By Keith Darcé, Union-Tribune Staff Writer
TIJUANA — About 1 million adult Californians seek health care in Mexico each year – and that figure is likely growing as the recession expands the ranks of the uninsured who are drawn to cheaper care south of the border, said the lead researcher of the first major report on the topic released Tuesday.
The pharmacy business in Tijuana is still booming, despite crackdowns by the state to weed out illegitimate operators. - John Gibbins / Union-Tribune
These people live from the Bay Area to San Diego County. Most come to Mexico for prescription drugs and dental care, and a smaller number go for surgeries. Beyond finances, other factors prompting individuals to head south include language and cultural barriers.
Living within 15 miles of the border also greatly increases the likelihood of someone obtaining health services in Mexico.
Angela Tapia, 45, of San Ysidro crosses the border several times each year to see her gynecologist. She also had back surgery in Tijuana a decade ago.
“It’s cheaper to go there,” said Tapia, who doesn’t have health insurance. “When you go to those doctors, they give you time, they ask a lot of questions and they care about you.”
Roughly half of the cross-border patients are Mexican immigrants, a statistic that might challenge the popular notion of Mexicans burdening California’s hospitals and clinics by receiving all of their health care on this side of the border, said UCLA public health professor Steven Wallace, lead author of the new report.
“What this helps document is that (some) immigrants are facing barriers to receiving care in the United States, and they are turning to Mexico for that care,” said Wallace, who also serves as associate director of UCLA’s Center for Health Policy Research. “And it’s not just immigrants facing barriers here.”
Approximately half a million U.S. citizens living in California also seek health services in Mexico, Wallace and his UCLA colleagues found.
Altogether, about 4 percent of adult Californians traveled to Mexico for some type of medical care.
Wallace’s study was published Tuesday in Medical Care, a journal for the American Public Health Association.
He and his fellow researchers based their analysis on data from the 2001 California Health Interview Survey, which questioned more than 55,000 random households across the state.
The wide-ranging survey, conducted once every two years, is funded by a coalition of agencies and groups including the state Department of Public Health, the National Cancer Institute and the California Endowment. Those done since 2001 have not asked about accessing health care south of the border.
Wallace’s group was the first to delve deeply into the statistics on medical treatment in Mexico. Previous research relied on anecdotal accounts or small localized populations.
The cross-border trend likely will intensify as the number of Mexican immigrants living in California increases and the recession costs more people their jobs and health insurance coverage, Wallace said.
Between 2001 and 2007, the population of Mexican immigrants in California grew by 756,000 to 4.6 million, according to the Center for Immigration Studies in Washington, D.C.
“The numbers that are bad in this study have only gotten worse,” said Margaret Laws, director of the California HealthCare Foundation’s Innovations for the Underserved program. “Under the current climate, they will continue to get worse.”
The UCLA researchers found that more than 13 percent of Mexican immigrants traveled to Mexico for care, with the largest number visiting dentists.
Such patients make up the diverse range of U.S. residents who visit the Bartell Dental Clinic on Avenida Revolucion in the heart of Tijuana’s tourist district, said Dr. William Bartell Jr.
“Probably 95 percent of my clientele are self-employed or their jobs don’t provide any dental insurance,” he said.
The clinic, which has a Web site that targets Americans, sees about 10 patients a day – nearly all from north of the border. That’s enough to keep three full-time and several part-time dentists busy, Bartell said.
Mexican immigrants who lived in California for less than 15 years were less likely to cross the border for care than those who had been in the country longer, the UCLA report said. Many shorter-term immigrants are undocumented, so they face risks every time they leave the United States and try to return.
Among all other Californians, the top health-related reason for going to Mexico was to purchase prescription drugs.
Much attention has been given to doctors performing cosmetic and weight-loss surgeries on Americans in Mexican cities such as Tijuana. But Wallace found that only 7 percent of the 464,000 non-Latino Californians who sought treatment across the border went there for medical procedures, including surgeries and treatments for serious illnesses like cancer.
Health insurers offering relatively low-cost coverage plans that allow Southern Californians to receive care on both sides of the border should be encouraged by the study’s findings, Wallace said.
In fact, several of the largest players in the cross-border insurance market have recorded steady growth in recent years.
Membership in Health Net’s U.S-Mexico plan has reached 40,000, up from 23,700 in late 2007, said Brad Kiefer, a spokesman for the health maintenance organization.
Sistemas Medicos Nacionales S.A., the only Mexican HMO licensed to operate in California, now has about 21,000 members in San Diego and Imperial counties, said Christina Suggett, the company’s chief operating officer.
Staff writer Sandra Dibble contributed to this report.
Keith Darcé: (619) 293-1020;
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Broswe for Rosarito Real Estate, Baja Real Estate and Mexico Real Estate.
