The San Ysidro border crossing in southern California is a busy one \u2013 harried border guards wave through crowds of people chattering in Spanish and English as customs officials riffle through their bags.<\/p>\n\n\n\n
And while many of those crossing are simply returning home after a long day of work in the US, many others are crossing for another purpose: health care.<\/p>\n\n\n\n
On exiting the US, pedestrians making this crossing come face to face with a large pharmacy. About 50 metres from that \u2013 a full-service hospital. Along the busy roads snaking out from the border crossing are dozens upon dozens of medical and dental clinics, many with prominent signs in English.<\/p>\n\n\n\n
All are catering to a surge in medical tourism brought about by the soaring cost of health care in the US, which pushes millions of people across the Mexican border every year in search of cheaper options.<\/p>\n\n\n\n
The US spends about twice as much on health care as other industrialised nations, frequently with worse outcomes, as insurance middle men, hospital bureaucracies and other administrative costs siphon money away from patient care.<\/p>\n\n\n\n
Ahmed Abu, originally from Kenya, has lived in San Diego for about 20 years.<\/p>\n\n\n\n
\u201cI’ve been going almost, like, 15 years going back and forth to TJ [Tijuana] doing every kind of thing, even taking people there for medical reasons,\u201d Mr Abu tells The National<\/em>. \u201cI go myself also for fixing my glasses, for the dentist.<\/p>\n\n\n\n \u201cI have health insurance, but this health insurance doesn’t do a lot of things.\u201d<\/p>\n\n\n\n As a taxi driver, he has ferried many Californians as well as other people from across the US travelling to Mexico for medical purposes.<\/p>\n\n\n\n About 9 per cent of Americans have no health insurance, and even those with good coverage are often subject to high \u201cco-pays\u201d and deductibles that add thousands of dollars to costs.<\/p>\n\n\n\n Additionally, insurance companies can refuse to cover certain treatments deemed to be \u201celective\u201d, such as orthodontic care, meaning that millions of Americans must either pay out of pocket or go without care.<\/p>\n\n\n\n In 2021, Americans paid about $433 billion for out-of-pocket medical and dental services.<\/p>\n\n\n\n Mexico, meanwhile, offers private services at much cheaper rates. The roughly one million Americans that travel to Mexico every year save between 40 per cent to 65 per cent on medical and dental procedures, according to Patients Without Borders.<\/p>\n\n\n\n And gaining access to this care is relatively easy \u2013 Americans only need a valid passport to enter Mexico on a six-month visa. The Tijuana government also offers passes that allow medical tourists to enter the country via a special lane, expediting the immigration process.<\/p>\n\n\n\n Adina Smith, a long-time resident of San Diego, has travelled to Tijuana several times for dental services.<\/p>\n\n\n\n \u201cI know of about seven people that go [regularly],\u201d she says. \u201cI had heard from my friend what a great experience she had and the affordability of it.<\/p>\n\n\n\n \u201cI had a great impression about the service that I received. The office was very clean and the dentist had great equipment, I never got an infection or anything like that. My dentist and the assistants spoke great English.\u201d<\/p>\n\n\n\n Mia Nica, who is uninsured, has crossed into Mexico several times for medical care.<\/p>\n\n\n\n \u201cEven if I did [have insurance], the cost would have been more accessible [in Mexico],\u201d she tells The National.<\/em><\/p>\n\n\n\n \u201cMost of my extended family and friends in California and Arizona go to Mexico, for dental work especially.<\/p>\n\n\n\n \u201cThey [the healthcare workers] were respectful, professional, the facilities was clean, the procedures clearly explained and the prices straightforward.\u201d<\/p>\n\n\n\n The quality of service in Mexico is generally quite high \u2013 aspiring physicians in Mexican institutions face a rigorous preparation process that culminates in an exam to study a speciality.<\/p>\n\n\n\n And as medical school in Mexico costs only a fraction of what it does in the US, some American students looking to train as doctors end up crossing the border.<\/p>\n\n\n\n Eduardo Tanori, a professor at UC San Diego who helps international medical school graduates prepare for US board exams, told ABC 10News that students trained in Mexico have more than a 90 per cent pass rate.<\/p>\n\n\n\n Dr Sergio Aviles has been practising orthodontics in Tijuana for almost 50 years.<\/p>\n\n\n\n \u201cThere is a lot of movement, there is a lot of money, there is a lot of demand\u201d, especially in Tijuana, he tells The National<\/em>, explaining that not only do healthcare professionals from all over Mexico come to the city to practise, but from all over the world as well.<\/p>\n\n\n\n \u201cThe demand [for health care in Mexico] \u2026 is basically due to three factors: the price \u2013 really, the most important \u2013 the language \u2026 and the warmth [of treatment],\u201d he says, with this last referring to the bedside manner of Mexican doctors compared to American ones.<\/p>\n\n\n\n In his opinion, the only difference between quality of care in Mexico and the US is technology.<\/p>\n\n\n\n \u201cThey [in the US] have high technological quality but in human quality, Mexican medicine \u2013 or that of other countries \u2013 might be better,\u201d he says.<\/p>\n\n\n\n Dr Sol Klaja, a dentist in Mexico City who treats many American patients every month, agrees.<\/p>\n\n\n\n \u201cThe major differences are the use of sedation, the cost and the care,\u201d she adds, saying that the US has an advantage when it comes to technology \u2013 but not by much.<\/p>\n\n\n\n \u201cIt’s the cost and quality of services\u201d that brings Americans to Mexico, she says. The quality is \u201calmost the same, but here is cheaper\u201d.<\/p>\n\n\n\n Dr Francisco Contreras is director, president and chairman of Oasis of Hope Hospital, a cancer treatment centre.<\/p>\n\n\n\n He says that not only do American patients appreciate the warm bedside manner of Mexican doctors, but he also points out that, as malpractice is such a large concern, health professionals in the US are reluctant to explore alternative treatment options.<\/p>\n\n\n\n \u201cA doctor in America is so threatened by lawyers, the patient, they very easily are sued,\u201d Dr Contreras says. \u201cSo a doctor talks to the patient or through the patient to the patient’s lawyer \u2013 and what I mean by that is, especially in cancer, they’re gonna give you the worst-case scenario.\u201d<\/p>\n\n\n\n Oasis of Hope and other cancer treatment centres in Tijuana offer alternative approaches to treatment that are either unavailable or not widely used in the US due to Food and Drug Administration restrictions.<\/p>\n\n\n\n \u201cPatients that come from all over the world, especially from Europe or the States, [and] they love that they can actually sit down with a doctor and talk about possibilities of them surviving, and not just that they’re going to die,\u201d he says.<\/p>\n\n\n\n Travelling to Mexico for health care does not come without risks. Undergoing an invasive procedure and then travelling exposes patients to a higher possibility of infection.<\/p>\n\n\n\n In 2019, 11 <\/strong>Americans who had surgery in Tijuana returned home with dangerous antibiotic-resistant infections. Online forums are full of horror stories of quack surgeons flubbing surgery or suspicious generic drugs purchased in sketchy pharmacies causing severe reactions.<\/p>\n\n\n\n And most Mexican border towns, where the highest concentration of medical tourism infrastructure exists, have a high level of criminal activity and violence.<\/p>\n\n\n\n Tijuana is the most dangerous city in Mexico, with 138 homicides per 100,000 people. Mexico as a whole has a homicide rate that is seven times higher than the US, according to the UN.<\/p>\n\n\n\nCost and quality<\/strong><\/strong><\/h2>\n\n\n\n