MERIDA MEDICAL TOURISM: 

Good Enough for the U.S. President!

by Alan Graham

Geography and good value make Merida the most attractive medical tourism destination in North America.  Merida offers the highest quality treatment at low costs combined with a well-situated and safe city.  And, private medical and dental procedures are 30% to 90% lower in Merida, Yucatan compared to similar procedures in the United States.  And you just can’t beat the location.  Why spend more money flying elsewhere?

Ex-pats living on the Yucatan Peninsula have already learned the fine features that Merida offers the Medical Tourist:

•    Humane physicians and dentists who spend time with you

•    Easy and speedy health appointments

•    Spotless, clean environments

•    Physicians and Dentists fluent in English

•    Professional training in the U.S. and Europe

•    Low costs

•    Attractive insurance plans for foreigners

•    One of the Safest Cities in North America

•    Easy Access from the U.S., Canada, Caribbean

TRAVEL FOR THE HEALTH OF IT

A 2009 Medical Tourism Association (MTA) study shows over half of patients who sought care in a foreign country used a company as an intermediary to facilitate their trip and treatment.  93% felt “very safe” or “safe.”  And 63% said the foreign medical care was better than it would have been in the U.S. and 37% stating that it was equal to what they would have received at home.  Reasons for going:

32% Weight Loss / Bariatric

22% Orthopedic

12% Cosmetic

  2% Spine

32% Other

IN MERIDA, A COMPLETE FACELIFT AND NECK LIFT COST ABOUT  $10,000 … COMPARED TO $30,000 AND UP IN THE U.S. …

The Deloitte Center for Health Solutions forecast that by 2015, between ten and twenty million Americans will travel abroad for treatment each year.  The economic slowdown did cause some medical tourism patients to postpone elective procedures that involve big out of pocket costs. 

The exception is cosmetic surgery where medical tourism continues to boom.  The cosmetic surgery profile is 86% female and middle class, with 60% having an annual income of less than $90,000.  In Merida, a complete facelift - and additional necklift, eyebrows, and forehead procedures - cost about $10,000 including surgeon’s fees, hospital stay and anesthesia, compared to $30,000 and up in the U.S. for the same package.

DENTAL CARE IN MERIDA

Among the busiest dentists in Merida is Dr. Javier Camara.  Another Meridano who returned to serve at home, he traces his family tree to the 1540s Spanish colonists. 

Foreigners account for 50% of his patients at his dental offices in Altabrisa and Garcia Gineres.   While most are Americans and Canadians, 1 of 4 is from Europe and other countries.

Recently as I was packing to leave Merida, I cracked a huge chunk from my molar on a Friday and Dr. Camara saw me immediately, drilled, and made crown impressions.  Just two working days later he set the new crown in perfectly.  While the charge was a tad more than normal for the emergency crown creation, the total cost was still 70% less than what I pay in the States.

Dr. Camara spent six years of training in Oral Rehabilitation in Houston.  Further study at UCLA and Mexico City earned him degrees in Implantology and Orthodontics.  Currently he is an Affiliate Member of the American Dental Association and the World Federation of Orthodontists.  “For updates in my fields of expertise, I attend the Greater Houston Dental Meeting and other professional conferences.  Twenty people work with me in the offices including an oral surgeon, a periodontist, an endodontist, a pedodontist and several general practitioners.”

Some of Dr. Camara’s foreign patients even plan their vacation around scheduled major dental work.  At the conclusion of their appointments they visit the Mexican Caribbean beaches or enjoy colonial Merida.  Their flight, hotel, and dental work are less than the dental work alone back home.

Here is a breakdown of some typical dental procedures and their costs:

•    OFFICE VISIT, EXAM & CLEANING -  $30 (90-150 pesos)

•    X-RAY - $8 each (40-60 pesos)      

•    FILLINGS - $30 - $65 (90-175 pesos)

•    VENEER – $270  (800 – 1800 pesos)           

•    IMPLANTS – $960 (3,000 – 4,000 pesos)           

•    CROWNS – $175 (800-1200 pesos)

•    ROOT CANAL – $145 (500-900 pesos)

•    BRIDGE - $175 (800-1200 pesos)

•    WHITENING - $135 (400-700 pesos)

•    FULL ORTHODONTIC TREATMENT – $1100 (4000-10,000 pesos)

http://www.yucatan-dentist.com 

(Please note that prices quoted by Dr. Camara & Associates are converted from pesos to U.S. Dollars. Comparable U.S. price ranges in parenthesis.  Quotes throughout the article are approximate costs.)

PATSY PARKER’S CANCER SCARE

When Patsy made an appointment with an Oncologist at Star Medica Hospital & Clinic it was for a bothersome calcified growth on her jaw line.  She had no idea Dr. Victoria would discover a potential thyroid cancer danger unrelated to her visit. 

