Prologue
As many of you know, Michael and I are too young for Medicare. When we came to Mexico we signed up for Private Insurance ($2,176.00 for both of us per year with a $5K deductible vs. $24K for both with an $8K deductible in U.S.). Now, to be fair, the policy we got in Mexico was for catastrophic coverage & did have some exclusions like knee replacement etc. Then we found out they excluded us from cardiac care for a preexisting condition even though our high blood pressure was controlled. Well, maybe not, but we didn't know it.
So, we went to Seguro Popular (the national health insurance) and got lots of good treatment for free. We figured that if we had heart problems we could use them until we could figure out the insurance thing. At Seguro Popular they discovered that Michael had uncontrolled high blood pressure and his EKG wasn't perfect. Switched his meds which controlled the high blood pressure better and scheduled him for a stress test in October.
Then we found out we could get a group policy with Boomers in Paradise (love the name) for $900 p/p per year with the same $5K deductible. We'd have another year exclusion for cardiac but after that we'd be home free. Signed up. Part of that package was that they had found a doctor (American born but completely bilingual) who would work with the group & give us a group discount. So we went to the intake appointment. We brought our medical records. Dr. Hernandez spent a full hour with each of us reviewing everything (including stuff we'd forgotten) about our health. I can't remember spending that long in a doctor's office unless I was sitting in the waiting room.
Cutting to the chase, Dr. Hernandez looked at Michael's EKG and said, "Hmmmm... October for a stress test. I think not. If it were my father sitting in that chair...." While initially resistant to doing anything before our next trip (but there is always a next trip with us), we caved and said OK. On to the stress test.
The Procedures
We sauntered off to Guadalajara for a chemically induced echo cardiogram stress test. I loath chemically induced things but Michael's knees (another installment) precluded running so chemical it was. It is very different here. You can pick your hospital. Some are way less expensive than others (like the U.S. but WE get to choose). For this test, Dr. Hernandez suggested a very nice, Catholic, art deco hospital which was economical but had everything we needed. I was invited in to watch the procedure or loll about outside the curtained room as was my pleasure. Dr. Hernandez was with us at the hospital and introduced us to our cardiologist, Dr. Salas and the test proceeded. Regrettably, Michael refused to stress to the desired levels so they really couldn't get a good diagnostic view other than to see that the boy had some extremely funky (told you I'd spare you the medico talk) stuff going on cardiac-wise.
After a short confab, Dr. Salas said that they would do a Holter Monitor Test where Michael wears this monitor for 24 hours and they track his heart on three levels -- all of which escape me at the moment. So, two days later, monitor on. One day later, monitor off. Dr. Salas looks at the results. Now what is interesting, is that while he is analyzing the results we are there and he is going over them explaining as he goes. We realize that in every situation (both Seguro Popular and private) we are getting lots more information and much more opportunity to ask questions than we did in the States. We also get to see Dr. Salas' photo of his son who was born the night before. Very cute. All said and done, Michael needs angioplasty. In a hospital. Overnight. Great. And we're going on a trip. Soon.
Not a problem. Dr. Hernandez talks to Dr. Salas and he says he can do the procedure the next day. Once more, we review the hospital menu. This time we go upscale. We have our reasons that involve a brand new ICU and drive time. Some reasons were better than others. The angioplasty is scheduled for 5PM and we're told to be there by 4:15 which we are. However, admissions is rather "relaxed" and they seem to be processing about one person per millennium. Ever conscious of being the ugly Americans we wait. But, being an American with that overwhelming fear of tardiness, at 4:45 I start making noise in my hideous Spanish and they admit us.
I kind of lose track of Michael as he goes to prepare and I go to our room. Oh, did I say room? I meant suite. Now, at this point, no one has discussed price with us, and as I take in the leather sofas in our living room and the two person Cantera-lined walk in shower, I begin to have heart palpitations of my own. Oh well, it's only money and I do love him dearly. I am impressed by the security on our floor. There is a sliding glass door operable only by a magnetic key. The security guard lets you in and out. I ask for a key. They smile and shake their heads NO. Hmmm.
As I descend to the waiting area (no viewing angioplasty, thank God) I contemplate why I don't get a key. Oh....they are not worried about some stray drug cartel person waltzing in and taking out the ward. They are worried about dead beat patients going on the lam. Interesting. However, I don't have time to take offense because now it is after 5PM and my husband is lying on the table and I have to start my wifely duty of worrying.
Based on absolutely no factual data, I have decided that the procedure should not take more than one hour. They are to start at 5:00 so should be done around 6:00. No. Nor at 6:30. Now I'm really kicking in with the worry. A passing nurse smiles and say all is "bueno". At 7:00 I ask the next passer by how things are going in the O.R. and she tells me she doesn't know because she is the cleaning woman. Everyone wears uniforms and it is confusing. The security guard witnesses my growing agitation and says many comforting things that I don't understand.
