Monday, February 11, 2019

Salud - To Your Health

Monday, February 11, 2019

I'll start off with a funny story.  At lunch, we were talking about the demise of the Ma and Pa stores and how even stores like Macy's are cutting back because so many people are ordering online now and the brick and mortar stores seemed doomed.  Fred shared that he even ordered his underwear online.  Larry joined in to tell us he, too, had ordered underline for the trip.  There were so many kinds, but being a basic kind of guy, Larry went for a package of Haynes.  When it arrived, he discovered that it had no fly!  There was no opening!  I immediately said it must have been a defect.  "No," Larry insisted.  "It's a new style."  Both Kat and I were a bit incredulous.  Is it really possible that men would want to pull down and pull up underwear every time they wanted to pee?  We women have been doing that forever- but that's because we HAVE to.  Why would anyone choose to go through all that if they didn't need to?  So here is a call to all you men out there:  Is it true?  Is there a new style of men's underwear with no fly?  Have any of you tried them?  What's the scoop?

Last night Fred invited the neighbors to join us for dinner.  Ed and Susan are a young American couple who moved in across the street about nine years ago, and Fred and Kat have developed a nice relationship with them.  Ed is an architect for Skidmore Owens and Merrill and Susan works for an American Medical supply company.  They live and work in Mexico City and come to their home in Cuernavaca on the weekends.  Prior to coming to Mexico, they lived in London.  They have no children and seem like a very happy and successful couple.

I couldn't wait to ask Ed about the two architectural debacles in San Francisco:  The "Leaning Tower of Pisa" and the disaster that beset the Transbay Terminal just a few weeks after it opened.  He had heard about both but hadn't followed them and didn't know the problems involved.  I didn't get any inside information I was hoping for.

Then the discussion turned to health care in Mexico.  Susan said it was a mixed bag.  She had seen some deplorable conditions in the government hospitals with sick people lying in filth in the hallways, but that there was also excellent care available. There doesn't seem to be any working insurance system.  Both Susan and Ed have insurance through their American companies, but if they need care in Mexico, they get the services, pay for them, and then they are reimbursed by their American insurance companies.  Ed told the story of a recent knee injury he had. He went to a doctor who ordered an MRI.  He was able to get the MRI a half an hour later.  Then he went back to the doctor for another consult.  When he went to pay the bill, it was 3000 pesos- or a little over $150- and that was for two doctor consultations, an MRI and pain medication.

I asked how people like Gilberto and Lucy, the caretakers of our villa, would be taken care of if they needed medical help.  Ed said that they would provide any medical help for their help, especially if something happened while they were working for them, but there didn't seem to be any set rule.

Why is health care so inexpensive in Mexico and so exorbitantly expensive in the United States?  It's an enigma to me.  I asked the question and Fred posed government regulations as a cause.  But what about insurance companies?  Here in Mexico, there doesn't seem to be any big insurance plans - could that be a way to lower costs?  But I'd be very nervous not having health insurance if something big happened.

Susan also told us that when she is doing her sales pitch for the medical devices she is selling, she knows that the contract will go to the lowest bidder.  It often doesn't matter which device is better.  As a result, the same device sold in Mexico would be cheaper than the one sold in the US.  Her company sells high-quality devices and in the US, doctors and hospitals will pay extra for that;  in Mexico, price is more important than quality.  So presumably we might be getting better care in the states.

There is also the exchange rate and the differences in the economies of the two countries.  Ed and Susan often take Uber from Mexico City to Cuernavaca.  This is a distance of about 55 miles and takes about an hour and a half up and over a mountain.  The cost:  800 pesos, or $40.00!!  Loren and I paid $45.00 to get from Clipper Street to SFO- a distance of 12 miles that takes 15-20 minutes!!  I haven't ever taken Uber to the airport, but I dare say is around $30.00 or more.

Our lunch at the Hacienda Cortez, where the six of us had margaritas,  a large appetizer for the table and then all of us had a lovely meal the bill came to about $20.00 a piece.  In San Francisco, one margarita would have come close to that!

So maybe doctors don't get paid as much in Mexico, or nurses, or technicians, or administrators - nevertheless, they are still able to enjoy a very nice lifestyle.

Here is yet another topic that is going to be up front in the news over the next two years.  I don't think anyone would argue that the cost of health care in the United States has skyrocketed and needs to be reined in somehow.  Is the answer more or less government regulation?  Is it single-payer or more competition among the insurers?  I certainly don't know the answers, but I wish I had confidence that our legislators were getting together and listening to experts and trying to find the answers.

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