First, Dr. Victoria escorted her to Radiology for x-rays that revealed a heretofore unknown growth in her thyroid.  Dr. Victoria scheduled her for the next morning with another specialist, an Oncology Pathologist, who would perform an in-office fine-needle aspiration biopsy. 

However, they could not palpate it correctly and changed strategies immediately.  Following a quick phone call, Patsy and the doctors met with a 3rd physician just 30 minutes later who performed the identical procedure - but this time a transendoscopic ultrasound-guided, fine needle aspiration biopsy.

 

“All 3 doctors were in the room for my entire procedure.  It was incredible.  I was scared, but felt so cared for and the doctors were all so comforting and sensitive.  The very next day I went back to Dr. Victoria’s office to learn that the tumor was benign - but still a thyroid problem,” cautioned Patsy. 

Dr. Victoria referred Patsy to an Endocrinologist the following day. With advanced training from the University of Texas-San Antonio, Dr. Cervera would take the reins. “The new doctor is medically managing my thyroid problem satisfactorily.  It was quite a week and I was so happy by how quickly everyone responded to my crisis – I surely didn’t wait long for the good no-cancer news!” exclaims a very relieved Patsy Parker.

Patsy’s treatment for those 3 days, including all medical procedures, hospital costs, lab work and the attention of four doctors was less than $300 – without insurance.  In the U.S., the procedure, hospital and lab costs alone run upwards of two thousand dollars.

MEDICAL TRIP COMPANIES – YOUR LIAISON TO TRAVEL HEALTH

Travel agents have been booking health vacations for years.  But due to the increased popularity of medical trips abroad, many Medical Tourism companies have emerged.  In Canada, over 20 companies exist for the sole purpose of arranging all-inclusive trips for patients.  And in the States many times that number.

Another sign of the growth of this industry can be seen in the number of newer annual conferences, including this year’s 4th Annual World Health Tourism Conference and only the 2nd year for the World Medical Tourism Conference. http://www.MedicalTourismAssociation.com

A need exists for knowledgeable, ethical, and caring medical travel managers.  A welcome consumer-friendly innovation is when U.S. and Canadian ex-pats (who actually live in the patient’s selected destination city) serve as on-site facilitators in the “foreign host city” - where the patient receives the medical treatment - rather than to administrate long-distance from the faraway “departure country.”  Having afellow countrymen there in-person coordinating your stay, and even providing hand-holding along the way, is reassuring in making your foreign health experience a success.

One out of three medical tourists travels for weight-loss surgeries known as bariatric surgery

WEIGHT LOSS SURGERY IN MERIDA

 

One out of three medical tourists travels for weight-loss surgeries known as bariatric surgery.  As an elective surgery this popular choice changes your digestive system, usually limiting the amount of food you can eat.  According to the Mayo Clinic, these surgeries help you lose weight and can lower your risk of medical problems associated with obesity.

Laparoscopic Gastric Bypass is the most frequently performed bariatric surgery.  Many surgeons recommend gastric bypass surgery because it usually equates with fewer patient complications than other weight-loss surgeries.  It is a surgical procedure that causes weight loss by simply reducing the quantity of food intake by lowering absorption. 

Another weight loss strategy is the placement of a balloon, known as the Intragastric Balloon, in the stomach basically decreasing your stomach’s storage capacity.

Take a look at Clinica De Obesidad at Star Medica Hospital in Merida.  The team consists of a Gastroenterologist, a Laparoscopic Surgeon, a Nutritionist, a Psychologist and the Coordinator for English speaking patients.  Several consumer-friendly health packages are personalized to each patient’s particular need with an overriding mission:  combine the correct treatment with lifestyle changes in nutrition, physical activity, behavior, and diet.

For about $14,000 US all-inclusive costs (expect to pay at least double to triple that amount in the U.S.) Gastric Bypass at Clinica de Obesidad includes:

1)    Doctor and Surgeon’s Fees

2)    Anesthesiologist

3)    Operating Room Costs

4)    All Hospital Costs Including Your Stay (3-4 Nights), Medications

5)    Up to 5 Pre- and Post-Op Consultations with each Doctor

6)    Up to Double that number with Psychologist and Nutritionist

INTRAGASTRIC BALLOON

This procedure is performed on an outpatient basis and runs about $3000 US all-inclusive costs. http://www.cirugiabypassgastrico.com

AMERICAN MEDICAL ASSOCIATION GIVES GREEN LIGHT

Surprising to many, the American Medical Association in 2008 adopted an officially “neutral” position on Medical Tourism.  But the AMA shows “de facto” endorsement for Americans seeking health care in other countries.  They state “our AMA advocates that employers, insurance companies, and other entities that facilitate or incentivize medical care outside the U.S. adhere to the (nine) principles.”

