I received a comment from David on my entry about California's Universal Health Care Bill (SB 840) which recently passed the legislature and provides care for all residents -- including illegal aliens.
David is a semi-retired American living in Mexico and extols the great, cheap health care they have there. Here is his comment in full and my response below on why we in America would not want Mexico's Universal Health Care System..
Re Calif. HB 840 (Univ. Healthcare) I'm a semi-retired American living in Cabo. Here in Mexico - basic healthcare is virtually FREE. Even for Gringos! No one is turned away - even poor Americans knocking on the hospital door.
And Mexico isn't whinning about all the Gringos running up their health care budget or for educating their kids who are living here. Don't even begin to think Mexicans are flocking to the USA for free medical care... Why should they? Its already free or nearly so in Mexico. They go to the USA for jobs and expect that the richest country on the planet can afford to care for its workers.
Fact is - a poor Mexican field worker or hotel worker has better access to a doctor or dentist in Mexico than a middle class American who can't afford American health insurance! $2 to 5 bucks is all it costs for a poor person for a consultation with a doctor at clinics everywhere throughout Mexico.
Mexicans expect health care to be provided by their govt. Its a better use of govt. monies than spending it on wars all over the world don't you think?
Fact is - since I was a child (over 50 years ago) the USA has always been at war somewhere... Not Mexico. Ever wonder why? Without sounding like a socialist - how about priorities? Did we need Vietnam? What good did it do? For anyone? Or all those piss-ant military involements in Latin America and elsewhere?
One of our dental patients here in Cabo recently had his foot nearly torn off by a shark. Was in the local public hospital for four hours in surgery with four docs and a micro surgeon who reattached all the nerves, vessels etc. Bill was under $500usd. (correct number) Another friend went into shock passing a kidney stone - bill for the house call from an endocrinologist was $35usd.
Another American visiting here in Baja told me he had the same kidney stone problem but in San Francisco California. He paid $5,800usd for the ambulance ride, two cat scans and emergency room charges.
The problem isn't the illegals jamming up the American health care system - the problem is the structure of the American health care system. In Mexico, Canada, Britain, Germany etc. there is a dual health care system. A Mexican (or expat Gringo) can pay high prices for private care or get most basic service for pennies on the dollar at a public facility vs. costs in the US.
My Mexican cardiologist here charges $50usd for a consultation. An Ear Specialist charged me $35 including a treatment using an intrascopic device used to remove a fungas. Root Canals & porcelain crowns run $250 - $450usd in Baja vs. $800-2,500usd in the States. Same materials same equipment ordered from the same catalogues as American dentists use.
Sorry, but Americans need a little perspective on their health care problem - Western nations with govt. sponsored health care do just fine with a DUAL system. People can then have options. In the USA - Americans don't have options - pay, go into debt, or be sick or die. Thats the fate of 40 percent of all Americans per the media.
Part of the solution to the American health care crisis begins with govt. paid or subsidized education of medical professionals as in Mexico. So there's lots of doctors per capita. And they're not treated like demi-Gods in Mexico. They don't drive Mercedes and spend a $100,000 for golf club memberships. All the doctors and dentists I know in Los Cabos drive VW's, Chryslers or Fords.
The medical industry in the USA doesn't serve the people the way the police, fire, teachers and other public servants do. The American medical industry in the USA serves itself.
David Mandich
San Jose del Cabo
Baja California Sur
Mexico
My Response:
Hi David,
Your explanation was well put and I appreciate it. I will however point out that there are tons of flaws in Mexico that you're not seeing in your "bubble" of Cabo -- a well developed portion of Mexico because it brings in tourist dollars.
Maybe they have cheap health care there, but what suffers because of it? Undeveloped portions of the country, mass poverty, poor to non-existent education, because the funds have been diverted to things like that. Cuba is another example, mass poverty, but free health care and education. Cuba even has developed tourist destinations like Cabo while the rest of the country lives in squalor and lives hand to mouth each day in a shack.
I mean we could shut everything down here in the US and divert all of our resources and have the most advanced health care system in the world for free to all, but at what expense? One issue is that nobody wants to cut anything here. If you divert education funds people will complain and students will suffer. If you divert law enforcement funds people will complain and crime will skyrocket. Government is always a big bloated mess and sinkhole. The only other option would be to dramatically increasing taxes for all which would then make the poor pay in the end anyway and then stand in line to get service.
