Heath Care Delivery In Mexico and Arguments of Lack of Medical Access in U.S. Immigration Hearings

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Introduction:

The purpose of this article is to examine the health care delivery system in Mexico and how it impacts repatriated Mexicans who have ongoing medical issues. In the United States, the level of care for the poor or unemployed exceeds Mexico’s by several fold. Upon return to Mexico, most deportees struggle to find employment and fall under the state issued medical care Seguro Popular. This program is inadequate and could endanger those who have received life-sustaining treatment in the United States but are forced to return to Mexico. Given the health care delivery issues in Mexico, arguments can be made in immigration proceedings that a respondent or family member’s life could be in danger if they are deported and forced to rely on Seguro Popular.

Health Care Levels in Mexico

According to Mexico's constitution, all citizens are entitled to health care benefits from the government. Health care is overseen by the Ministry of Health's National Health System, a massive bureaucracy that employs about 427,000 doctors, nurses, technicians, support staff and administrators, and is funded at US$2 billion annually. Care is provided by three sub-groups – the Mexican Institute of Social Security (IMSS), the Institute of Services and Social Security for Employees of the State (ISSSTE), and the Secretariat of Health and Medicine (SSA) -- the essentially systems within the system.

The largest is the Mexican Institute of Social Security (IMSS), which is charged with providing care to about 50 million people. It is the nation's general health care insurer, providing care to individuals and their families in all professions - from factory workers to accountants. The IMSS maintains its own facilities, which tend to be located in developed, urban areas.

The second largest care provider in Mexico is the Institute of Services and Social Security for Employees of the State (ISSSTE). It provides health benefits to state and federal employees and maintains facilities similar to those of the IMSS. Combined, the IMSS and ISSSTE provide coverage for about 55% to 60% of the population.

The remaining 40% to 45% of Mexicans are without formal coverage seek care from the third division of the health system, the Secretariat of Health and Medicine (SSA) which runs Seguro Popular. The SSA attempts to provide care to individuals who are without work, or whose employers do not offer health benefits. Most migrant farm workers, street vendors, day laborers, small landowners and indigenous people seek treatment here. [1]

Repatriated Mexicans

Almost all repatriated citizens will fall under Seguro Popular until they obtain jobs through either an established employer or state entity after which they may obtain upgraded health insurance. This could take months, years or may never occur if the deportee is unable to obtain employment. For deportees and their families with health care concerns, Seguro Popular is limited and does not cover hospitalization, diagnosis, and treatment costs for many diseases. Critics have also identified other limitations in the system that adversely impact access to health care, including inefficient regional distribution of specialized health resources; limited access to health care in rural and geographically isolated areas; and the financial instability of Seguro Popular. Quality care is difficult to come by and patients often wait weeks or months for service. Those who depend on SSA services are expected to live 7 to 10 years fewer than the national average of approximately 70 years. [2]

In addition U.S. National Institute for Health has characterized Seguro Popular patients’ access to medicines to treat chronic conditions such as asthma and glaucoma as having problems because of the “low availability of medicines in health care units is particularly related to shortcomings in facility management, including through the purchasing, distribution or storage processes, as well as lack of training for personnel and insufficient investment in medicines in general Consequently, ensuring equitable and affordable access to medicines is an ongoing challenge for health systems.” [3]

Conclusion

Repatriated Mexicans with health care concerns would face severe difficulties with accessing health care in Mexico because of their medical conditions and difficulty in obtaining employment. Deportees are often hard pressed to pay for medical care and there is often difficulty in accessing care if they can find a way to pay for it.

This leaves repatriated Mexicans who have health issues with the possibility of suffering catastrophic medical outcomes. Given these facts, one can argue effectively in immigration proceedings that deportation could prove a death sentence to those who are forced to rely on SSA’s Seguro Popular

Endnotes:

[1] “OECD Reviews of Health Systems: Mexico 2016” January 7, 2016 http://www.oecd-ilibrary.org/social-...89264230491-en ; See also: Mexico: Availability and Cost of Health Care—Legal Aspects July 2014, Report for the US Department of Justice. https://www.justice.gov/sites/defaul...PT%20FINAL.pdf

[2] See for Example: Public Health Doctors Protest Conditions in Mexico. The Yucatan Times. June 24, 2016. http://www.theyucatantimes.com/2016/...ons-in-mexico/

[3] “Access to Medicines by Seguro Popular Beneficiaries: Pending Tasks towards Universal Health Coverage” PLOS- Open Access Journal, U.S. National Library of Medicine, National Institutes for Health, September 25, 2015. Access at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583285/


About The Author

Robert Kirkland is a retired U.S. Army lieutenant colonel and operational Latin American Foreign Area Officer. He has a B.S. from the United States Military Academy, West Point and a M.A. and Ph.D. in Latin American history from the University of Pittsburgh. He also has a graduate certificate in Latin American Studies from the Center for Latin American Studies at the University of Pittsburgh. He has provided expert testimony on drug cartel and gang violence in Mexico and Central America since his retirement from the Army in 2014. He can be reached at info@robertkirklandconsulting.com

Grace Kirkland is a pre-nursing student at La Sierra University in Riverside, California.