Why is Medical Care So Expensive in the US?
Topics: Health Care
Published: Sunday, February 23, 2014
By Monica Rix Paxson
In January, a 20-year-old posted his $55,000 hospital bill for an appendectomy at a hospital in Sacramento, California on Reddit with this comment: “I never truly understood how much healthcare in the US costs until I got appendicitis in October. I’m a 20 year-old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the US”.
What followed was a firestorm of response with 10,729 comments posted to date. Even with coverage through his father’s insurance policy, this young man was saddled with over $11,000 in debt that will take him years to repay.
I think we can all agree that emergency procedures like appendectomies are not only essential, they must be handled quickly and near home. But why is it so expensive to have what is a routine surgical procedure in the U.S? Many would argue that it is because of the quality of the care provided. The implication is essentially “you get what you pay for.” But is that true? For example, in Mexico medical care costs a fraction of what it does in the USA. Does that imply that the quality of care is lower? Exactly why is care less expensive in Mexico?
While there are many reasons why quality care is less expensive in Mexico, here are a few that illustrate the differences.
Doctors can get a free or low-cost education. Mexico offers high school graduates who can pass the required testing what is essentially a free (just a few dollars a year) world-class education at UNAM (National Autonomous University of Mexico). Many graduates leave school with no debt burden. The starting salary for a physician is only $12,000 per year, but this is a living wage.
Doctors own their own practices. Unlike the US where many doctors contract with HMO and PPOs, most doctors in Mexico are not employed by corporations that control every aspect of their work, set quotas on the number of patients seen and demand a quarterly profit. There are no middlemen between the patient and the physician in Mexico and this means that doctors can spend more time with patients and offer the care they feel is appropriate.
Doctors don’t go into medicine for the money. Many physicians in the USA are attracted to the profession because of the high salaries ($120,000 is the national average starting salary). The drive for high pay continues to be a motivation throughout the career for many US physicians. With a starting salary of only $12,000, the money seldom motivates doctors in Mexico.
Mexican physicians can have multiple sources of revenue. The public health sector hires many doctors and gives them both a modest salary and a pension for what by US standards would be part-time work. Many of these doctors also have private practices. There are also many private hospitals in Mexico that are owned by physicians.
While the examples cited above are just part of the whole picture, it should be clear that it is entirely possible to offer world-class medical care at affordable prices because well-trained physicians are paid less and there are no complex layers of corporate interests grabbing profits. And, while you have no choice where to get help when you need an appendix removed in a hurry, in many cases you do have a choice of where to go for healthcare–and more people than ever are considering medical travel as an option.
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Monica Rix Paxson is an expert in the field of Mexico healthcare. She is author of the English Speaker’s Guide to Medical Care in Mexico, an eBook available for immediate download. She resides full-time in Tepoztlan, a beautiful highland town situated about 50 miles south of Mexico City.