Nobody Wants to Talk About This... part I

I do. Health care and medical insurance in Mexico.  There are numerous sites and blogs where everyone speaks glowingly of the excellent and inexpensive care they have received from physicians and hospitals throughout Mexico. And we know that there is a burgeoning medical tourism industry for those wanting decent treatment at a fraction of the cost they would pay in the United States. Think dental care and plastic surgery. I've heard reports of an entire mouth full of crowns for about the cost of a root canal and crown that one would pay NOB. I've heard of people ending up in the Emergency Room with a broken arm or leg, and marveling at the kind treatment received and how they simply paid the reasonable cost in cash or credit card at the time of discharge. What I haven't heard is the story of an expat who has had the misfortune of a catastrophic illness while living in Mexico with, or without, major medical health insurance. I suspect that those younger expats, in their twenties, thirties or early forties, don't worry terribly about such things. Those of us closer to full retirement age just might be a bit more concerned about the what-ifs. Having spent a lifetime in the health care industry and seeing first hand the horrors that can occur in the blink of an eye - a car crash that requires multiple surgeries and days in an intensive care unit, or a stroke that will require weeks or months of rehabilitation - I think about these things.

In the United States, those with good insurance are lucky and those with no insurance cannot be denied treatment. Hospitals routinely write off millions of dollars in unpaid medical bills by those who simply do not have the means to pay tens of thousands, much less a hundred thousand dollars for the first rate yet costly care they received. I read somewhere that in Mexico an expat must pay the entire cost of treatment before they are allowed to leave the hospital. Paying for the cost of a broken limb, or a bout of colitis and dehydration, or an emergency appendectomy would not be so bad. Perhaps a few thousand dollars or less? A 2005 study from Ohio State University Hospital cited the cost of the first day in ICU with mechanical ventilation to be $10,794.00. Without mechanical ventilation the cost was around $7000.00. That's just the first day and ICU stays can last from a few days to weeks. The study is also 8 years old and you all know the cost of health care goes up, not down, each year.  I'm not sure about the cost of an intensive care stay in a Mexican hospital, but I found one international major medical insurance policy that paid up to $1500.00 per day. This means that it will likely cost more than that as most insurance does not cover the entire cost of a hospital stay. There is usually a co-insurance charge of up to 20%. Throw in a surgery, x-rays, CAT scan or MRI and the cost goes up from there.

I think the question for many expats is whether to risk paying for medical treatment up front and hope that the out of pocket costs don't wipe out our savings or to enroll in a decent international major medical plan that will cost several hundred dollars a year, depending on your age,  or a few thousand a year if you are approaching retirement age.

The other option is to enroll in IMSS, Mexico's free (socialized?) health care. Actually, it's not free, but the annual cost for coverage is around $300.00. I'm amazed that Mexico even allows foreigners to participate at such a low cost, especially when most expats are paying very low taxes or none at all to the federal government.

More on our options in part II...

Speaking of Changes...

Word has it that the Paseo de Montejo is scheduled for a facelift. The Champs- Élysées of the Yucatán is soon to see a few miles of newly paved streets and other enhancements. This information comes from two reliable sources, a successful business owner a few doors down from the Remate and our über knowledgeable, reliable and Spanish teaching taxi driver, Juan Ortiz. We also noticed a building we had not seen before - a tall, sleek black stone and glass office-like structure that is a drastic departure from the typical architecture seen on the Paseo. I regret not snapping a photo, but to be honest, neither of us took our cameras out of the bag the entire time we were in Mérida. I think it is perfectly fine to incorporate a bit of modernity into an otherwise architecturally significant historical district. For example, in Norfolk, Virginia there is an attempt to make every new building look as if it has been here for 150 years -red brick, fluted columns, fake pediments. It ends up looking drab and boring and rather than complimenting the historical structures, dilutes the entire block into an uninspired landscape. The problem here, I think, is a long standing and rather staid architectural review board. Mérida must surely have a similar process to review architectural designs, particularly in the historical districts. Let's hope they exercise a restrained, yet creative vision for this lovely boulevard.

A Garage Sale in Mérida ...

We've been gradually eliminating some of the furniture we inherited (purchased) with Casa de las Lechuzas and replacing with pieces more in line with our tastes.  At times we have thought that we wanted to move to a more contemporary look after over 30 years of living in a house full of antiques and traditional furniture, but we always end up being drawn to the traditional.The previous owners of our home did an admirable job of decorating, using modern pieces and interspersing with a couple of antique painted and decorated Chinese cabinets. Their art works, which were mostly abstract or modern, did not remain with the house. About the only personal belongings we will bring to Mérida are some of our paintings. For that reason we have purchased very little art for the house. Other than a wonderful oil on canvas by a Cuban artist purchased at SoHo Galleries, there are a few inexpensive prints currently adorning our walls.

This trip we wanted to get some comfortable furniture for the studio/media room, but before having it delivered we needed to eliminate two rather large ultra-suede corner chaise lounges. Enter Yucatán Online Garage Sale, a Facebook site originated by TheYucatán Times. I took some quick photos, logged in to the site and easily posted the items for sale. Within less than an hour I was messaged by a potential buyer, who dropped by to see the furniture, paid cash on the spot and returned the next morning to pick up. I have, at various times, seen individual items and what appears to be the entire contents of a house for sale. It's quick and easy to find something you might like or to sell an item you no longer need.

A Busy Week

This trip to Casa de La Lechuzas has been interesting and busy. A lot has been done, but new ideas about future possibilities with the house have us dreaming again. It hasn't been all work, however. We've managed to eat dinner at two new restaurants and have enjoyed Rescoldo's twice. I repeat myself when I say that I could live off their Greek salads and thick, warm, open oven-baked pita. Add a side of tzatziki and roasted red pepper hummus and I'm in heaven. The cooling effect of cucumbers, strained yogurt, mint, dill and Greek olives makes Mediterranean food perfect for this hot climate.  The ever changing gelato flavors are not to be missed -Toasted Coconut, Cranberry Almond, Dulce de Leche, or Honey Lavender. Lavender flavored gelato, you say? Delicious. Now, if we can just find a great Thai and Indian restaurant, we will be happy.

On the work side, we have accomplished a few tasks with many more remaining after we are gone and just before we arrive in September. Painting will be completed, pasta tiles polished to a spit shine and electrical issues will, hopefully, be resolved. The electrician wants to investigate further and probably redo some of the lines. It is nothing major, but annoying things like dimmers not working. The configuration of outlets is confusing and we still have to press one toggle switch after another to turn on the lights that we want. We would like to simplify the operation. It's tough getting older.

Did I mention that it has been a bit warm in Mérida this week? We have enjoyed the pool this trip much more than other times. For once, it is being maintained properly and the heat has made the water temperature comfortable. The pool is fairly large and warms up slowly but seems to cool down quickly after the sun goes down. A swim just before midnight last night was relaxing and refreshing.

We managed to meet a few new friends and neighbors as well as seeing an old friend. Our stay finally coincided with that of these two guys, both extremely nice and comfortable to be around. One is a deep Southerner like me, the other with an unmistakable accent from a land far down under and away. Then, there was a neighbor from around the corner ( a reader of this blog) who stopped by for a nice chat and with whom we hope to have many more conversations. Finally, we met a new Facebook friend with an opinion (his words).

More to come...