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On ‎15‎/‎07‎/‎2016 at 2:46 PM, gringal said:

The source of a ton of pesos dumped into the system is not the poor, so let's not confuse the issue.  I believe it's the government, which is the taxpayers.

 

Those gringos who sign up with SP are often people wanting to get something for nothing so that they can enjoy an even better lifestyle, and the Mexican government is tolerant enough to apply a very generously interpreted "means test"  with no verification of claims, so most get in the system. It's alsp true that there are some expats whose means ares such that SP is all they can afford.  They don't have two cars, country club memberships and 5 dogs, either.  We're not talking about them.

The IMSS system, on the other hand, charges a yearly fee to all, based on age, with no means test.   Both systems are under financial strain at present.

This issue, as I see it, is a matter of simple ethics, not of what one can legally do. A person can get a free meal at many soup kitchens in the states.  But is it "right" for someone who can afford to pay for his or her own meal to line up for a free soup kitchen meal, or not?   

Where did you get the notion the 2 main socialized medicine systems are under financial stress at the moment? When is paying taxes getting something for nothing? Why say the Mexican government is tolerent enough? As I stated earlier they are required by federal law to not be prejudice against citizens and residents alike. The systems is designed to be free for 98% of families and still is, not tolerent but called socialized medicine Worldwide.  It would be great to see you getting your facts straight instead of guessing or repeating things from the past that are no longer revelent today.

Your ethics are your's alone and casting them onto people who have not done anything wrong according to laws and rules seems odd. IMO Isn´t it politically correct for everyone equally to have the freedom granted them by law the right to chose their own medical care without someone bringing up their definition of ethics about what their decision should be as to what is best for them? I think it should.

My wife retired as a federal government top administrator for the Secretaria de Salud in our state for the Seguro Popular and said these types of late payments are not that uncommon and no big deal. The Secretaria de Salud at the top administration level funds [along with fees collected and state funds set aside for their state´s health services]  Seguro Popular, IMSS and ISSSTE  and has more money available now than ever since the Tax reforms took effect and the restructuring of the IMSS medical and pension plans. Both IMSS and Seguro Popular have had a vast expansion going on these last 10 years and have hudreds of new hospitals and clinics all over Mexico and added 20  million or more  enrollments. Seguro Popular in SLP built 15 new clinics the last 2 years in the state and in the city of SLP 2 new hospitals opened 3 1/2 years ago and this last year built an operating theater and new operating rooms expansion at their very old Hospital Central which is attached to the state university medical school and upgraded their equipment in all the departments including a state of the art MRI, the old one kept breaking down, but still are waiting for some of the all new operating room equipment and still using the old rooms for surgery right now. We tour these places when taking my wife´s aging relatives for treatment at the IMSS hospitals, Seguro Popular hospitals and belong to our ISSSTE hospital where my Comadre at our wedding was the administrator there for decades, recently retired. My wife knows all the directors and administrators everywhere here and we are always helping the elderly in her family or friends get the proper treatment. I have been in more hospitals including 3 private ones where her mom was sometimes before she passed than I can remember the last 8 years and I worked in a General Hospital in Winnipeg [5,000 employes, school of nursing, 550 beds in rooms plus wards and a large psychiatric ward]  for 3 years when I graduated as an electronics engineer. I am a tag along and very interested in all of it .

Here IMSS has one newer hospital and has starting remodeling recently and has upgraded equipment in 2 very old hospitals [looks like 50s or early 60s construction or older]. These types of investments to me indicate both IMSS and Seguro Popular are not in anyway under financial stress. This upgrading is typical of the socialized medical systems in most states. Mazatlán is about to open a large state of the art IMSS hospital and Hermosillo opened a large state of the art IMSS hospital last year. Our one ISSSTE hospital here has recently been completey remodeled and has new state of the art equipment. They were in the planning stages to build a new larger hospital but the financing was put on hold by the federal government so did the remodel instead. it was falling apart as they were told they were building a new one sometime soon - many years of holding off repairs. The Seretaria de Salud and health services of the state of San Luis Potosí moved into a large modern 5 story  office building the Secretaria de Salud built less than 2 years ago and gave up renting many buildings around the city. As is typical of all these hospitals and other buildings and clinics the local municipality or state needs to donate the land for them to the federal government before they build them. The total cost is the cost of the building and it´s contents. I think it has been that way all along with federal buildings but I am not sure. [donatig the land locally]

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1 hour ago, Yo1 said:

Alan--I read just a couple of days ago that the Federal money for SP and IMSS is being cut back by 20% because of decreased oil revenues and the devaluation of the peso on the world market.

http://eleconomista.com.mx/sociedad/2016/05/25/pena-anuncia-ampliacion-seguro-popular

Google Translation:

"Seguro Popular to benefit 8 million more people

The president said he seeks to close the gap between those who have this benefit and those who do not yet have access to health services.

