Medical Care Delivery in Mexico Compared With the United States

Medical Care Delivery in Mexico Compared With the United States

This paper will discuss Medical Care Delivery of Mexico and compare it with the United States. This paper will discuss the process of medical care delivery in both countries. The topics that will be covered are: focus of care for the patient, the percentage of people in both countries who do not have access to health care or insurance. We will also cover how long it takes for a patient to get a diagnosis and to be treated. This paper will also cover the overall quality of care for both Mexico and the United States. This paper will address the growing demand for long term care that has become a necessity since a large portion of our populations are getting to the retirement age in both countries.

Describe the process of delivering medical care in Mexico
After researching the question of what is the focus of care in Mexico I wasn’t able to find very much information that could give me a definitive answer to what was the focus of care in Mexico. I did finally find a paper that was written by a group from Ohio University who went down to Monterey, Mexico to observe the healthcare system and the nursing practices in Mexico. In one of the accounts that the students gave one of the students stated that the Hospital Unidad Media Familiar No.26 in Monterey’s focused its care on Prevention and the prevention of disease first (Lucas & Denham, 2004). On another note one of my coworkers is from Mexico and her father is a Family practice doctor in Aqua Prieta Mexico and I asked him what the focus of care in Mexico was and he also stated that the focus of care in Mexico is prevention first and foremost (Carlos Juarez MD, 2011). The focus of care in the United States is acute treatment (Kovner & Knickman, 2010)

Do you have to wait for a diagnosis and treatment in Mexico?
In my research there wasn’t a whole lot of information that stated that a patient would have to wait for a diagnosis and the treatment needed for that diagnosis. I did however find some information that stated that in Mexico a patient is able to get quicker care from a specialist faster in Mexico than they could get in the United States (McConnaughey, 2011). I was unable to find anything that said there was any kind of waiting limits for treatment after the initial diagnosis. I did find something that did intrigue me and that was in Mexico General Practitioner doctor’s still make house calls. That is something that has become almost unheard of in the United States today.

What is the percentage of the population is uninsured in Mexico?
In Mexico even though there are three main subsystems of health that is either funded by the government or by the citizens themselves there are still 50% of the 100million inhabitants who still do not have health care coverage (Barraza-Llorens, Bertozzi, Gonzalez-Pier & Gutierrez , 2002). In comparison the in the United States as of 2009 there were approximately 47 million US citizens who did not have access to health insurance or healthcare ( Norton, 2009).

Is there Uncompensated Care in Mexico?
In Mexico there isn’t uncompensated care. If the citizens are not covered by one of the Healthcare programs then the patients must pay for the services up front before the care is administered. In the Unites States however a patient will not be turn away from an emergency room for a life threatening event regardless of their ability to pay for care. The Doctors and hospitals end up doing the care as a charitable act (“Rationed health care”, 2007).

Is Health Care Rationed in either country?
I wouldn’t say that healthcare is specifically rationed in Mexico or the United States for that matter, but the difference is that in Mexico if the patient does not have healthcare coverage or the ability to pay for their treatment then they will not receive it. To a point the same is true in the United States except in a life or death situation as I stated earlier in the paper (“Rationed health care”, 2007).

Are patients able to choose their physician?
In Mexico if you are a recipient of the Social Security Organization known as the Instituto Mexicano del Seguro Social (IMSS) then the patient is not able to receive medical treatment (“Health-care system in”, 2007). Although, there are loopholes that the people in Mexico can use to circumvent the choice of a provider. This can be done by seeing a private physician who has IMSS privileges. These physicians are then able to refer the patient to the best possible care. If a patient is part of the private medical sector in Mexico then the patient is able to choose what physicians that they see as well as the facility where they will receive their care. The private sector is the people who either pay cash for their services or the patients that are able to pay for the private healthcare coverage out of their own pockets. In the United States patients are allowed to choose the physician that they see and where they receive their treatment in fact market competition in the United States between physicians is very common(Norton, 2009).

Quality of Care
Quality of care is not measured by any one federal or state governmental body in Mexico. The national health plan has specific goals according to (King, et al., 2007)but this has mostly to do with ensuring patient access to health care. Access to care is a primary component of the quality of care; this is because without access to health care the best facility and resources in the world still would go unused. Mexico’s public health plan the Seguro Popular, was designed to provide access to care to Mexico’s citizens. (Malkin, 2011) Unfortunately the method used ensures financial coverage for health care received, not the establishment of health care facilities within their state. Some states of Mexico have extremely limited number of medical facilities and the available facilities may have limited capabilities. The public health option is Mexico has enabled many people to access health care that otherwise would not have had access.

