Trump’s wall could hit Mexican medical tourism market
What does President Trump’s Mexican wall plan mean for medical travel across the border? Some Mexican hospital groups have already reported a fall in US patients, but opinion is split on what the long-term effect will be. We talk to operators in the region to find out more.
Last month Donald Trump looked at prototype sections of what his finished wall might look like, and Mexico is reportedly assessing the economic impact of America’s withdrawal from NAFTA.
An exact figure for the number of people going south from the USA for cheaper medical treatment is hard to come by. The International Medical Travel Journal (IMTJ) thinks it is around 100,000, while healthcare business consultant Irving Stackpole tells us it is at least 250,000 – and neither estimate includes day-trips to buy cheap prescription drugs. Patients mostly go for treatment not covered by insurance: dentistry, bariatric surgery and experimental oncology, for example. The main draw? Costs are 40-65% cheaper than in the US.
But some see problems arising because of what Stackpole calls Trump’s “rhetorical wall” that is already being built. Julie Munro, president of the Medical Travel Quality Alliance (MTQUA) in Scottsdale, Arizona, tells us that a negative atmosphere is developing on the border which might have ramifications for ease of travel for bargain-seeking US citizens. Speaking to us from the International Hospitals & Medical Tourism Conference in Barcelona, she said: “Because of the increasingly negative political climate between the two countries, there is a sort of retaliatory attitude among border guards. For a long time you’ve basically been able to wave your drivers licence and be let through, which is against the rules but is very much done.”
This is changing. She explains: “Based on conversations with stakeholders in the industry it is now increasingly recommended that you do not go to Mexico without your passport.” Is this a kind of retaliation against the negative rhetoric coming from the US? “Yes, you could say that.”
Another consultant we spoke to says passport-less crossing is a tiny fraction anyway and so this won’t change things much. But he says other factors are leading to the same outcome of fewer medical travellers to Mexico and there is anecdotal evidence of this.
He explains: “Medical travel to Mexico has tiers. One is low-income workers in the border states going over for basic care, sometimes covered by a union’s insurance policy [there is one in California covering half a million farm workers]. This won’t change no matter what wall goes up.
“The demographic that is changing – and this has been reported by groups in Mexico – is the higher-end demographic that might go for a tummy tuck or a new smile, and from further afield. Those upper and middle class consumers are certainly thinking twice about travelling to Mexico for care now, resulting in lower occupancy in hospitals close to the border.”
He tells us that Mexican hospital groups have already reported that they are seeing a fall in business from this demographic. Groups like the huge chain Grupo Hospital Angeles which has 2,554 beds and estimated annual revenue of $950m? “Yes, and there are others.”
Munro adds to this that suggestions of over-charging and other abuses of medical tourists in Mexico, levied against some groups and which she says is a widespread but undocumented phenomenon, might also be increasing. A recent switch to charging in dollars instead of pesos by some operators is one example.
But one operator on the border we spoke to is relaxed about Trump’s plans. Pablo Chee, CEO of the 56-bed Almater Hospital in Mexicali, says that up to 18% of his patients come from the US, and doesn’t think any wall will reduce visits to his hospital, which lies a few hundred metres from the border and a five-minute drive from the nearest crossing.
“We don’t think the wall is going to affect us too much. It’s generating a lot of noise in the news, but in the long-run there are other more important issues like going back on Obamacare.”
Chee sees opportunities in any repeal of the Affordable Care Act. If Trumpcare is passed, the Congressional Budget Office estimates the number of uninsured in the US to increase by 15 million immediately and 22 million in 10 years, while premiums for older Americans will skyrocket, even tripling in some cases, though falling for others. The consultant we spoke to says states are, for now, managing to block the Republicans attempt to kill Obamacare by 1,000 cuts, but the blows are coming.
Fewer patients going to Mexico wouldn’t be such a bad thing according according to some. Munro is sceptical of the quality of healthcare provided by convenience clinics. She says many go to the border towns because its easier, when the high-quality healthcare can be founded further inland in places like Monterrey. “It [quality healthcare] is there – in some hospitals – but finding it is the real challenge.”
Maria Todd, CEO of US-based medical travel consultants Mercury Healthcare International actually thinks Trump might stem the flow of patients seeking care outside the US, period, if his healthcare bill makes any changes to Health Savings Accounts which 20m Americans can use to pay for necessary care abroad. But as our consultant says, it’s a very slow process which is being proceeded with incrementally.
Three questions will determine the fate of Mexico’s market of US medical travellers which could be worth over $1bn. Will Trump’s wall make getting over and back across the border more cumbersome – assuming it is built? Will “Trumpcare” be passed and increase the number of uninsured patients or increase premiums for some groups? And will his stoking of anti-Mexican feeling lead to retaliation on the other side?
We would welcome your thoughts on this story. Email your views to Cameron Murray or call 0207 183 3779.
