhausted his entire estate; he was too young to be under Medicare. He calculated that his care in Mexico would cost about $3,000 for his final six months of life. His doctors in Massachusetts referred him to a doctor in Guadalajara who they said was as able as the best of American doctors.

RH: I assume that, when Dick refers to the rural population, he means they must have regular employment and pay into the IMSS system.