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MEXICO: Public health

Linda Nyquist, who has first-hand experience with the Mexican health system, says I simplified matters when I said that the Instituto Mexicano del Seguro Social (IMSS) was responsible for public health: "Just a clarification, but Seguro Social (Social Security) in Mexico isn't exactly responsible for public health. Although IMSS, Salubridad and ISSTE (government worker's system, comparable to IMSS) are now under the umbrella of the Sector Salud (SS), the work of public health is probably more unique to Salubridad, as they are the arm of the health care system that provides for all the uninsured of Mexico, which is essentially the majority of the population. Although many millions are covered by IMSS, ISSTE and others, such as the military hospitals and the Pemex hospitals, a huge number of Mexicans have no resources other than the public health hospitals and clinics (Salubridad). They are grim places, indeed. They lack equipment and resources, to say the least. In the rural areas there are little "Casas de Salud," sometimes run by Salubridad and other times by the Sector Salud, often staffed with new physicians doing their obligatory year of service. A few Mexicans are able to purchase private services.

Often, because of "Social Security," (IMSS) it is sometimes alleged that health care in Mexico is socialized. This would not fit my definition of socialized medicine at all, as it is a multi-tiered system with different benefits for different sectors of the population. Services are so lacking. Just one example, in the capital city of San Luis Potosi (at least as of 1 year ago), there was no facility for dialysis in the Sector Salud facilities. The only dialysis available was private. While the official claim is that patients needing dialysis would be sent to Mexico City, this doesn't seem reasonable. I was involved in an immigration hearing for a person on dialysis who did not want to be returned to Mexico. The American Embassy in Mexico City allegedly asked the Mexican authorities about the availability of treatment, and were insured that this person would get the needed treatment. She was deported to Mexico, received (I believe) 1-2 dialysis treatments, and then was unable to obtain more without paying. She had been assured that this would be free of charge to her under the public health system. She died.

I don't want to get into an argument over immigration rights here, but I do have an opinion. I wish in our immigration hearings that we would tell the truth, which is, apparently, that we can't have you here if you are not documented and that if you return to your country you may not survive, but that this cannot be a constraint on our ruling. It strikes me as inherently evil to deport someone on the basis that they will get needed treatment, thus making us feel very nice and sanctimonious about the decision, know full well that is is not and cannot be true, and that we are sending this person to a certain death. This case in which I was involved is not isolated. There are many similar cases. I hope that this can give us cause to reflect on what we say and do and on personal honesty and integrity.

RH: While this case is very sad, there are many poor Americans who cannot get the treatment and medications they need, and they are resentful of Mexicans who come here for treatment. I knew a Mexican who came here illegally and then brought his mother here for medical treatment. From my dealings with him, I knew he had no scruples.

Ronald Hilton - 8/8/03