Notimex
May 25, 2016 |

President Enrique Peña Nieto announced a deployment of efforts to ensure access to health services provided by the Seguro Popular, with a target of more than eight million beneficiaries of Prospera and 65 and over programs, by September this year.

During the announcement of the Seguro Popular universal for beneficiaries Prospera and seniors enrolled in the program 65 and more, the president said he seeks to close the gap between those who have this benefit and those who do not yet have access to health services .

He noted for example, that those who are beneficiaries of Prospera and have not signed the Seguro Popular to have coverage for the care of only 27 diseases, while those who have already registered are entitled to the care of 287 diseases and a drug supply for free.


Accompanied by Secretaries of Social Development, Jose Antonio Meade, and Health, Jose Narro Robles, the president announced that from 2012 to 2014, was reduced by 14 percent the indicator of the number of people without access to Health services.

In this regard, he stressed that the National Council for Evaluation of Social Development Policy (CONEVAL) revealed that in this period, 3.5 million people have access to these services, so that 25 million without health coverage, is it happened to 21 million people without these services.

In the Auditorium of the People, he said that it should be expanded and focus efforts on the two most important sectors for government, he said, who are the beneficiaries of the program Prospera and seniors enrolled 65 Program and More.


Before delivering policies in modules of Seguro Popular, the federal executive stressed that this task aims to reach 25 million beneficiaries Prospera, of which there are four and a half million who are not yet enrolled in the Seguro Popular "having this right" he stressed.

Meanwhile, there are "many seniors who are unaware they are eligible to enroll in Seguro Popular", so the goal is to adhere to this benefit to 3.5 people in this stage of his life, and who are enrolled in the program 65 Plus.

Peña Nieto called the beneficiaries of these programs to invite their relatives and acquaintances to join the Seguro Popular, "to share this information," while his government, in coordination with state governments "let's go look to sign up. " "

 

Seems to me the Seguro Popular and IMSS are stable and expanding, maybe not as fast as predicted in the projections at the 2014 Public Health  convention. but expanding never the less. It  needs to to service the about 100,000,000. members.

 

http://www.informador.com.mx/jalisco/2016/658475/6/anuncia-seguro-popular-limpia-de-170-mil-afiliados-dobleteros.htm

Seguro Popular Announces to 'clean' 170,000 affiliates doublers
 

They are enrolled in this program, but also IMSS or ISSSTE too

His place would be occupied by Prospera beneficiaries and '65 and  over

GUADALAJARA, JALISCO (29 / ABR / 2016) .- One of the goals of Seguro Popular at the federal level is to eliminate members who have duplication of services; ie who are enrolled in this program, but also have social security like the IMSS or ISSSTE.

Drafting Mesa, with the national commissioner of Seguro Popular, Gabriel J. O'Shea Cuevas, he confirmed that this year is the plan to withdraw the membership of 1.5 million people in this situation throughout the country, and another similar amount in 2017.

If we make clearance in Jalisco, the goal is to eliminate 170000 doublers this year and 100,000 in the next.

"The problem of duplication is not the patient an appendix or Civil Medical Center (West IMSS) is removed, the issue is that each institution is paying for the Mexican. I pay the cost per capita for every Mexican who has Seguro Popular, which is $3,037 pesos every year. "

He explained that President Enrique Peña Nieto asked him to establish a priority affiliating beneficiary families of social programs Prospera (3.4 million people) and 65 and over (three million). So the goal of debug affiliate duplicity is so, instead, enter the aforementioned beneficiaries.

In the retelling, nationwide there are 57 million Seguro Popular affiliates, of which three million 121 thousand 966 are citizens of Jalisco, with a policy term of three years.

In the Table Editor, Antonio Cruces Mada, secretary of Health Jalisco also talk about your goals, among which improve service and debug template unnecessary administrative staff.

Seguro Popular Jalisco allocated this year a budget of three thousand 419 million pesos to serve the three million 121 thousand beneficiaries."

 

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Alan -Tell your wife that she made an excellent career choice and excellent contribution in helping build something which will make a real difference in this country.

In most civilised countries there is compassion for the poor and elderly. While NOB seniors deserve access to the public health programs they helped build. I am always amazed meeting seniors here who are in their late 70's, surprised as heck they lived this long. They didn't budget for it, they have fallen in love with Mexico and had planned to live here permanently. They have fallen through the cracks, living in fear that a medical crisis, even a bad fall, will wipe them out. Who is advocating for them - no one. Seguro Popular can help these people and we are not talking 10's of thousand of people here. I know many people pay I.V.A. taxes here, but that is a drop compared to what is takes to build a public medical system. So people, new immigrants really, should be a little more willing to "tend the garden" as I say. This is often hidden force which built Canada and the U.S.A. into the great countries they are today, now it is Mexico's turn.

