Medicare is a key area within US health reform. Medicare does not pay for treatment overseas. Medicare has very strict guidelines on what hospitals it uses and how it pays them, so any country hoping for a Medicare paid medical tourism boom is going to be disappointed.
Medicare is a key area within US health reform. Medicare does not pay for treatment overseas. Medicare has very strict guidelines on what hospitals it uses and how it pays them, so any country hoping for a Medicare paid medical tourism boom is going to be disappointed.
Of the 800,000 American citizens living in Mexico, 200,000 are over 60 years old and at or near eligibility for Medicare benefits. Last year, Paul Crist founded Americans for Medicare for Mexico (AMMAC), a non-profit organization dedicated to bringing Medicare coverage to seniors living in Mexico. Crist has lobbied 85 members of the U.S. Congress and prepared a 34-page proposal in which he outlines the pros of extending Medicare to Mexico, “Medicare is now spending $6700 per year per beneficiary in the United States. For the same care in Mexico, my estimate is that it will spend only $3400 dollars, which translates to a very substantial saving.” His argument is that if Medicare is extended to Mexico, the programme would only work with hospitals approved by JCI.This is one reason why there are now 10 JCI hospitals in Mexico, over 20 in the pipeline, and most new ones are built to JCI standards. Crist argues that if Medicare is accepted in Mexico, the 64 percent of American retirees currently flying back to the United States for expensive care would opt for treatment nearer their homes, cutting Medicare overall costs by a minimum of 22 percent.
Although the health sector is regulated and certified by the Mexican General Health Commission, the task of getting JCI certification for private hospitals is of prime importance. One of the main reasons for pushing for certification is that the North American Free Trade Agreement obligates the Mexican medical system to be on a par with the United States and Canada, allowing for the free flow of patients from border to border and for fair trade. The logic is that as long as hospitals are prepared to accept the delays and detail of the Medicare system, it makes sense for Medicare to accept JCI hospitals in Mexico. Crist argues that Mexican hospital standards are similar so Medicare should accept all hospitals. That argument falls on the basis that if the standards are similar, why are Mexican hospitals keen to spend substantial sums of money in getting JCI accreditation?
Whether Mexican heath care meets Medicare’s quality standards and payment system is debatable. The US government is concerned that creating a Mexican medical exemption might be too complicated and costly to implement and would open the door for Americans in other countries.
The approval of Medicare would greatly benefit hospitals such as Christus Muguerza, a Texas chain that now has seven hospitals under construction across Mexico. Even without a Medicare deal, most Americans seeking overseas treatment seem much happier travelling the short distance to Mexico than hopping on a plane to Asia .It is easy to forget that in the US, Hispanics are now the largest racial group.
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