News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Tucson reporter travels to Sonora to get a simple clinical laboratory test and avoid hassles imposed by the U.S. healthcare system

Continuing growth in the number of Americans opting to become medical tourists shows that this trend is here to stay. The reasons behind this sustained growth sector have much to teach those clinical laboratory managers and pathologists in the United States who would like to make their medical laboratory organizations more competitive and customer-friendly.

For most products and services American consumers enjoy the lower costs and benefits provided by the generally free market in this country. But when it comes to healthcare services, many Americans are finding freer markets abroad.

More Americans Heading To Mexico for Healthcare

More and more, Americans—particularly those with high deductible health policies or no health insurance—are crossing the border or traveling great distances to obtain quality, low-cost medical services they otherwise could not afford, according to a series of reports published recently by Inside Tucson Business.

The series provided personal accounts by Americans who sought had healthcare services in Mexico. The news stories compared prices for specific services. Also included were interviews with Mexican physicians providing services to Americans, some of whom had obtained at least part of their medical education at U.S. or Canadian academic medical centers.

Why Healthcare Services are Not Part of the U.S. Free Market System

Inside Tucson Business reporter Keith Rosenblum, for example, crossed the border to obtain a clinical laboratory test after a Tucson lab had refused to do the test without a doctor’s order. He had simply wanted to check his creatinine level before applying for a life insurance policy that required a physical exam. Since creatinine is an indicator of renal health, a high reading would make it difficult to purchase life insurance.

Pictured is Inside Tucson Business reporter Keith Rosenblum, who travelled to Mexico for a clinical laboratory test to check his creatinine level before applying for a life insurance policy. He decided to go to Mexico after being turned down by a national laboratory in the United States because he didn’t have orders from a doctor. (Photo copyright Inside Tucson Business)

Pictured is Inside Tucson Business reporter Keith Rosenblum, who traveled to Mexico for a clinical laboratory test to check his creatinine level before applying for a life insurance policy. He decided to go to Mexico after being turned down by a national laboratory in the United States because he didn’t have orders from a doctor. (Photo copyright Inside Tucson Business)

The U.S. lab’s refusal was in compliance with the U.S. Clinical Laboratories Improvement Act (CLIA) of 1988, which requires medical laboratories performing tests to report results to an “authorized provider.” An authorized provider is generally defined as a physician.

Rosenblum noted, however, “It [the lab’s refusal] put into stark contrast the differences between the Mexican and U.S. healthcare system. It demonstrated, basically, that the free-market in the U.S. seems to be just a little shackled.”

Why a Tucson Reporter Traveled to Mexico for a Clinical Lab Test

Consequently, Rosenblum decided to travel 240 miles south to Hermosillo, Sonora, Mexico to get tested. In Mexico “healthcare providers are happy to show Americans how the client-provider system works elsewhere,” he observed.

Rosenblum visited Chécate Clínica de Diagnósica y Prevención, a clinical laboratory in downtown Hermosillo that had advertised various lab test panels for, 200, 400 and 600 pesos ($16, $32 and $48 US).

He noted that it’s common for Americans to seek medical care in Mexico. However, what is perhaps is less publicized is the fact that many people go there for medical tests to self-diagnose. They want to order their own blood tests, MRIs, and even three-dimensional ultrasounds.

In Mexico, Consumers Only Buy the Laboratory Tests They Need

When Chécate employee Sheila Citlaly Araujo Gutiérrez asked Rosenblum what test he wanted, he asked for a full blood-chemistry panel—the most expensive test available—assuming that’s what his own doctor would have ordered. Rosenblum then explained that he needed a creatinine test in order to qualify for life insurance.

Looking puzzled, the Chécate employee asked, “Then, why would you have all that other stuff done?

Dumbfounded, Rosenblum replied, “Repeat that for me?”

“Then, why would you have all that other stuff done?” she said again.

“Then, just have the creatinine tested,” she suggested, explaining that the cost would be 35 pesos, or $2.80.

U.S. Lab Executive Questions Quality of Mexico Lab’s Test Results

On returning home, Rosenblum discussed his experience with the medical laboratory in Mexico. He contacted the clinical laboratory in Tucson where he had originally tried to get his lab tests and spoke with Joyce B. Santis, Chief Operating Officer of Sonora Quest Laboratories.

When Rosenblum told her it cost just $2.80 in Mexico for the test he needed, she immediately questioned the quality of the results. In the story published by Tucson Business, Santis was quoted as responding; “How do you know that the instrument that produced your test result was properly maintained and calibrated? That quality-control materials were run with your sample? Did the Mexican lab repeat your sample to see if it had the same result again, or only run it once? Was a reading ‘slightly’ or ‘significantly’ higher than the normal value?

“Were you asked about exercise regimens or medications that you currently take? she added. “Had a physician ordered this test and received an elevated result, he or she would have your medical history, including medications, to help determine if further tests or procedures were indicated.

“You got your information for only $2.80. Do you really know what you have and what to do with it now?” Santis continued. “[T]he most important thing is how test results are used. The majority of us, even in healthcare, do not readily understand the implications of lab results, and we do not have the ability to prescribe our own medications or treatments to deal with abnormal results,” she commented.

Mexico’s Free Market Healthcare System Provides Both Quality and Value

As for Rosenblum, he was ok with the Mexican lab’s results. He paid Araujo Gutiérrez $2.80 from his change purse. She promised to send him the results of his creatinine test via email by 3 p.m. the same day. At 2:38 p.m. he received a PDF file of his results, which also contained a seal of Mexico’s Secretary of Public Health and a note stating that all results came from Roche (SWX EUROPE:ROG) clinical laboratory equipment.

“The Mexican system is essentially a free market,” Rosenblum concluded. “The U.S. system is painstakingly thorough, absolutely logical, and yet, entirely paternalistic. As so much in the United States, there is law that will protect me, even if I seek no protection or would like to opt out of it.

“For me, it was mission accomplished,” he said. “The tally? I had my information. A Mexican company earned 35 pesos from a foreigner.”

—By Patricia Kirk

Related Information:

Tucson lab says it can’t do a test — let’s try it in Mexico

In her own words: How one American came to do her hip surgery in Hermosillo

Send us your poor, uninsured and those yearning for top-notch care, Mexico says

How medicine has shrunk the world

Plenty of expert doctors, lower prices — and no need to bargain

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