About 50 percent of the business at Hospital Angeles Tijuana comes from north of the border.
About 50 percent of the business at Hospital Angeles Tijuana comes from north of the border. Jason Beaubien/NPR
As many Americans struggle to pay for health care or health insurance, hospitals in Mexico are expanding in hopes of attracting more patients from north of the border — in addition, a rapidly growing industry is marketing "medical tourism" to Americans.
Hospitals in Tijuana — just a half-hour's drive from San Diego — can do many medical procedures for half or one-third the cost in the U.S.
Grupo Angeles is the largest private hospital network in Latin America. Its hospital in Tijuana is a modern six-story building. Its glass lobby accented with orange looks like it could be the set for a soap opera.
Carlos Zavala Ruiz, the business director for Hospital Angeles Tijuana, says this facility opened three years ago.
"As you can see, all the equipment is just brand new," he says.
Right now, about 50 percent of this hospital's business comes from north of the border. Americans mainly come for elective surgeries, like hip and knee replacements, laser eye surgery and plastic surgery.
The greatest number come for treatments for extreme obesity. Hospital Angeles offers gastric bypass surgeries; it inserts gastric sleeves and installs lap bands.
Zavala says the cost of these procedures in Tijuana is just a fraction of what they cost in the U.S. For example, a lap-band surgery in the U.S. costs $16,000 to $18,000, Zavala says; in Tijuana, it costs around $7,000.
He says his overhead is far less than in a U.S. hospital. Wages are also far lower. A nurse just a few miles north in California might earn $70,000 a year; a starting nurse here earns $6,000 a year.
Zavala says the potential for growth in treating Americans is huge. Grupo Angeles plans to open 12 more hospitals in Mexico during the next five years. Much of this growth is to cater to international clients.
Miriam Gray, a nurse from Wisconsin, is recovering in a private room at Hospital Angeles after gastric bypass surgery.
"I'd like to lose probably 125 pounds, which is a lot, but I'd like to," she says.
Gray has a body mass index of 42, which puts her in the extremely obese category. After years of failed diets, she hopes gastric bypass surgery will finally help her to lose weight. She flew from Wisconsin to San Diego, where a driver from the hospital met her and brought her here. Gray, who doesn't speak Spanish, says the entire procedure has gone more smoothly than she expected.
"I was checked in, had my blood withdrawn, X-ray — all within about an hour," she says. "I know that that is impossible in the U.S. I work in hospitals. It just doesn't happen that fast."
Gray paid $12,000 for this operation — about one-third of what she says it would have cost back home in Wisconsin.
The medical tourism industry has been around for a while. Costa Rica has marketed its hospitals to foreigners for years. Even Cuba has a bustling business selling health care procedures to Canadians and Europeans.
But these arrangements have generally involved a single person paying for a single procedure abroad. Now, there's a movement to offer cut-rate health plans that provide traditional health care, but some big-ticket benefits may only be offered outside the country. Blue Cross and Blue Shield of South Carolina last year set up an affiliate to offer benefits abroad.
Some U.S. doctors are raising concerns about the quality of care being offered offshore and about the logistics of dealing with complications during or after the procedure.
In an effort to protect patients, the American Medical Association for the first time this year issued medical tourism guidelines.
Terry White with Bridge Health International is marketing health plans to businesses in which some of the procedures are only available in Thailand, Costa Rica or Mexico. White says participation in these plans should be voluntary.
"The patient shouldn't be forced to go to an international destination because their plan only offers surgery in Mexico, or something like that," he says.
What he's offering, he says, is health care coverage that can save both consumers and employers significant amounts of money. He says this needs to be about empowered health care consumers, who are able to make choices that have an economic impact with the assurance that they are getting good quality when they go someplace.
Like Zavala at Hospital Angeles in Tijuana, White sees a huge potential market for international health care — particularly during an economic downturn.