A major focus of the Seguro Popular has been preventative health and vaccinations. These services provide the public with health screenings for cancers as well as HIV, and can be conducted with mobile medical units. The establishment of a public payer system as enabled persons who may have avoided care, or had not had access to preventative health screenings now have both access and the means to receive care. The quality and the availability of health care is the responsibility of each of Mexico’s individual states. The Seguro Popular is a federal level program which pays each state for the number of persons enrolled. (Malkin, 2011)Gaps in care can been seen where states with very limited access or availability of health care services have full enrollment. This means a state is receiving federal monies for the health care of the individuals enrolled but many services must be obtained outside of the state that is being funded.

The US federal plan known as the Patient Protection and Affordable Care Act (HealthReform.gov, 2010) has features in common with the Seguro Popular in that it is designed to allow a larger group of the population the option for health coverage. The US program would have standards for individual states and facilities to meet to qualify for payment. The goal of the US plan is to increase health access as well as the efficiency of health care throughout the nation. These goals include increasing patient participation in preventative care as well as follow up care. The US has regulations set in place already that monitor and hold health care facilities responsible for the safety of the care they are providing but the quality of care at this particular time is not monitored by any specific group.bBoth the United States and Mexico have made plans to develop and measure the quality of care within their nations. Mexico has areas of great disparity when it comes to the availability of health care, and the same can be said for areas of the United States. The development of universal coverage national health plans has begun to introduce access to care to individuals who once financially were unable, but physical availability of care is a limitation not only in Mexico but the United States as well.

Growing Demand for Long Term Care
Mexico has no federal programs specifically in place to provide long term care to the elderly; each individual state is left to establish what services they provided if they will be providing any at all. (OECD, 2011) Most elderly individuals receive care from family members; there is not an established program to ensure long term care for the elderly. Some programs exist that provide financial support to the elderly but not specifically, they are provided for under other programs which benefit those in poverty and provides assistance to them in the form of financial support. Mexico’s elderly population considered above 60 years old will grow “32.0% between 2000 and 2020” (González-González, et al., 2011) This will require an increase in both financial support as well as infrastructure to support long term care.

Mexico’s lack of federally funded or state funded programs to support the elderly with long term care, is worsened by the general lack of private options available, for instance group homes and nursing homes are not common in Mexico. Some facilities exist such as The National System for the Integral Development of the family has 4 homes for the elderly that is “covering on average 470 individuals” (OECD, 2011)Mexico does not seem to demonstrate a goal to develop the infrastructure to support a growing elderly population, but has made efforts to provided financial support, through programs such as the Seguro Popular.

In comparison the United States “Medicare doesn’t pay for long-term care, Medicare pays only for medically necessary skilled nursing facility or home health care” (Long-Term Care, 2009)Medicare the federally funded health care program for the elderly and the disabled covers medically needed services but medical services are only part of long term care. Neither Mexico nor the united states have a federally funded program designed to care for the quality of life and daily activities for the elderly. In the United States private enterprise has established a number of “nursing homes: 16,100” in total. (Service, 2004) These facilities provide medical care as well as daily care for elderly persons, but are not fully funded by Medicare. Payment for long term care comes from many place in the US, Social security a federally funded program but often does not cover the costs medical care but for daily care, private insurance purchased beforehand know as Long term care insurance, and financial support from families. Because of the financial status of many persons in Mexico being below poverty the social support for long term care faculties does not exist, as it does in the stratified social status of the United States.

Conclusion
The United States and Mexico can learn a lot for each other in the coming years as it comes to addressing the needs for long term care. Mexico has had great success implementing national health coverage and applying financial support for medical needs to its citizens. On the other hand Mexico’s health care landscape leaves much to be desired in many of the individual states. The US has the infrastructure to offer more long term care but lacks a control of costs and funding. City planners in Mexico could learn a great deal about the effectiveness of Long term care facilities in the US and develop a strategy to implement them in Mexico. The US can learn from the success and from the short fall of Mexico’s journey to establish a universal health care system. Health care is changing from a private enterprise in both countries and both are looking to the future to better ensure the Health of their citizens.

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