The AMA principles acknowledge that there are advantages to seeking medical care outside of your own country.  Some principles are sound while others - including accreditation issues – are controversial.  Experienced medical travelers know that obtaining a mandated type of accreditation does NOT always guarantee quality health care. 

Many superior foreign hospitals may not even consider the AMA’s recommendation on certification or accreditation because they see it as an unnecessary duplication of accreditation – their current accreditation may already be sufficient, and perhaps it is simply too expensive to seek another accreditation. 

After all, patients seek health care in foreign nations because their own country’s medical and insurance establishment makes medical care prohibitive one way or the other.  It is wiser to combine the recommendations that make sense to you, with the positive experiences and success stories of other “veteran” medical tourists when selecting the right physician and hospital.

The AMA provides welcome support for a consumer’s right to choose medical care across borders.  However, there are political agendas as the AMA and others intend to craft and support legislation “regulating” Medical Tourism.

TIMELY TRAVEL TO MERIDA

 

On any given day you can cruise Merida’s medical centers and spot license plates from Belize, Guatemala, and Honduras as well as U.S. and Canadian plates. Most recurring U.S. plates are from Florida, Texas, and Virginia while Ontario overwhelmingly represents Canada.

Many plates - after the home-state Yucatan license plates and neighboring Campeche - are from the Mexican Caribbean’s Quintana Roo, the country’s newest state and Yucatan’s eastern neighbor.  Quintana Roo includes Cancun, Playa del Carmen, Tulum, Chetumal, and Mahahual on the Costa Maya.  Rather than drive to clinics and hospitals closer to home many ex-pats choose to make the trip to Merida instead. 

I was in a spotlessly clean private room with nice artwork on the walls.  The surgeon was trained in the U.S. and his care was excellent and personal.

One of those ex-pats is Kevin Graham, U.S. Counsel Warden who lives in Mahahual, a 5-hour drive away, and doubles as owner of Costa Maya Living Real Estate.  His thoughts and experiences are compelling,

 ”Where would we go if something serious were to happen?  When I asked other ex-pats about their healthcare experiences here in the Yucatan Peninsula, Merida was consistently mentioned and with positive comments too.  I have always been partial to using hospitals that are near to teaching institutions.  Again, Merida fits the bill. 

The need did arise one evening when I had an appendicitis attack.  I threw a few items in a bag and made the long trek to Merida.  I arrived at the emergency room of Star Medica Hospital, and was seen by the emergency room physician in less than five minutes.  A prompt examination and a few tests and my suspicions were confirmed.  They called in a surgeon and I was in surgery shortly after my arrival.  (The surgeon was actually sitting in a chair outside of the operating suites, waiting for me.)

I only spent one additional night in the hospital.   I was in a spotlessly clean private room with nice artwork on the walls.  The surgeon was trained in the U.S. and his care was excellent and personal.  He gave me his personal cell phone number and made arrangements for me to have my sutures removed back in Mahahual.  The hospital staff was attentive without interrupting my rest and recovery.

The cost for emergency room, emergency room physician, all tests, surgeon, operating suite and two nights in the hospital - $3,000 USD.  That was my deductible when I lived in the U.S.!

A reason I picked Star Medica was due to positive things I heard from other expats.   It always makes you feel a little better when you run a doctor’s name by someone.  I have come to appreciate how really good health care can be here in Merida.” 

3 PRIVATE HOSPITALS IN MERIDA – WITH COMMENTS

Star Medica Hospital & Clinic

Calle 26 No. 199 between 15 & 7

Col. Altabrisa, Mérida, Yucatán

http://www.starmedica.com 

(New hospital, and quickly became the #1 choice of foreign visitors and ex-pats)

Clinica de Merida

Ave. Itzáes No. 242

Col. García Ginerés, Mérida, Yucatán

http://www.clinicademerida.com.mx   

(The previous #1 choice among foreigners before Star came to town)

Centro Medico de las Americas

Calle 54 No. 365 by Perez Ponce Ave.

Centro, Merida, Yucatan

http://www.centromedicodelasamericas.com.mx  

(Competent, caring doctors but the hospital is old-fashioned and worn)

INTERNATIONAL INSURANCE BENEFITS

Bi-cultural and independent insurance agent, Hector Lopez, grew up in the States but returned to his Merida roots.  His clients are nearly all foreigners including 70% American, 20% Canadian, and 10% European.

