I have been reading Shannon from Rat Race Refugee and her experiences with Seguro Popular. Seguro Popular is the Mexican Health insurance for people who don’t have other insurance. Any legal resident of Mexico is eligible to apply. For more information about the program you can go to their website.
It’s interesting to me that our experiences with Seguro Popular are so different. I wonder if it’s a combination of where we live, our last names, and our appearances. Dark haired, black eyed, I have standard Mediterranean looks, she’s blonde and fair skinned. I have a very common Spanish surname Díaz, I have no idea what her last name is but I’m willing to bet it isn’t a Spanish one. She lives in San Miguel de Allende, a beautiful city, but has to go to Querétaro for treatment, while Mérida is the medical hub for the Yucatán peninsula. It’s hubris but I’m pretty sure my Spanish is better, if nothing else I have been speaking it much longer.
Some of the things are the same, the long waits. One of my friends said that when you have a Seguro Popular appointment, you pretty much have to assume it will take all day.
Here is my story:
Being unbalance physically was causing me problems; my right shoulder is now significantly higher than my left, my rib cage is expanding, and I have some pain. So I decided that I would have my left breast reconstructed and my right one reduced. Dr. Bastarrachea and Dr Ceballos both thought that I might as well have a prophylactic mastectomy instead of a breast reduction.
I went to see the plastic surgeon, he felt my best option was getting implants instead of a tram flap operation. (If you are at all queasy don’t look these things up.) He explained it would require two or three operations. When I got the estimate, 260,000 pesos (around $22,000 usd at the time), I became very depressed. He had mentioned removing my porta-cath as part of the initial operation but it wasn’t included in the estimate. Installing it had cost, $22,000 pesos so I had no reason to expect that extracting it would be less. It’s not an office procedure, but a full blown operation under anesthetic by a general surgeon. I got terribly depressed.
We don’t have medical insurance, we have been self insured since moving to Mexico and doing well. Husband has pre-existing conditions, so insurance isn’t really an option for him, or at least affordable insurance isn’t. I’ve always been incredibly healthy. Everyone in my family lives to a ripe old age, even my grandfather who died of emphysema was 92 years old! I’ve never been hospitalized outside of giving birth. My cancer changed all that. Fortunately we had savings, but the idea of completely depleting what was left of our savings just for the sake of bi-lateral symmetry just didn’t work for me. Husband was willing but I just couldn’t see doing it. Thinking about the approximately $45,000 usd my cancer has cost us so far makes me uncomfortable. I realize that if we’d been NOB, the Herceptin alone would have been $70,000 usd, but that doesn’t make the other sum any smaller. Husband is philosophical about the money, but it troubles me.
A couple of my friends suggested that I investigate Seguro Popular. There is new satellite office on the corner of Calle 66 y 53. It is almost always empty, so I decided to apply. It probably took me five minutes to apply and receive my policy! I was flabbergasted, Mexico is the land of the tramite (paperwork) but this was as simple as apply for my bus pass had been!
After receiving my Seguro Popular policy, I had to go the Centro de Salud located downtown near the Mercado Galvez. First stop, was at a dutch door labeled archivos, I surrended a copy of my certificate, my original certificate, and my inmigrante permanante visa (used as identification since I don’t have a Mexican voter registration card). The gentleman asked if I wanted morning or afternoon appointments, stressing that this is a permanent designation and not subject to change for any reason. I chose mornings. He then issued me a general practitioner, Dr. Solis.
From archives I went upstairs, past a long line of people waiting for blood tests, to a central area with four small metal desks and two physician’s balance beams all overseen by four nurses in starched white uniforms and caps.
Feeling lost, I asked one of the patients already waiting what to do. She motioned towards a motherly looking nurse, Nurse Carla. After looking at my policy, she made me an appointment for the following day at 7 am. She suggested that I show up at 6 am to get my place in line. I found this confusing, I thought that I had a fixed appointment, but at 6 am the next day, I showed up. Thirty-five people were already lined up ahead of me. I comforted myself with the thought that they probably weren’t all there for the same doctor and some of them were just there for moral support for the patients. It’s a fact of life in Mexico that no one goes anywhere alone, especially to the doctor. I have seen entire waiting rooms empty out when one person finished their appointment. Secretly, I hoped that most of the crowd were hangers on.
Once upstairs, we sorted ourselves out by doctor, and arrival time. I was number 5. Nurse Carla and her cohorts arrived around 8am. The nurses wrote our names down on a waiting list. Carla looked over Dr. Solis’ patients sternly admonishing us, “You know where you are in line, please respect each other.”
After sorting our files, she called us up to her desk in appointment order. We were weighed, our height and stomach circumference measured, and our blood pressure taken. She asked the standard questions regarding fever, vomiting, and other noxious body functions.
At 9 am, I got to see the doctor. He commented that the computer system was running slowly, so everything was proceeding at a much slower rate than normal. I explained why I was there. Having finished Herceptin treatment and chemo, I no longer need my porta-cath, but since it’s in my chest, it’s not an outpatient procedure. As a cancer patient, I also should be under the care of an oncologist, with ongoing monitoring of my health. He motioned to the bulky CRT screen on his desk, it didn’t want to load the codes he needed, eventually he succeeded and then we waited while the ancient dot matrix printer noisily clanked out my referrals. He assured me that I would be taken care of, but in return I would need to have patience.
Once out of Dr. Solis’ office, I gave my scripts to Karla, after making a notation in my file, she instructed me to go to the social worker’s office, located downstairs where they would approve my referrals. To be honest, I don’t remember exactly what we talked about, but eventually, I got a piece of stamped set of papers and was told to go to the Hospital General O’Horan and see someone there.
Arriving at the O’Horan (pronounced Oh ran and named for Agustín O’Horan), I eventually ended up in an office with two doctors. Or maybe they were administrators, now looking back, I think I went to the wrong place, but they stamped my papers and sent me to the appointment line to make an appointment with a general surgeon. Sometimes I think that I get stuff signed or stamped because I give off this befuddled grandma vibe and people find it just easier to send me on my way.
The next appointment with the general surgeon was three weeks later in June. This is where my experience starts to differ from Shannon’s. In part two, I’ll cover my doctor’s appointments and lab tests.