Part of the solution to the American health care crisis begins with govt. paid or subsidized education of medical professionals as in Mexico. So there's lots of doctors per capita. And they're not treated like demi-Gods in Mexico. They don't drive Mercedes and spend a $100,000 for golf club memberships. All the doctors and dentists I know in Los Cabos drive VW's, Chryslers or Fords.
That's nice. However what is the incentive to become a doctor in America then? There would be none. Let's see, I can spend $250,000 to get a MD and then spend my life barely making enough to buy a Ford. The difference is that here there are opportunities in other fields and with no incentive to go into medicine nobody would. In Mexico the opportunities are very limited. You settle for crappy pay as a doctor because maybe otherwise you'd be picking some lettuce for a dollar a day or some other manual labor task that barely feeds your family.
While your description sounds like pie in the sky for the patient, the costs to their society as a whole has been severely detrimental.
Here in the US we have another program that is a DUAL system as you call it, it's called the education system. Free education for all or you can go private if you wish. Where has that gotten us? A system that is sucking taxes like there's no tomorrow and a substandard education at best for the majority of the students. Massive class sizes, overworked teachers, higher property taxes and an almost cattle-like mentality of just "push them along".
I'm sorry, but I don't want that system when it comes to health care.

I'm going to have to disagree with you on this one. David has some valid points.
First of all, you are using Mexico and Cuba as examples and that's distorting the facts of good socialized medicine.
Almost all of Europe, Canada, Turkey and Australia have some system of socialized medicine and most of Europe has a higher quality of life than the U.S. does so it's not a matter of diverting funds from the poor.
It's true that there are downsides to socialized medicine like having to wait for optional surgery and other reasons, but there can be no bigger reason than leaving almost half of the population without any means at all.
As for the subsidising of medical degrees and not having any reason for becoming a doctor after years of long hard training other than to live exhuberantly, I disagree with you on that one also.
Actually I'd rather not have to deal with a doctor that thinks on those terms. There are many out there whom do it or would do it because of the love for others, amongst many other valid reasons, including the contemplation that they would economically be set for life, although not making 1/2 million dollars a year but an above average secure income, the pride in just being a doctor... an angel that heals people would be enough for many... and so on...
There are thousands of doctors whom have left the worldly comforts of civilized life in their countries and dedicated themselves to the more needy in poor countries... those are the motivations that really matter.
Also, I think David hit the nail square on the head when you consider all the monies we have been spent on war and although I believe that some wars were and are necessary I don't believe we should shoulder the total cost of any war... and that means not going it alone without concensus.
I have always wondered why, if the government wastes billions if not a trillion in social and medical programs, the government couldn't just give each American without a violent crime record a million dollars with certain controls to ensure it wasn't squandered, starting with the eldest and working their way back to 21 yr olds during a cycle period of 5 years and then start over. Technically the money "as Bush likes to say" belongs to the people anyway. There would be no politisizing of government programs, the elders could retire comfortably with no need for social security checks or medicare and the younger could build their reserves or start a business and create more jobs and more taxes would be paid, violent crime would all but disappear (if you wanted to secure your future cut). Even the poor would have something to look forward to.
I will say however that David is totally wrong when it comes to illegal, legal immigration or guest worker programs. The Mexican government has failed it's poor people miserably and we are paying the consequences. Those consequences involve changing the traditional American way of life, it's middle class workers and families and it's natural resources forever. A price that should be too high for any true American.
So if he really thinks Mexico is so much better or could care less about the threat of the "re-conquista" to his ex-homeland, then why not just renounce his American citizenship, we would be better off without him.
I am a 53 yr old independent Puertorican American voter and have been for many years. I tend to be conservative on many issues such marriage, immigration etc. but with liberal tendencies when it comes to uncontrolled greed and abuse in our capitalistic, unregulated, free trade philosophies. Immigration is now my pet peeve until the matter gets taken care of in favor of America and the traditional American way of life... Apple pie only, no tacos please... keep this country great, American workers and their families only... foreigners need not apply...
Posted by: Antonio Santos at
September 10, 2006 05:00 AM

Dear Mr. Digger:
I read your response to my comments regarding the Mexican health care system and feel a need to clarify some things. Judging by your comments about Cuba and Mexico, I wonder if you have ever visited either place or even traveled beyond a Mexican border town? I've visited both countries and live in Mexico and cannot understand a lot of your comments.
The health care situation in Cabo is representative of the whole country. Not just an isolated area filled with rich tourists as you allude.
