Medical Migration: Strategies for Affordable Care in an Unaffordable System

(COEMH) Presentation

By Jennifer Miller-Thayer, ABD

UC Riverside

Generously supported by grants from UCMEXUS, EGARC, and

UCR Humanities

“I think the government and insurance companies are ripping the American people off straight out!” ◦ (Earl, a divorced 65 year old retired veteran

and year round Arizona resident, 2004)

“America is the best country in the world. It’s sad something’s wrong with the medical care system. Four more years of Bush then it will get better. We’re supporting the Mexican economy by buying prescriptions here.” ◦ (Sheila, a married 78 year old retired

housewife and year round California resident, 2004)

US-Mexican Border

Transnational Medical Consumers

SnowbirdsYear round border populations

Day/weekend crossers

Age in decades CountUnder 30 030s 240s 250s 460s 1170s 1080s 390s and older 1Total 33Average Age 65.8

Table 1: Age of Interviewees

Sex Count Percent

Female 21 64%

Male 12 36%

Total 33 100%

Table 2: Sex of Interviewees

Marital status Count Percent

Single, never married

5 15%

Married 23 70%

Divorced 3 9%

Widowed 2 6%Total 33 100%

Table 3: Marital Status of Interviewees

Education completed Count Percent

Less than high school 4 12%

High school diploma only 9 27%

Some college, no degree 12 36%College graduate (A.A., B.A.) 5 15%Graduate school, no degree 1 3%

Graduate school graduate (M.A., Ph.D., etc.)

2 7%

Total 33 100%

Table 4: Educational Attainment of interviewees

Income Range Count

Under 15,000 315,000-25,000 625,001-35,000 135,001-45,000 345,001-55,000 255,001-65,000 365,001-75,000 075,001-85,000 185,001-95,000 195,001-105,000 2Over 105,000 1Declined to state 10Total count 33

Table 5: Income of Interviewees

Insuranceall but two people had some type of

insurance. Medicaid, Medicare and a

supplemental insuranceemployee retirement benefits, military veterans and received

insurance from a veteran plan, others had HMO or PPO plans such

as Blue Cross and Aetna the Canadians had their Canadian

insurance, plus a supplemental U.S. plan

Medication* Cost in U.S. Cost in MexicoAzucort triamcinolona cream

$6.50 per tube $2.50 per tube

Cipro antibiotic 100 pills $100.00+ $11.00Advair inhaler $200.00 $40.00Serftin 20 pills N/A $22.00Sintrocid $5.00 (30 generic pills) $17.25 (100 pills)Actose $135.00 (30 pills) $135.00 (30 pills)Delanotin 700 pills $700 (Rite Aid), $380 (Walmart) $42.00

Claritin D $7.00 for 5 pills $11-12 for 20 pillsActinal 4 pills $90.00 $53.00Nexium (prilosec) 40 mg (brand name)

$145.00 (30 count) $32.00 (100 count)

Prilosec generic $135 (30 count) $14.00 (100 count)Generic of Lipitor 100 pills $186.00 $62.00Alapulmol 300 mg. (for gout) $14.00 for 2 months (VA) $5.00 for 2 months

Asthma inhaler (no brand) $5.00 (1 count) $5.00 (3 count)

Table 1: Cost savings for medications reported by U.S. and Canadian populations

Medication* Cost in U.S. Cost in Mexico Cost in Canada

Vioxx 25mg $357 (100 pills) $48 (100 pills) $149 (100 pills)

Premerin .625mg $32 (100 pills) $8 (100 pills) $19 (100 pills)

Lopressor 50mg $17 (100 pills) $8 (100 pills) $14 (100 pills)

Salbutamol N/A $12.98 (600 doses) $18.31 (200 doses)**

Flovent N/A $18.11 (60 doses) $78.00 (120 doses)**

Prozac 20 mg. N/A $20.00 (100 count) $98.00 (80 count)**

Penicillin 500 mg N/A $8.50 (100 count) $50.00 (100 count)**

Servent 60 doses N/A $24.99 $44.00**

Table 2: Cost savings for medications reported by U.S. and Canadian populations

Sources: Fieldnotes, RVnet.comAll amounts are in U.S. dollars*Note that some medications may not be spelled correctly as I am using the spelling that the interviewee gave or one that is phonetically matching their pronunciation of the medication.** includes $10.00 dispensing fee

Economics of AccessSaving $ is not fundamentally about getting the best deal,

it is about granting access where it may be limited or denied elsewhere

Quality of life and quantity of life

System for profit or system for people?

Conclusion