Mexico as a Test Case for Medicare Coverage Abroad?
Among the most frequently heard counter-arguments to extending Medicare coverage abroad to those who have contributed into the system are:
- concerns about how to administer claims from numerous countries. As ACA points out in its "Medicare and Overseas Americans" paper, for years overseas claims have been routinely handled under TRICARE, the health coverage for retired military and their dependents. This objection is foundless.
- cost to the Federal government. Qualified individuals living overseas are only asking for services from the system they would be entitled to if they were based in the US. Furthermore, it is well known that competitive medical care can be provided in much of the world at costs considerably below those in the USA.
- "ensuring compliance with Medicare standards by foreign medical personnel and facilities". Numerous countries have highly qualified (often US-trained) medical personnel and stateof-the-art facilities. Accreditation procedures already exist on an international level, and could easily be adapted.
To address the above concerns, strong arguments have been made for testing extension of Medicare abroad by testing the process in a single country, contiguous to the United States: Mexico. ACA wholeheartedly supports this concept.
"An estimated 200,000 American retirees live in Mexico either full or part time. These individuals have worked in the US, paying into the Medicare system for an average of 31 years. A survey on the issue found that amost two thirds either have, or would travel back to the US for a serious illness requiring hospitalization or extended care – not because of concern about the care available in Mexico, but to utilize Medicare coverage. If preventive care and doctor visits were covered in Mexico (Medicare Part B), at least some of that high-cost hospitalization would be avoided, saving money and improving health outcomes." (from proposal of a grassroots group called Americans for Medicare in Mexico (medicareinmexico.org), whose founder, Paul Crist, was also cofounder of the Washington, DC based Center for Medicare Portability (www.medicareportability.org)).
Professor David Warner of the Lyndon B. Johnson School of Public Health of the University of Texas in Austin has led extensive scholarly research into the feasibility and proposed methodology of extending Medicare coverage to Mexico for a number of years. Conferences have been held, with participation of numerous experts and US Government officials.
- 1999: Getting What You Paid For: Extending Medicare to Eligible Beneficiaries in Mexico, U.S.-Mexican Policy Report No. 10 (http://uts.cc.utexas.edu/~healthp/Medicare_files/US-Mexico_PRP_98-99.pdf);
- 2007: Medicare in Mexico: Innovating for Fairness and Cost Savings, Policy Research Project Report 156 (http://www.utexas.edu/lbj/chasp/publications/downloads/Warner_Medicare_in_Mexico.pdf);
- 2010: Extending Medicare to Mexico: Impact on Mexican-Born Beneficiaries, Policy Research Project Report 168. (http://www.utexas.edu/lbj/chasp/publications/downloads/Warner2009-10PRPbook1.pdf)
A number of other countries – e.g. Panama, Costa Rica, the Philippines – have attempted to obtain certification to provide Medicare coverage, without success to date.