There are multi-million dollar private facilities for those that can afford it, and public hospitals and clinics of various quality for the working class. Not only in Cabo, but in rural Baja towns, and throughout Mexico where I have traveled. Mexicans do not need to travel to America to stand in line at a charity hospital - they can do that in Mexico. And often not have to stand in line as there are more medical facilities and doctors per capita than in the USA. In fact there is a glut of doctors in Mexico and the doctors would be delighted to have more Gringo patients who can pay a little more than the locals and patients who even show up on time for appointments.
People have a choice for Medical care in Mexico - not so for 40 million Americans who are shut out of the American health care system. Check out Ameri-Med hospitals in Cabo and other cities on the net. Check out the first class hospitals in other cities such as Guadalajara or Chihuahua. Smart Americans visit these places for medical vacatons and save serious money on major treatments.
If you visit small towns in Mexico you need not worry about what to do for a basic medical emergency as you can easily walk into a government clinic staffed by nurses and a young doctor intern on his government required community service stint and get care. For five or ten bucks. If you need more advanced care, most likely the Red Cross or Bomberos ambulance (fire dept.) will take you to the nearest town for a donation. Not $500 bucks as in the States for a ride across town.
What is wrong with the American government subsidizing the education of doctors? Is there some God mandated taboo that says that taxpayers can't get something back for their money? American doctors always use the same worn out excuse that they have to go substantially into debt to pay for their educations and to open a clinic. If the US government subsidized medical education there would be more doctors trained and in government clinics that folks could afford.
The wealthy would still be able to pay through the nose for the same care in a deluxe facility with marble floors and ferns. Americans would then have better access to health care in the US as taxpayers do in most other Western Industrialized nations. And in Mexico.
As an American who often comes into contact with Europeans vacationing here in Mexico - I get embarrassed when I hear of the excellent health and dental care (free) Germans, French and others are used to vs. our lousy American system back home. One of the many reasons Americans enjoy retirement in Mexico is the low cost of medical care and medicines.
Re Your use of Cuba in comparing the concept of opening up health care to the majority of people instead of just those that can afford to pay for it, is a reactionary cheap-shot. Having a dual system of health care - one that is more socialized and government supported in tandem with private health care as in Canada, Western Europe and China has not turned Canada into a poverty stricken totalitarian country like Cuba. You know that's not going to happen in the USA just because the government one day gets enlightend and decides to educate doctors and make them available to average people. Government medical subsidies never turned a country into a totalitarian regime. Political revolutions are made by guns, not doctors armed with syringes.
The Mexican government has not "failed" its people as you stated either. It's really doing a fair job with its limited resources and history. Don´t forget culturally it's a society that by 1810 had just emerged from 350 years of Spanish Colonial rule. Were talking a nation of former Mestizo/Indian wage-slaves suddenly freed. And then it had another 100 years of revolutions trying to get itself organized into a country. Some of the turmoils were aided and abetted by American political interests. A popular saying in Mexico is "...that no revolution ever succeeded in Mexico that was not supported by America". Finally by the 1920's- Mexico became relatively stabilized. But during that previous hundred year period of instability Americans stole or bought at gun point, half the best agriculturally and minerally productive parts of the country i.e. Texas, New Mexico, Arizona, Utah, California, and Nevada? Did I miss any? America killed most of its Indians or put them on barren reservations and let their cultures slowly stagnate or often die. But Mexican Indian and Spanish cultures blended and created a new race of people. Same Indians - two different solutions.
Mexico is doing a pretty damn good job for it's people for a country that was invaded numerous times by the Americans, French, British, William Walker type revolutionaries and even the Texas Rangers! The country was left with little more than a lot of desert, some oil and fabulous coastlines that Americans and Canadians now flock to for vacations and to build retirement homes. Don't be too hard on Mexico - it hasn't been easy for the country given all those who have tried to destroy it.
Today Mexicans in Cabo grumble that the Gringos are buying up all the beachfront and ocean view properties on both sides of the Baja peninsula. I tell them that Amercans are trading Los Angeles for Baja. If you want to buy a condo, luxury home, learn about whales or have a medical or dental vacation in Cabo because you can't afford care in the States - Goto: bajainsider.com There's a lot of fine articles on this Ezine written by American people that actually live in Baja and Mexico.
Keep on digging Digger. This kind of discussion by opposing points of view eventually gives the reader an educated perspective on issues. And that's good.
Thanks,
David Mandich
Posted by: David Mandich at
October 5, 2006 11:57 PM