For years, Mexican border towns have been popular among Americans seeking more affordable dental care and prescription drugs.
For Alexis Monson, it was worth traveling from San Francisco all the way to Mexico City even for basic health-care appointments. In October, she managed to fit visits to the dermatologist, gynecologist, and dentist into a three-day trip south of the border.
Monson, who's self-employed, has gone about a year without insurance. She used to have insurance through the Affordable Care Act, but she says it was too expensive to maintain. Before the Mexico City trip, she hadn't seen a gynecologist or dentist in over two years.
Monson's situation is not such an unusual one, and, given the White House's efforts to dismantle the ACA, it might become more common. As of 2015, about 65 percent of those traveling for medical procedures were not covered by insurance, according to the Medical Tourism Association's most recent survey. Mexico is among the top medical destinations for Americans because of its proximity and affordable medical costs. The Medical Tourism Index ranks Mexico 29th in the world for its volume of medical travelers.
While the ACA has reduced the number of uninsured by about 20 million, it hasn't curbed the medical tourism industry.
Deepak Datta runs the Medical Tourism Corporation, a Dallas-based company that facilitates medical care for about 500 to 600 patients who travel from the United States and Canada to Mexico every year. Many of his clients have medical insurance that doesn't cover surgery in the U.S., or, in the case of dental work, they don't have insurance at all and it's too expensive to pay for the surgery out of pocket.
"When the Affordable Care Act came, there was a lot of hope, and a lot of people who needed [non-emergent medical care], for example, knee replacements ... they decided to hold off. They had a lot of hope Obamacare would take care of that," Datta says. "But as time proceeded, that hope evaporated. So we had a lull in those types of procedures for a couple of years, and they are are back again, going to Mexico for [these treatments]."
People most commonly travel to Mexico for procedures and treatments that include bariatric surgeries, dental work, stem cell treatments, and fertility treatments. In Mexico, Americans can expect to find dental care that's 60 percent cheaper than in the U.S. and bariatric surgery that's 70 percent cheaper.
Monson says the quality of care was comparable to the U.S., if not better. "The dermatologist was much more thorough than any U.S. doctor I've seen," she says. Her visit, which included a mole check, cost just a little over $300. "He explained what he was looking for. You don't feel as rushed. It's not like in the U.S., where you wait for a long time before seeing a doctor for 15 minutes."
At her gynecologist appointment, she had an annual check-up, as well as an intrauterine device replacement—all for just $300. The best part, Monson says, was that she was given the cost of the appointments up front. No surprise expenses. (Monson does have an advantage that some Americans don't have: Her husband has family in Mexico City, which made finding the right doctors and making the appointments easier.)
It's not that health care is so different in Mexico, says Arturo Vargas Bustamante, an associate professor of health policy at the University of California–Los Angeles' Fielding School of Public Health; in fact, it's quite similar. About half of the population is covered by Seguro Social, an employer- and employee-funded insurance program, and the other half by Seguro Popular, a subsidized public-health insurance system implemented to provide coverage to Mexico's large informal workforce, similar to Medicare. A small portion also has private health insurance for more expedient care.
Americans traveling abroad for medical care are using private hospitals and private clinics, therefore not putting any strain on the national health-care systems. Many Mexicans also end up using private health-care providers.
"Even if you have access to Seguro Popular, many times you will encounter that they don't have the prescriptions that you need at the hospital, or some services are not covered, so most Mexicans actually have to pay out of pocket in the private market ... to compensate the inefficiencies and lack of coverage that they should be receiving from public hospitals, but, given resource constraints, they're unable to get," Vargas Bustamante says.
In other words, while medical coverage is considered incredibly affordable for Americans crossing the border—especially because they're taking advantage of the strong dollar—Mexicans might see high out-of-pocket costs.
Erika Lee, who lives in Los Angeles, has visited Tijuana the last few years for her low-cost dental care.
"Even with dental insurance, you end up paying so much for anything beyond cleanings," says Lee, 27. "For me, especially being in Los Angeles, there's no reason not to go there when there are well-established practices that are more cost-effective."
So last year, when she needed a crown, she started researching. "Everybody's concern is that it's not going to be safe, a scam or not good quality," she says. "You're not going to have the same care and amenities [as in the U.S.] but what they provide in care is the same."
She ended up paying just $175 in Tijuana for a procedure that would have been three to four times in the U.S. with insurance. Now she schedules teeth cleanings every six month with her Mexican dentist. Most recently, she had a filling that was less than half the cost of what it would have been in the U.S.
Tijuana, Mexicali, and other border towns continue to be popular for medical tourism, but Cancun, Guadalajara, and Puerto Vallarta are increasingly common because they're known as tourist destinations among English-speakers, says Datta, who runs the Medical Tourism Corporation.
Hector Perez, a surgeon in Cancun who performs weight-loss surgeries, partners with the Medical Tourism Corporation. His practice sees about 10 to 14 foreigners a month, mostly Americans and Canadians. While his American clientele is largely seeking a reprieve from financial costs three and four times more expensive than those in Mexico, Canadian patients often head south to skip lengthy wait times under their nationalized health-care system.
"In the United States, surgery is three or four times more expensive than Mexico, and it's not always covered. In Canada, while it's covered under insurance, there are much longer wait times. It can take them six months to a year just to see a doctor for a consult," Perez says.
Can we expect more Americans, like Monson, to go to Mexico for basic health-care needs? Datta says that's not likely. Traveling to Mexico for regular visits to the doctor is just not within reach to most Americans.
But until she can afford basic medical care in the U.S., Monson says she wouldn't hesitate to go back to Mexico for check-ups. "For sure the dermatologist and gynecologist," she says, which saved her hundreds of dollars even after airfare.