Tuesday, October 13, 2009

Health Care

This morning, like many other mornings here in Ajijic, we hung out at Doctor Polo Ibarra's office/pharmacy.  Polo literally has a hole-in-the-wall business like many others near and around our town's main plaza.  In the "room" open to the street, Polo has medicines and medical supplies behind a long counter, a desk and cash register, and the chair he rolls around on while serving his customers.  (Now that Polo's broken foot is healed he'll likely serve more of his clients on both feet.)  The next room is his exam room and beyond it is a supply room.  Through the back door of Farmacia Jessica, named after Hilda's and Polo's oldest daughter, is a small outdoor courtyard/patio/garden.

The pharmacy has a loveseat style bench for waiting customers or bullshitting gringos and Mexicans.  It is there where Memo and I often kill an hour or two visiting with Dr. Polo.  We talk about everything.  Everything.  And, it is there that we have had the unique opportunity to observe a small snapshot of what health care in small town Mexico is really like.  We don't pry into anyone's business and have only on occasion assisted the doctor with translations, though Polo's command of the English language is probably better than my English speaking nephews and nieces.

An American lady came in today with some laboratory results that she wanted Polo to interpret for her, and then recommend to her a course of action to correct her current medical problem.  Doctor Polo first apoligized to her for having to charge her for an office consultation.  He read the lab results and offered her the treatment and medication needed.  The consultation or what we'd call a brief office call cost her $150 Pesos.  Medication -- $150 Pesos.  The dear gringa left the Farmacia Jessica with instructions, a medication, and a request to return in 4 days -- all for a mere $300 Pesos.  Today, that equals about $22.79 USD.  Yes, twenty-two dollars and seventy-nine cents for a medical consultation, with a real doctor, and a "prescription" medicine purchase.

"Prescription" medicine is not the same here in Mexico as in the United States.  Back in Michigan, I can not walk into a pharmacy and buy thyroid medication, heart and blood pressure medication, and an antidepressant without prescriptions from a doctor.  Of course to obtain the prescriptions, I would have to pay for an office call.  Here in Mexico, I may buy all my medications without a doctor's note.  "Sin nota?" I used to ask.  Yep.  All you have to do is tell them what you need.

When we first arrived here a little more than two years ago we consulted with Doctor Polo.  When our medications from the States were gone he switched us to Mexican or European equivalents and/or some of the same, but still expensive, American brands.  Now that we have a Wal*Mart, it is more difficult for Polo to compete with the low low prices of some of the generic brands of medicine that Wal*Mart has in its stores.  We now buy most of our maintenance medications from Wal*Mart.

We save money.  We do not pay for unnecessary physician office calls.  We do not pay deductibles.  We do not have to pay some un-godly amount of money towards our health care before an insurance company will start to reimburse us for our costs.  Medicine is cheap and readily available.  And, if I were smarter, I would pay the less than $300 USD per year to buy into the national health insurance of Mexico.  If I were to become a policy holder, in 3 years the plan would pay for all of my "pre-existing" conditions.

Yes.  While all the Democratic politicians are squabbling over whether or not the poor should have the same health care as the rich, we are paying for our own routine care with less dollars than what we would pay in the United States.  The Republicans have already decided that the poor are unworthy of equal medical treatment.  The Republicans have already agreed to the concept that the almighty dollar determines who will live and who will die.  And, it really is disheartening that the Democratic Party does not yield the power that they have right now and get things fixed.

For now, I am content and healthy living in central Mexico.  I do not see donations jars in restaurant and businesses seeking support for someone's medical bills.  I do not see notices for the pancake breakfasts or spaghetti dinners to raise money for someone's medical bills.  I do not drive by the parking lots where teens and adults wash cars to pay for someone's medical treatments.  Those are American values.  And, really, what a damn shame it is.

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