An Apple a Day

Healthcare. It´s a hot topic in the U.S. It´s a hot topic in Mexico. Why? Because we want to be healthy. We want to go to the doctor when we need to. We want to get our teeth cleaned and our blood pressure taken and have a nice person in scrubs tell us everything is ok. From what I can tell, this is a universal desire. I can also say that this is not universally available.

Before I start throwing out personal experiences and opinions, I want you to understand the "Official Situation" of healthcare in my state here. So I´ve done some homework for you:

-There are three main types of health care in Mexico: Private Physician, Private Healthcare, and Public Healthcare.

-Private Physician/Healthcare Plan - This is most simple to understand: There are private physicians who have private offices and relationships with families who come to them. They have "regular" customers. It is run on the "free market" system:If you can pay, awesome. If you can´t, you don´t use this. These families seem to have the best healthcare: having a physician you can always just go to. These families also have MONEY. This is not a cheap option, but seems to be pretty common upper-middle class and upwards.

Public Healthcare This is where it starts to get a little more complicated, and the descrepancies start to appear. According to the 4th Article of the Constitution, every Mexican citizen is eligle for full or partially subsidized gov. health care. Great! But this depends on work status. Unemployed citizens get to use SSA Plan(English: Secretary of Health.) If you are working, you get to step up the ladder a bit and use IMSS (English: Mexican Social Security Institute). Public Sector workers are really special and use ISSSTE (English: Institute for Social Security and Services for State Workers). These different plans all have different levels of deductibles and different levels of care available. From what I can tell, in this sytem the length of acronym is directly related to the quality of plan.

According to WHO, México isn´t really doing that badly:

-100% of routine EPI vaccines here are financed by the government

- The life expectancy in Mexico is 73 (male) and 78 (female)

-94% of births are attended to by a skilled health professional

This is really great, and probably contrasts with that image stuck in your head of Mexico City in facemasks (H1N1). So I´m going to confuse you even more now and describe the "emergency room" situation as I know it. This is where the personal opinion/experience comes in:

The sign read urgent care. Judging by their faces, the sign was correct. There were about three dozen people, from children to very elderly folks sitting around the door. They weren´t sitting on benches or padded chairs. They weren´t reading "People Magazine". The kids didn´t have suckers and the space was devoid of inspirational posters and fake plants. Actually, it looked sort of like a parking lot to me: Outside, and with a concrete floor. We were there to hand out bread.

Inititally, I didn´t understand this service project. "We are going to distribute bread in a hospital?". But hospitals were full of bread! And really: Who has time to munch on a hard roll when they are in the emergency room? Quickly, like so many situations here, I realized how wrong my preconceptions were. The people in front of me had all been sitting there for more than 12 hours. Some of them would wait 12 more. We were distributing bread, because they couldn´t get up and leave or they would lose their place in "line".

I say "line" because patients with really URGENT situations get to enter first. We do this in the U.S. too: The dramatic freak-accident needs to be seen before the "I think I have an ear-ache". Fine. But the problem is that here, the patients with the better "coverage" get seen first too. This is where those acronyms start to be really important. The family who´s been sitting outside for 12 hours will have to sit a little bit longer if a government official shows up. But that family will still be able to enter before the unemployed mother who is REALLY at the bottom of the totem-pole.

The people who had done this service project before told us that it was most important to get bread to the people sitting down. It´s easier to get to the door first if you are standing up, so sitting down implies something is really wrong. What kind of strange planet was I on? This did NOT feel like a hospital to me.

Are you starting to feel the contradiction? Both of my host parents are doctors. I go to a school with a medical program, and 50% of the students I see wear white scrubs every day. Many people in the U.S. fly down to México to have surgeries because it is cheaper. I have been to some REALLY nice doctors offices with my host family that seemed exactly like something you might find in the states. The doctors here are well trained and it is safe and modern. But there´s a whole group of people without good access to this.

My brain still can´t comprehend the spotless offices with high tech equipment and the eighty year old woman outside who has been waiting for 10 hours.

This may just be specific to that hospital, or this city, or this state. I don´t really know, so I am not going to make any sweeping comments about Mexico in general. But even if what I described is only reality for a small group of people: I think that´s still too many.

I´ll be thinking about this the next time I go to the doctor and need to wait. At least, I´ll be thinking about it untill I sit down in the padded chair, smile at the receptionist, and begin to catch up on celebrity gossip...