Kidnapping in Mexico draws attention to medical tourism

Last week, four Americans were kidnapped in the Mexican state of Tamaulipas after crossing the Texas border. Two were later found dead. A sister of one of the victims said they went to Mexico so one of them could have a tummy tuck.

Each year, millions of Americans visit Mexico and other countries to receive medical care, a practice often referred to as medical tourism. Mexico’s National Exterior Commerce Bank estimated the industry was worth $5 billion before declining during the coronavirus pandemic. For patients, the motivation is often financial.

“Part of that is a desperate search for access” to medical care, said Felicia Marie Knaul, director of the Institute for Advanced Study of the Americas at the University of Miami.

Many people cross the border for drugs at greatly reduced prices from what you pay in the US. Others, particularly Americans and Canadians in the last two decades, travel for surgery or treatment. The Centers for Disease Control and Prevention says dental work, surgery, fertility treatments, organ and tissue transplants, and cancer treatments are the most common procedures people go abroad for. Electoral processes are an important part of medical tourism, said Daniel Béland, a professor of political science at McGill University who has studied health policy.

In 2016, the CDC surveyed more than 93,000 people; Of those who left the United States for care in the past year, Mexico was the most common destination.

But while crossing national borders could be an affordable way to get quality care, medical tourism is largely unregulated, and it’s almost impossible to track the outcomes or volume of procedures Americans receive in Mexico.

“There are really very few rules,” said David G. Vequist IV, director of the Center for Medical Tourism Research and a professor at the University of the Incarnate Word in San Antonio, Texas. The ones that exist are vague, he added, and people “make it up over time.”

How many people go to Mexico for treatment?

It’s difficult to find solid data on medical tourism, said Valorie Crooks, a professor of geography at Simon Fraser University in Canada, who has been studying it for over a decade.

She calls the industry a “Triple U”: It is “untracked, untraced and unregulated”.

Most Mexican hospitals that Americans visit are private and do not report their data to the federal government.

Josef Woodman, the executive director of Patients Beyond Borders, which serves as an international health travel consultancy and patient guide for people seeking care abroad, estimates that about 1.2 million Americans travel to Mexico each year for medical procedures. After a drop in medical tourism during the pandemic, Mr Woodman said he saw a surge in people seeking treatment in Mexico as they got vaccinated.

“After the first Vax, people just poured in,” he said.

Complex dental procedures such as root canals, veneers and full mouth reconstructions are among the most popular procedures, Mr. Woodman said. Los Algodones, near the California-Arizona border, is known as “Molar City” because it serves that market.

According to Denise Rodriguez, who is studying for a Ph.D. in Health Geography from the University of Brasília in Brazil and interviewed hundreds of people involved in medical tourism in Los Algodones for her master’s thesis.

When she counted the number of private hospitals and medical professionals available, she found that Baja California Sur was the state with the most medical tourism.

Why is the industry booming?

Because the overhead of running a clinic or health center in Mexico is much lower, patients typically pay far less than they would for a procedure in the United States, said Dr. Crooks.

A study that polled more than 400 people near the US-Mexico border about travel for healthcare found that 92 percent cited lower costs in Mexico as a guide to their decision. Andrea Miller, a clinical pharmacist in Arizona who led the study, was struck by how widespread advertising and infrastructure for medical services were in a Mexican border town.

“You look down the street and it’s like pharmacy, pharmacy, optical clinic, dental clinic, pharmacy, dental clinic,” she said.

Some patients also go abroad to avoid bureaucracy and restrictions that might hinder them at home, Dr. Crooks.

“You might be too young or too old for orthopedic surgery; You might be too small or too big for bariatric surgery — and then you find a surgeon in another country who’s willing to offer you the treatment,” she said.

Other patients travel to have procedures that are illegal where they live, including abortions.

Money only explains so much, said Ms Rodriguez, who noted many travelers were simply looking for more personalized attention and time with a doctor.

“Why are people coming back?” she said. “You are treated like a human being”

Medical tourism carries risks.

While travel to certain areas of the world for healthcare can be dangerous, experts say the risks for most patients have more to do with the medical procedure than the travel to receive it.

Patients who embark on medical tourism seek care themselves and pay out of pocket, added Dr. Crooks added. This can mean their GPs are uninformed, potentially creating problems when patients seek follow-up care at home.

The CDC recommends patients schedule a consultation with their U.S. health care provider before leaving the country for medical care, said Allison Tayler Walker, head of the epidemiology and surveillance team in the agency’s Travelers’ Health Branch. The CDC also advises patients to schedule follow-up care in advance with the professional performing the procedure abroad, as well as with a primary care physician in the United States.

There are also specific risks associated with certain procedures — for example, doctors warn against flying too soon after some surgeries, Dr. Béland because the procedures can make a person more susceptible to blood clots.

Mr. Woodman recommended going to hospitals accredited by the Joint Commission International. It’s important for patients to ensure that anyone providing medical care to them has received proper training, said Dr. Patricia Turner, executive director of the American College of Surgeons. This includes, for example, not only the operating doctor, but also the person who performs the anesthesia or evaluates X-rays.

It can be complicated to get a complicated service like surgery in another country with different laws and cultural norms. For example, someone receiving inadequate medical care abroad may have little or no legal recourse and may be unaware of their rights. And any procedure carries the risk of complications, and in another country a patient may have to stay longer than expected to recover or recuperate, warned Dr. Crooks.

“It’s not necessarily that those risks are higher when you go abroad,” said Dr. Crooks. “But your ability to remediate or address those risks could become more difficult.”