| | |  Health & Beauty | September 2009 
Medicare In Mexico for U.S. Citizens?
 Richard C. Morais - Forbes
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September 06, 2009
| | Vallarta businessman Paul Crist founded the non-profit Americans For Medicare In Mexico, and has since lobbied 85 members in the U.S. Congress to get Medicare accepted south of the border. Contact him at paulcrist(at)hotel-mercurio.com | |
Washington - The U.S. government should pick up the cost of health care for the elderly Americans living in Mexico. That's the gist of a new lobbying effort aimed at pushing Washington into covering foreign medical expenses for the first time via its sprawling Medicare programs. There are over 1 million U.S. citizens living south of the border, many of them retirees.
The government's current position is that retired citizens cannot claim benefits for medical treatments received overseas, even if they paid into the Medicare system during their working lives.
The U.S. government is worried that creating a Mexican Medicare exemption might be too complicated and costly to implement and would open the door for Americans in countries as far afield as Poland and Thailand to press for similar benefits, according to David Warner, a professor of health care policy at the University of Texas at Austin and a specialist on Medicare in Mexico.
Paul Crist, a former aid to Sen. Paul Sarbanes, D-Md., now running a hotel in Puerto Vallarta, Mexico, isn't buying it. Last March, Crist founded the non-profit Americans For Medicare In Mexico. The American businessman has since lobbied 85 members in the U.S. Congress to get Medicare accepted south of the border.
It is Mexico's unique proximity to America that makes the whole process economically viable, he says. The current inflexible Medicare benefits system is the reason why 64% of retired Americans in Mexico currently return to the U.S. for medical treatment; the remaining U.S. retirees are getting treated in Mexico but picking up the costs themselves.
They can pay out-of-pocket because "health care is extremely affordable in Mexico with or without health insurance," as are "comprehensive private insurance policies," according to MedToGo.com, a Web site owned and operated by U.S. physicians.
An office visit to a doctor in a Mexican city typically runs between $30 and $40, according to MedToGo, while a hospital room costs $90 to $100 a night. Besides private health care insurance, the Mexican Institute of Social Security (which goes by the Spanish initials IMSS) provides affordable, if basic, health insurance for all Mexican residents, regardless of nationality. Studies suggest that health care services are 70% less expensive in Mexico than in the U.S.
If Medicare were accepted in Mexico, the 64% of American retirees currently flying back to the U.S. for expensive care would instead opt for treatment nearer their homes, cutting Medicare's overall costs by a minimum of 22% net, Crist figures. The Mexican government, hoping to lure more retirees from the U.S., including those born in Mexico, is largely open to accepting Medicare, says Professor Warner.
So is the U.S. Congress, claims Crist. "Response has been quite positive, especially on the House side," he says.
But the offices of Reps. Jim McDermott, D-Wash., Carolyn Maloney, D-N.Y., and other sympathetic legislators have also told Crist that this year they have too much on their plate, and that it would be politically wiser to introduce a stand-alone Mexico-Medicare bill next year, separate from the complex health care reform package currently working its way through Capitol Hill.
Professor Warner, who also supports the granting of Medicare coverage in Mexico, says an in-depth three-year Mexico-Medicare pilot project is needed to better understand the economics, determine whether Mexican health care meets Medicare's quality standards and determine if the payment system is sufficiently free of fraud.
"I don't think it need be a big deal," he adds. "The Center for Medicare & Medicaid Services ... is taking the position that Congress has to give it [a special] waiver to pay overseas. But this does not require a large appropriation of money. If any."
While AARP, the retiree interest group, has yet to take a position and did not respond to Forbes' request for comment, Crist's lobbying efforts appear to be picking up support, including from real estate developers hoping to build assisted-living villages for American retirees in Mexico and influential lobbying groups, including the Association of Americans Resident Overseas.
The association and others are instructing members to send letters to their congressional representatives, urging that at minimum a demonstration project be undertaken to study the consequences of accepting Medicare benefits in Mexico.
"As an American who has worked outside the USA, I will be eligible for Medicare benefits, having paid for them during my working life. Because I live outside the USA, however, I will not be able to receive these benefits in the country where I live," one letter from the AARO states.
In a year when U.S. politicians have been battered by constituents' claims that the U.S. government is trying to take away their medical choices, a potentially cost-saving pilot allowing for more choice in Medicare seems, on the surface, a political slam-dunk.
It would also help ease immigration pressure: Long-term U.S. residents who were born in Mexico, and are interested in returning when they retire, would no longer be reluctant to do so for fear of losing their Medicare benefits. |
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