Healthcare in Mexico

[Emergent, RN]

My first husband has lived in Mexico for a while. He is 80 years old, he was quite a bit older than me when we married. He lives in Oaxaca. 

I think he basically lives there because he didn't work very hard his whole life, and so the cost of living there is much less. We divorced many, many years ago when the kids were pretty young. I went to nursing school and got my act together, and he got lazier and lazier. Other than that we got along fine after the divorce.

He is currently undergoing a major health crisis there. One of my sons is there helping him. A couple of the 4 boys speak Spanish so, the other one who does might go down if he needs to. They have no interpretation services at all in the hospital, and the doctors don't speak English. I was surprised they didn't even utilize an online service. There are a lot of expatriates from the United States there.

He was supposed to get his prostate out, but now he is hospitalized with sepsis, and Dengue fever. I'm learning a lot about the healthcare system in Mexico from my son. 

They are using a private hospital because he is not a citizen. There are also free hospitals for the general populace. He did a GoFundMe, since he's totally broke, and it raised $5,000 thanks to one of the boys having an online comic site that is popular. The prostate surgery was going to cost $2, 800. Basically, they will do the surgery as soon as you pay them ahead of time. 

He started to have complications from the catheter removal, and had to have it reinserted,  so I advised my son to take him to the emergency room. The emergency room cost $250 cash. They won't see you unless you pay them up front. The doctor fee was $50, and the nurse came in and said the doctor fee and my son handed him $50 in cash. I actually think it was a thousand pesos or something like that, maybe he paid him in Mexican money. He handed the doctor cash and the doctor put it in his pocket. 

Unfortunately now he is hospitalized with this infection, so the prostate surgery will be delayed, if he survives. Just as I had heard, family members are expected to basically do all the personal care. My son is there and will stay in the hospital with him. 

I looked up online a comparison of the life expectancy in Mexico versus United states. Mexico has 74 yrs, USA 77 yrs, in 2022. That is an average for male and female of course. I think they're not doing bad considering they have a much less expensive system. I think we have made our system ridiculously complicated and expensive. 

[LibraSunCNM, BSN, MSN, CNM]

Sorry your ex is going through that.  I agree our system is ridiculously complicated and expensive!  I feel like we need to totally wipe the slate clean and start from scratch with healthcare in the U.S., but that's just not gonna happen.  There are so many different systems around the world that work better, but not for as large a country as the U.S.  My friend moved to the U.K. and works for the NHS, which sounds like it's awful in other ways--even worse staffing than the U.S., terrible pay--although access to basic care is guaranteed and no one goes bankrupt from medical bills.  We're currently hosting an au pair from Germany, and their system seems better--there's much wider access to government-funded care than there is with Medicaid in the U.S., but also plenty of private options and seemingly no issues with wait times for procedures.  I think the original ideas for the ACA were really strong, but got too watered down, and that was even with a Democratic majority in Congress.  Politicians don't want to jump out of the corporate pockets they're comfy in.

[Bug Out, BSN]

LibraSunCNM said:

We're currently hosting an au pair from Germany, and their system seems better--

I toured a new "state-of-the-art" hospital in Germany. As I walked through a hallway with about a team of 10 we paused to watch a surgery that was occurring. See, the ORs were only large enough to house anesthesia and the lower half of the patient so since they were operating on the patient's skull, the procedural team was in the hallway with the upper half of the patient. I was close enough to literally touch the patient's brain if I so wanted. This was not a private OR hallway but the main hallway open to the public. 

The problem with most European healthcare is that they generally do not track complications or outcomes nor have any other incentives to actually improve healthcare. This hospital had never had an surgical site infection or any other hospital acquired infection in it's short history. The fact that they do not look for such things is besides the point. 

U.S. healthcare is expensive and complicated but the one really good thing we do is we are the most open and honest about the care provided. We track and report complications and patient outcomes. 

[Bug Out, BSN]

The healthcare in Mexico is interesting to me in that there is a wide variety of care provided and generally, you get what you pay for. It's easy for tourists to judge the healthcare based upon the looks of the facility but I have generally found the knowledge and experience to be very good. Where they generally suffer is a lack of adoption of more advanced technologies, but that is also how you control costs. 

I wish your family the best. 

[Emergent, RN]

The ex is out of the hospital. Our son is getting him set up with a better living situation, where the landlord is nearby and speaks fluent English, and there are people who can help an elderly expatriate. Mexico is a much more down to earth society for sure.

