Health Care System Complementarity

Exchange of Health Services

by Editors

While the U.S. and Mexico continue to become more interdependent with healthcare services, data regarding usage and costs remains nonexistent, a growing problem as more Americans living in the border region are without health insurance.

U.S.-Mexico Mode 2 Imports and Exports of Health Services: Report to the Organization for Economic Cooperation and Development

Despite high levels of interdependence between the United States and Mexico in healthcare services, it difficult to determine if healthcare consumption can be categorized as Mode 2 Trade in Health and Services, i.e. consumption that takes place abroad. For instance, there is neither a system in place to tally healthcare costs paid for by remittances nor a method to count care that is unreimbursed (by insurance companies). As a result, comprehensive data on U.S.-Mexico and Mexico-U.S. expenditures on health services is essentially nonexistent. This study’s goal is to quantify Mode 2 expenditures between these two countries by dividing healthcare consumption into four different groups: natives of one state who are living abroad due to employment or retirement, border residents and workers who regularly cross the border for health services, visitors and tourists who receive healthcare, and true medical tourists, including those who travel to the other country specifically for healthcare services. With this categorization and in the absence of solid data, the authors utilize a variety of calculations and estimates for each group.

A pesar de los altos niveles de interdependencia entre Estados Unidos y México en servicios de salud, es difícil determinar si el consumo de servicios de salud se pueden categorizar como Mode 2 Trade in Health and Services – consumo que sucede en el exterior. Por ejemplo, no existe un sistema para contabilizar los gastos de salud provenientes de las remesas, ni un método para contabilizar aquellos gastos de salud que no fueron rembolsados (por compañías de seguro). Como resultado, data completa sobre gastos en servicios de salud México-EUA y EUA-México es básicamente inexistente. El objetivo de este estudio es cuantificar gastos Mode 2 entre ambos países dividiendo el consumo de salud en cuatro diferentes grupos: nativos de un estado que viven en el exterior debido a empleo o retiro; residentes fronterizos y trabajadores que cruzan la frontera regularmente en busca de servicios de salud; visitantes y turistas que reciben tratamiento de salud; y verdaderos turistas médicos, incluyendo aquellos que viajan a otro país específicamente por servicios de salud. Con estas categorías y en la ausencia de data más sólida, los autores utilizan una variedad de cálculos y estimaciones para cada grupo.

Read this report in its entirety: U.S.-Mexico Mode 2 Imports and Exports of Health Services: Report to the Organization for Economic Cooperation and Development 

 

Cross-Border Utilization of Health Care: Evidence from a Population-Based Study in South Texas

International Competition and the Demand for Health Insurance in the US: Evidence from the Texas-Mexico Border Region

Health Migration: Crossing Borders for Affordable Health Care

This series of articles provide a comprehensive overview of cross border personal healthcare exchanges. Given that data regarding Americans utilizing healthcare services in Mexico is limited, the first study moves beyond nonrandom, local samples that target specific healthcare services and focuses on a population-based, random survey that covers 32 border counties in Texas. It seeks to assess Texans’ use of different types of services in Mexico and to identify contributing factors which lead to Mexican service utilization, e.g. medication purchases, dental visits, outpatient care, etc. Building upon this, the second article explains why large numbers of Americans in the border region are uninsured. Focusing primarily on dental services in Mexico, the report identifies several factors leading to high percentages of uninsured Americans living in Texas, California, Arizona and New Mexico. These include the jobs immigrants and first generation Americans tend to hold (which have no health benefits) and language and cultural barriers. Ultimately, the study concludes that the availability of affordable health services in Mexico drives down demand for insurance in the United States’ border region. Lastly, the third publication examines healthcare services utilized by three specific demographics, “snowbirds,” i.e. older Americans who frequently travel to the border for health services, permanent border residents, and weekend border crossers. All three groups share two characteristics: old age and lower income. They are essentially those who are excluded from the U.S. medical system in some way such as a lack of prescription coverage. The author contends that medical services consumed in Mexico by Americans are a reflection of insurance disparities within the United States, which are reinforced by social networks, diminishing fears of low quality healthcare abroad and a thriving health industry in Mexico.

La siguiente serie de artículos presenta un resumen exhaustivo sobre intercambios de servicios médicos fronterizos.  Considerando que los datos con respecto al uso de servicios de salud de parte de los estadounidenses son muy limitados, el primer estudio va más allá de muestras locales no-aleatorias que se enfocan en servicios de salud específicos, y se basa en una encuesta aleatoria de una población que cubre 32 condados fronterizos en Tejas. Busca evaluar el uso de diferentes servicios de salud en México hecho por tejanos, así como identificar los factores que contribuyen a la utilización de los servicios, por ejemplo, compras de medicinas, visitas al  dentista, el cuidado de pacientes de entrada por salida, etc. El segundo artículo explica porqué tantos estadounidenses en el región fronteriza carecen de seguro de salud. Enfocándose principalmente en servicios dentales en México, el reporte identifica muchos factores que causan los altos porcentajes de estadounidenses no asegurados en Tejas, California, Arizona y Nuevo México.  Estos factores incluyen aquellos trabajos que los inmigrantes y personas de primera generación de americanos tienden a tener (y no incluyen beneficios médicos), así como barreras culturales y de lenguaje.  El estudio concluye que la disponibilidad de servicios de salud accesibles en México reduce la demanda del seguro de salud en el región de la frontera en los Estados Unidos.  Finalmente, la tercera publicación examina la utilización de los servicios de salud por tres demografías específicas: estadounidenses retirados que viajan frecuentemente a la frontera por servicios de salud; residentes permanentes de la frontera; y los que cruzan la fronteraúnicamente por el fin de semana.  Todos los grupos comparten dos características: la gente es de edad avanzada y de bajos ingresos.  Son aquellos que han sido excluídos del sistema de salud en los Estados Unidos, por ejemplo, que su plan de seguros médicos no les cubre las medicinas por receta. El autor afirma que los servicios médicos usados por estadounidenses en México son un reflejo de las diferencias de seguros médicos en el interior de los Estados Unidos, mismas que son reforzadas por redes sociales, un menor miedo a cuidado de salud de menor calidad en el extranjero y una industria de salud próspera en México.

Read these research articles in their entirety:

Cross-Border Utilization of Health Care: Evidence From a Population-Based Study in South Texas

International Competition and the Demand for Health Insurance in the US: Evidence from the Texas-Mexico Border Region

Health Migration: Crossing Borders for Affordable Health Care

ABOUT THIS PROJECT

The U.S.-Mexico Network’s Imagining 2024 project is designed to provide readers a quick overview of key issues in US-Mexico relations – the background of the issue, its current state, where we ought to be by 2024, and how to get there.

 

Each short essay is coupled with suggested background readings for those interested in a more detailed understanding of the issue at hand.  And as an electronic publication, both the essays and their associated resource pages are updated as needed to keep the information and analysis fresh.
 

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