ITIC Global: Healthcare and travel assistance in Mexico

Susan Yates, Head of Americas, Falck Global Assistance

Yates began by highlighting that the overwhelming majority of visitors to Mexico – 84.6 per cent, or 33.5 million people – are travelling from the US. Of these, Falck’s data suggests that over half are visiting the country either for a vacation (33 per cent) or to visit friends and family (21 per cent) – and not necessarily prioritising access to high-quality healthcare in the region they are visiting.

Additionally, a further 13 per cent visiting the country are there for business – Yates noted that the country has seen increasing levels of foreign investment in recent years, with key investors coming from Canada, Germany, Japan, Spain and the US.

However, while business travellers and expat employees tend to be better covered than others, she noted that the type visiting Mexico tend to be higher ranking, typically older and consequently more likely to suffer health complications.

Yates noted that healthcare facilities in Mexico tend to vary widely in terms of quality, resources and expertise, saying that it was critically important to establish early just what level of care the patient is receiving.

She recommended that: “Best practice is to go to the bedside and verify that the patient’s condition is what you were told it would be – because in Mexico, it is not uncommon it to be different to what you were told.”

Yates added that that there isn’t a ‘cultural norm of donating blood’ in Mexico – she cited one example where the patient’s family was asked to donate their own blood, or find their own donors. However, the involvement of family in the process can be beneficial when supporting a patient in Mexico: “This goes against everything I usually believe – but if [the family] are on-site, and at the bedside, they’re going to be your best source of medical information.”

This is important, as ‘your patient may be moved based on financial motivations’, without regard for what is best for them, to an inferior healthcare facility and may be subjected to unfair ‘overcharging’ on medical bills.

There are few restrictions in Mexico on setting up a ‘hospital’ – many facilities are small and based out of shopping malls, often advertising services that do not actually exist.  

Despite this, ‘there are also many excellent options for care in Mexico’, with growing interest from many facilities ‘to comply with international norms, accreditation and standards’. Likewise, partnerships with international healthcare providers to improve training and capabilities was improving things. “However, inconsistencies are prevalent,” she said.

Ultimately, she concluded that the best way to avoid being caught out by poor-quality providers was to ‘develop your trusted provider list’. “If you don’t know the facility in Mexico, or if you don’t have experience handling medical cases in Mexico, then maybe consider working with a partner.”

Salvador Belilty MD, CEO, Logimedex Health Control and Risks Management

Belilty agreed, saying that it was important to ‘get a reliable partner in Mexico’. “You need someone who knows the system and can guide you through it,” telling them how to navigate it effectively and which institutions are good, he added.

He explained that many of the inconsistencies in quality across Mexico are due to a ‘fragmented health system’. “We have the public and private – then within the public sector, we have different kinds of facilities for a variety of patients.”

Private sector healthcare is of a very high quality – but only for those ‘who can afford to pay’. Below this, there is public sector healthcare for full-time employees, their relatives and retirees, which serve as a mid-tier option. The basic level is offered to the self-employed, unemployed and those in ‘informal’ work.

Belilty added that providers in major cities and places where medical tourism is common, such as Tijuana, have experience with international patients. “If you go elsewhere,” he said, “they do not know how to work with international insurers.”

The sector also suffers from a lack of billing regulation and few consequences for overcharging – a situation exacerbated by an unwillingness of insurers to challenge questionable bills.

“Insurers need to start saying, ‘I won’t pay you’ [in the event of an inaccurate or extortionate billing],” he said. “But everyone’s afraid of getting into a legal process in Mexico. Every time you pay a bill that is overpriced, you are effectively saying that ‘I know this is wrong, but I will pay you anyway’.”

However, he explained that knowledge of how to bill for international patients is improving – alongside a boom in larger hospital groups opening and buying hospitals, which has generally made it easier for international insurers and assistance firms to operate in the country.

Dale Buckner, President and CEO, Global Guardian

Buckner, of security services provider Global Guardian, argued that while the Mexican healthcare industry suffered from an inconsistent level of resources and expertise, many travellers could avoid navigating this if they spent more time considering their destination.

“I think Western visitors in general are focused on ‘wow, this is cheap, and it’s all-inclusive’,” he said. “They have no idea what is waiting for them. The information is out there, but they don’t read it.”

He added that when briefing clients for international travel, in Mexico and elsewhere, he asked them to consider:

• Where they will go or what they will do if they get injured
• How they will manage in the event of a disaster
• What they will do if they, or a member of their family, or party gets kidnapped.

If they are unable to effectively answer every question in this ‘litmus test’, he recommends that they should not go.

Speaking about Mexico specifically, he noted that the country has an issue with ‘corruption’. “It’s not unique, but it is prolific, and the reason is one word – money.” He explained that huge amounts of money is currently being poured into Mexico through the llicit drugs trade.

More importantly, tourism in many areas is frequently correlated with this trade, and consequently with a higher rate of violent crime – primarily because many tourists ‘like to get high’.

Consequently, the potential exists for foreign travellers to get caught in the crossfire of firefights between rival cartels or security personnel – such incidents can cause significant collateral damage. Likewise, he said: “One common tactic the cartels have begun to exploit is that they’re lighting stores and vehicles on fire [to] create chaos, to distract first responders’ attention – it takes their eye off the ball.” Such strategies have proven to be ‘wildly successful’, and again can result in serious collateral harm.

Beyond so-called ‘narco-terrorism’, cartel violence has become a problem in Tierra Caliente due to the avocado industry – with growers being extorted and threatened for control over production of the valuable crop.

Kidnapping and extortion are also potential risks, with travellers ‘being taken from ATM to ATM, emptied of money and dropped on the outskirts of the city’.

Buckner also warned that many of these problems go ‘under-reported’ in Mexico, due in part to police corruption and threats to journalists by cartels.