Somewhere around 7:30 Dr. Hernandez finds me and lays out the results. It appears that Michael has not been a compliant patient. Oh, he laid still and stayed perfectly calm. It was his body. In Mexico, they do angioplasty the way they do in Europe (and I think are starting to do in the States). They go in through the arm not the femoral artery in the groin. Well, they went in Michael's left arm (closest to the suspected blockage) and his artery spasmed and collapsed. But they had planned ahead and prepped the femoral area. The femoral artery runs straight like the highway across Montana in most people. Michael's runs like the cloverleafs on a California freeway. Next plan. Dr. Salas goes in through the right arm and manages to go from the completely opposite side to the area of suspected blockage. But this all takes time. And there is no blockage. However, they now have a complete view of what is going on and see that Michael has been, due to high blood pressure, developing the wrong muscles. Muscles in the arteries vs. the abs or pecs. They will use medication to relax the arteries, increase the blood flow and deliver, once more, a near perfect Michael.
They serve up a walloping array of new medications which the nurse administers all at once that night. I am sincerely hopeful that she has received orders to do so, but am not able to express myself that clearly. While all the Doctors spoke good to excellent English, the nurses didn't speak any English. Inexplicably the woman who delivered meals spoke perfect English and I considered kidnapping her to serve as my translator. She proved wily, however, and escaped. By the next morning when Dr. Salas visits, Michael's blood pressure is perfect. They run an EKG -- perfect. No funny spikes or dips. Bueno.
Leaving the hospital turned out to be the most grueling aspect of the sojourn. It was fraught with procedures and forms (Mexico LOVES forms) that had to be completed and provided in a certain order at certain junctures. I stumbled through in Spanish but it was a little trying. And then you get to pay. You'd better. They hold one of you hostage until you do. So here's the part you've all been waiting for.
Comparative Costs
Well, I know what it cost us. But I decided to try to figure out what it would cost in the U.S. Now, don't fault me. The New York Times has been trying to figure out health costs in the States and they can't say for sure. And they're professionals. So, I'm giving you my best research results on U.S. costs.
All figures USD.
Chemically Induced Stress Test:
U.S.-- $2,000 -$4,000
Mexico -- $478
Holter Monitor Test
U.S. --$1,000- $2,500
Mexico -- $117
In my exhaustive research I came upon a site that discussed Holter Monitor tests for Boxers (dogs not athletes). It only costs them about $250.00 in the U.S.
Angioplasty (Dr. and Hospital Costs)
U.S. -- California $44 -$145K, Seattle $60K, Tenn. $48K, Florida $56K, Oregon $54K -- I'm guessing an average of $55-56K
Mexico -- $9,120
Hospital Rooms
U.S. -- Semi-private $325, Private $995
Mexico -- Suite $232.70 (this was probably the most expensive hospital in Guadalajara)
Totals:
U.S. Average assuming a semi-private room -- a little over $60K
Mexico-- $9,351
The Mexican price includes all of the the "incidental" hospital costs included on the bill, including meals.
Conclusions:
* We wish he never needed it (or waited until the exclusion ended, damn it) but we now know that we'll get top quality care and we can relax.
* Having a doctor here is just completely different and we think so much better. They give you their cell phone numbers. They go with you for tests and to the hospital. They tell you everything. In part, they tell you because they are not afraid that you will sue them. They are incredibly warm and open.
* I need to learn better Spanish faster (although, God knows, I'm trying). Michael needs to learn Spanish or I'm in deep trouble.
* If you need a Holter Monitor test in the States go to a vet.
Well, this certainly is a departure from our normal blogs. But all part of the experience. Off today to the three day Tequila festival which is featuring many bizarre things including a 260 liter Vampiro cocktail (tequila, grapefruit soda and Chapala's famed Sangrita chaser) that they are preparing as a test run for the Guinness Book of World Records. Less than a week before blast off to Tennessee, Boston and Maine. It will be great to see everybody. Take care.
Most of the photos for this blog were taken by Deirdre (for obvious reasons).
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| The entrance to the hospital with the gift shop on the left. |
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| Looking out from the entrance. |
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| The ante room of our suite at the hospital. |
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| The hospital room. Note the leather sofa is as long as the bed. |
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| The cantera stone shower. |
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| Wardrobe & big flat screen TV in the room. |
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| Dr. Santiago Hernandez, our primary physician. |
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| Michael, back in the room, after his angioplasty. |
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| Michael with Dr. Salas, his cardiologist. |