He'll be strong enough for the prostate surgery in about a week they said. Also, there is an old couch surfer person. My ex was hosting through an app for couchsurfing people who are traveling abroad, and other people host them for free. It's kind of a good cultural exchange thing for an older person to do. This person is coming to help out and give my son some relief for a few days.

[DavidFR, BSN, MSN, RN]

Bug Out said:

The problem with most European healthcare is that they generally do not track complications or outcomes nor have any other incentives to actually improve healthcare. This hospital had never had an surgical site infection or any other hospital acquired infection in it's short history. The fact that they do not look for such things is besides the point. 

 

I can't speak for Germany but that is absolutely not true of our health care here in France. It's not perfect, it has its problems but on the whole it works very well. A mixture of public and private that work together in tandem, between state funding and a mutual top-up that's usually provided by your employer, you essentially don't pay for health care and never have to worry about the bill. Our standards are good. There IS follow up to track complications and outcomes. Every country has the incentive to improve health care because it is ALWAYS an issue come election time.  

The World Health Organisation sadly doesn't publish its health service outcomes league tables any longer. When it did France and Sweden consistently alternated for first place. The US used to come way down. 

I have friends who've experienced the Spanish system personally and say it's good. My husband once needed treatment in Montenegro - it was free and it was good.

[Bug Out, BSN]

DavidFR said:

I can't speak for Germany but that is absolutely not true of our health care here in France. It's not perfect, it has its problems but on the whole it works very well. A mixture of public and private that work together in tandem, between state funding and a mutual top-up that's usually provided by your employer, you essentially don't pay for health care and never have to worry about the bill. Our standards are good. There IS follow up to track complications and outcomes. Every country has the incentive to improve health care because it is ALWAYS an issue come election time.  

The World Health Organisation sadly doesn't publish its health service outcomes league tables any longer. When it did France and Sweden consistently alternated for first place. The US used to come way down. 

I have friends who've experienced the Spanish system personally and say it's good. My husband once needed treatment in Montenegro - it was free and it was good.

I have not been impressed with French healthcare to be honest and have similar stories from France. I don't think you can say it is very good when you do not track and report basic things like SSI, CAUTI, CLABSI, VAP, etc. How do you know it is good if you are not assessing? Some hospitals will track some outcomes but whether they report those or do anything with those numbers is hit or miss. Now there are definitely some better facilities than others, Bichat-Claude for example. 

[DavidFR, BSN, MSN, RN]

Bug Out said:

 SSI, CAUTI, CLABSI, VAP, etc. 

Please can you explain what these abbreviations mean. I've never heard of them. I have only ever worked in two countries (one not Anglophone) and in both, abbreviations in health care are strictly forbidden due to the safety risk (misinterpretations or double meanings) so please can you clarify. What kinds of things are we apparently not tracking and reporting and can you provide your sources? 

Interestingly I found this:

https://www.statista.com/statistics/1376359/health-and-health-system-ranking-of-countries-worldwide/

According to this France has slipped to 20th since the World Health Organisation league table days, however the US doesn't even make the top 50. Meanwhile lots of European countries are up there. 

Of course these surveys can be very subjective and one has to ask what is being measured and how. But the real test of a system is living it. I've never lived in the US but I note the comments of many posters on here who believe the US system is expensive, inefficient and inequitable. Thats how it would seem to me on paper - I'm prepared to believe otherwise, however I don't read many happy bunnies on All Nurses as regards the US health care system. I'm not saying you don't have good care. I only know what I've read, much of it on this forum. I cannot comment on the US from experience.

Have you ever lived in France? Worked here? Been treated here over a significant period of time? I've lived and worked here since 2001. Ironically the one hospital you rate - Bichat Claude-Bernard, is absolutely not one of our better hospitals. Like all countries there are good and bad facilities and of course, there are problems. My personal experience of working here is that I get to give a good standard of care in a system that for the large part, works well. My experience as a service user is that I can get to see my local doctor (general practitioner) at a moment's notice when I need to and he'll refer me to the appropriate specialist when needed. For both chronic and acute conditions, my husband and I have received first rate care AND follow up - not least I am a stroke survivor whose life may have been saved by the French system. Everybody's swift intervention has left me with NO deficits - and yes, I was intensively followed up. And never paid a centime. 

Recently I attended the emergengy department with a hand injury. I was seen immediately - within no time had an anaesthetic assesment and was taken to the operating theatre where I was operated on under nerve block and dealt with professionally. AND correctly followed up. Again, I was out of pocket to the tune of €0.00.

Your personal experience of France is?