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 Health & Beauty | December 2007 
Retirees are Looking South for Healthy Golden Years
 Dudley Althaus - Houston Chronicle
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| With the health insurance crisis growing in the United States, Mexican officials expect many of the Americans retiring here to flock to the government's hospital. Dec. 7, 2007. Video by Johnny Hanson.
HOW TO APPLY:
• To be eligible for Mexico's social security health insurance, Americans, Canadians and other foreigners must first establish legal residence in Mexico, obtaining citizenship or a resident visa, said Azucena Bateman, an immigration attorney.
• Foreigners also must provide a birth certificate, officially translated into Spanish, and proof of residency in Mexico.
• Full privileges in the social security system are granted three years after a foreigner joins the system, and pre-existing medical conditions are excluded from coverage.
• To obtain a resident visa, foreign retirees must prove income of $1,300 a month if they're renting a home in Mexico, or $650 a month if they are homeowners. |
Chapala, Mexico — With his bad heart, bum knee and hemorrage-prone blood, Aubrey Righton knows a thing or three about the way of all flesh. And as a 19-year resident of Mexico, the retired trucker also knows a good deal about his adopted land.
So the 78-year-old Righton and his wife, Mary Ellen, have melded that knowledge to keep themselves as healthy as possible. And, for the past decade, they have been enthusiastic patrons of Mexico's vast but tottering social security hospital system that offers health care to all at low costs. "They don't have to accommodate you, but they do," said Righton, who holds dual Canadian and Mexican citizenship.
With health insurance a growing crisis north of the border, officials here expect many retirees like the Rightons — and future North American retirees from the baby boom generation — to flock to the Mexican social security system. "This is a bargain," said Salvador Orozco, the surgeon who runs a hospital in Guadalajara.
But it's a bargain fraught with problems.
Like its counterparts in the U.S., Mexico's social security system faces a serious financial squeeze. The system's hospitals are aging and under-equipped, its medical staffs almost hopelessly overworked, its pharmacies often short of medicines.
Still, more than 1,400 foreign retirees have joined the Mexican Social Security Institute, or IMSS.
For a premium of $270 a year, they have access to a network of outpatient clinics, full-service hospitals and pharmacies where care and medicine are provided at no extra charge.
"It's wonderful," said Mary Ellen Righton, 81, an American citizen who spent two weeks in a Guadalajara social security hospital several years ago after suffering a fall. "The care is just great. And of course your medicine, your hospital and everything is free."
For now, the number of elderly foreigners using the system is an almost imperceptible sliver of the estimated 60,000 retirees in Jalisco state, which includes Guadalajara and the retiree havens that line the shore of Lake Chapala.
The retirees in the system make up an even smaller percentage of the more than 1.4 million Mexicans who use the public hospitals and clinics in Jalisco. Those numbers illustrate the system's problems.
"The system is saturated, that's the reality of it," said Juan Jose Gonzalez, the spokesman for the IMSS regional office in Guadalajara.
The overload is all too evident at the IMSS Hospital No. 89 in Guadalajara, a well-worn facility where most American and other foreign retirees in the area go for major medical care.
With just 226 beds, the 40-year-old hospital serves a potential clientele of 420,000 people fed by 60 clinics in Guadalajara and nearby towns and villages. The hospital's emergency room receives some 5,300 patients a month, many of them eventually admitted for extended care.
But with beds short, and three or four people to a room, patients often spend a night or two on gurneys in the corridors of the emergency room.
"This is our reality," surgeon-administrator Orozco said as he toured the emergency room while doctors and nurses scrambled to tend to more than 40 patients.
"We do what we can," Orozco said, "but we ask that the patients do what they can. Especially those who stay for a long time."
Perhaps not surprisingly, even many Mexicans insured by the social security system avoid its clinics and hospitals if they can afford to. Paying for private care is preferable, they say, to the long waits and often harried staff at the system's facilities.
Language, a small barrier
Many foreign retirees say they prefer to pay for private care, keeping their social security insurance as an emergency backup should something go seriously wrong.
"The care is pretty good," said Jerry Eubanks, 77, a retired banker from Florida who credits the IMSS hospital with saving his life after a burst ulcer. "But it ain't fast."
Orozco and other public doctors point out that older foreigners present special problems that create a burden disproportionate to their numbers. But they emphasize that they're dedicated to serving foreigners as well as they do anyone else.
"There is a difference in the cultures, obviously," he said. "The foreigner who comes here has to adjust to this culture. And that can be a problem, both for the foreigner and for us."
Many of the retirees suffer from diabetes, hypertension and heart disease — the costliest diseases treated in the Mexican system, according to a Pan American Health Organization study. And many retirees, even those who have been in Mexico for decades, speak limited Spanish. "Pain is the same in Spanish, English or French," Leticia Valles, a floor nurse at the No. 89 hospital, said with a grinning shrug. "But language is the biggest problem we have."
Still, though most nurses speak only Spanish, many of the Mexican public doctors speak a smattering of English and some are fluent. Many foreign patients bring a Spanish-speaking employee or friend to the hospital, Orozco said.
Despite their limited Spanish, Aubrey and Mary Ellen Righton have developed a warm relationship with their regular doctor, who has been seeing them monthly for the past six years at a social security system clinic in Chapala, a small town on the lakeshore favored by many retirees.
On their most recent visit, the doctor quizzed the Rightons in passable English about any particular problems they've had in the past month, checked their blood pressures and heartbeats, listened attentively to their medical complaints.
A visit to the doctor
Aubrey told the doctor that his new artificial knee probably would be approved by IMSS authorities and he hoped for surgery soon. They briefly discussed his problem with hemorrhaging — caused by blood-thinning medicines used to control his heart condition — which landed him in the No. 89 hospital for weeks earlier this year after he couldn't stop bleeding from a dental procedure.
Satisfied that things were going well, the doctor wrote the couple prescriptions for their multiple medications, which they filled at the pharmacy on the clinic's second floor.
Then the Rightons went home to get on with their lives, which include golf, gardening and parties in a gated country club outside Chapala.
"You're part of an extended family here," Aubrey Righton said. His wife nodded, adding, "I don't plan on ever leaving."
dudley.althaus(at)chron.com |
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