Hector represents ALLIANZ and has been my agent for years.  At 59, I pay $1,500 annually for private and complete medical insurance.  My deductible is 5,000 pesos or about $385.  Better news is that the maximum age to enroll in an ALLIANZ health insurance plan is 70.  You can even apply a few months before your 70th birthday to qualify. No medical exam is required, but you have to complete a medical questionnaire and cite any serious preconditions.  International insurance adds value to already affordable private medical treatment.

ALLIANZ, an international insurance company headquartered in Germany, is the second largest global carrier.  Their presence in over 70 countries is almost twice that of their nearest competitor.  And my health insurance policy covers me for up to three months while in the U.S. or Canada.

There are other health insurance companies available for your consideration.  GNP (Grupo Nacional Provincial) is headquartered in Mexico City, AXA (acquired the Mexican insurance arm of ING in 2008) and Metropolitan Life.   But not as much bang for your buck in Yucatan, and lacking the extensive worldwide presence of ALLIANZ. 

http://www.yucataninsurance.com

ARE THERE MAJOR DRAWBACKS TO MEDICAL TOURISM? 

Medical Tourism is not for everyone.  Some patients find that they are just not capable of traveling to another country for treatment - even when advantageous.  Reluctant patients may exhibit mixed emotions of leaving loved ones behind, or are unaccustomed to traveling anyway, or irrationally buy in to the media’s fear-mongering about foreign countries. 

But for many others, medical travel provides great peace of mind via financial savings alone – especially if you are not covered for a particular procedure, have too large of a co-pay, or have to wait eons in your home country for a much needed surgery.

Despite the AMA and others embracing medical travel – some critics continue to cry, “But what about shoddy care in foreign countries?”  That myth has been shattered already in this 2-Part series (see December, 2009 issue for Part 1) and by independent research studies. 

A better question – depending on the procedure - might concern continuity of care when you return to your home country.  A good response is to inform your home physician of the planned treatment beforehand, then follow up after you return.  And Merida’s proximity provides easy, affordable access if a return trip is needed.

Of course, your home country’s laws do not apply abroad.  In the worst case scenario there may be little recourse for poorly delivered treatment.  However, high medical standards and pertinent accreditation should eliminate most apprehension.  But legal liability may concern some doubters who find medical travel too disquieting for them.  (Ironically, one major reason for out of reach, overpriced medical care in the

U.S. is the astronomical liability premium that physicians and hospitals face due to the fear of unbridled lawsuits.) 

Wiser medical tourists will weigh the advantages of treatment abroad accordingly. For those who take this route - access, timeliness, choice, affordability, or not having to be on a waiting list, eclipse any perceived risks every time.

MERIDA WEBSITES FOR FOREIGNERS

YUCATAN TODAY is a useful resource for foreigners.  Combination tourist magazine, event calendar, and ex-pat bulletin board plus a helpful website.  http://www.YucatanToday.com

http://www.YucatanLiving.com  Chockfull of information featuring articles about the nitty-gritty of living here and finding your way around Merida. 

http://www.Yolisto.com  An entertaining site whose focus is on the beach ex-pats (beach is 30 miles north of Merida) who utilize Merida’s services.

The U.S. Consul in Merida provides an incomplete list of English-speaking physicians in Merida. Rarely updated, all information is supplied by the contributor.  http://merida.usconsulate.gov/merida/doctorlist.html

GETTING TO MERIDA, YUCATAN, MEXICO

Flying into Merida

Continental Airlines offers non-stop flights Houston to Merida most days of the week; departing at 7pm makes connections easy.  Some travelers find it convenient to make a connection in Mexico City rather than Houston.

Flying into Cancun

Regular flights or charters into Cancun are plentiful but you must rent a car or take the 1st class bus to reach Merida. 

Driving from Cancun

About 200 miles, Cancun to Merida - a straight, safe shot across the peninsula.  If you rent a car, the autopista (excellent, well-maintained toll road costs about $30), although not very scenic, is fast with no traffic. 

Bus from Cancun

Luxurious 1st class buses run from the downtown Cancun bus terminal non-stop to Merida’s Altabrisa medical area.  Be sure to take an ADOGL or UNO bus.

Author: Alan Graham is a guide and freelance writer, Alan Graham focuses on the Yucatan Peninsula of Mexico.  He spent several years as relocation and investment consultant guiding foreigners in establishing a home in Yucatan.  Alan wrote a series on the Mexican Caribbean in 2007 for Caribbean Property and Lifestyles Magazine.  His articles have also appeared in academic publications, International Living Magazine, Mexico Insider, and others. A Pelican Publishing author of an irreverent guidebook to New Orleans, he has written many editions over a 15-year span.   Alan divides his time between Yucatan and New Orleans, and can be reached at or 52-999-139-9885.

Email : Alan Graham