Seniors are welcome in Seguro Popular - I think that is what prompted an enthusiastic speech by a top representative of Seguro Popular at the LCS Inapam card event earlier this year. Of course she was speaking Spanish, and of course most of the attendees (2 or 3 hundred?) stared on like glazed guppies (including myself). If you find yourself in a Seguro Popular hospital, not by choice (car accident etc.) and you are financially fortunate, or don't consider yourself people of Mexico, order a private taxi to take you to San Xavier hospital, and you will see your gold drain away like an hourglass.

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Anyone ever had the fun experience of being buried in rhetoric?  The technique is to begin by changing the focus of the discussion.   Pretty well done here.

It began by questioning my allegation that MSS and SP are hurting for funds.  My dubious source was articles in the Guadalajara Reporter.  I have no relatives working for the Mexican government and no inside information. My allegation may well be 100% wrong. It happens.

Chillin's story about seniors being surprised at living this long and being unprepared and scared re medical crise may be true for people who are accustomed to living in denial. I am not. All the seniors I have known, both here and NOB, are very much aware of the downsides of aging, and are doing their best to cope with preparations. They have seen what happens to their relatives in their last years.   All of the expats I have met are very much aware of the existence of IMSS and SP.  What many of them are afraid of is being forced to use those facilities rather than private hospitals.  Many can't get any other kind of medical coverage and whether they want to use  it or not, it is a pure and simple blessing that those facilities exist for expats as well as Mexican citizens.  The U.S. would do well to build a system affordable to all.  So far, they're still fighting about it.  Some candidates promise to destroy what exists now.

None of this is related to the many words spoken above as a result of my outrageous suggestion that public health care was probably not designed to serve the well-off amongst us.  I will also speculate that the population of the SP wards does not include the upper economic crust of Tapatios, either.   I stand by my guess that the OP will never see the inside of a SP hospital as a patient.  But go ahead.................talk on.  I'm done.

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If Seguro Popular hospitals are so well funded, why do people have to wait, literally for hours sometimes, to see a doctor there? Maybe just a case of misappropriation of funds? (I'd be willing to bet the administrators of the program are making an attractive wage)

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You can't compare a Nayarit beach village and agricultural community to Guadalara region. They are waiting because they don't have vehicles. Offer to drive them to Tepic, and open your eyes. The popular opinion in Puerto Vallarta is that Nayarit offers better public hospitals. The man who moved his family to Tepic to help his autistic son is not poor - he is a Federal Prosecuting Attorney

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5 hours ago, mudgirl said:

If Seguro Popular hospitals are so well funded, why do people have to wait, literally for hours sometimes, to see a doctor there? Maybe just a case of misappropriation of funds? (I'd be willing to bet the administrators of the program are making an attractive wage)

Many rural people take the bus into town for specialists appointments or emergency care very early in the morning and wait for their lets say for a 2PM or 5PM appointment inside and outside the hospital or for emergency Triage care from sometimes 5 or  6AM and add incredible clutter to these places and this is very common at all Seguro Popular  hospitals. They usually bring 1/2 the clan with them when only 1 patient is there for service [a day in the city or town and buying stuff later on etc.]. If you see something you do not understand being not experienced in how Mexicans and Mexico operates you will more often than not get it wrong or at least think it is something else. Judging some things by a single or a few experiences is not really fair. IMO

Specialists are seen by appointment where all 3 systems give blocks of people the same time. Up to 10 people for say a 1 PM appointment. Next block at say 3 PM. etc. You have to go there  early as it is first come first serve for all 10. If you show up at 1 PM likely you will check in at the door of the consultorio when the assistant comes out and be # 9 or # 10. So you wait 2 or 3 hours to see the Dr. If you came at 11 AM you would be  #1 or #2 on the list and still wait almost 3 hours, from 11 AM until almost 2 PM. The good thing is coming at 11 AM once they take your vitals and you know your number you can estimate when you will be called and take off for an hour or so and come back.

Another thing is almost all specialists are only working 4 or 5 hours per day, Mon thru Fri. at the 3 systems and the other  5 or 6 hours at their private practise or semi retired etc.. This causes busy surgeons to sometimes be late to arrive as they not only have to see their private patients and also their socialized medicine patients after surgery but on other days also to release them etc.. These specialists can sometimes show up very late. No problem in the clinics as they are GP doctors. Clinics usually have 4 or 5 patients booked for the same hour. Show up late and you will be there quite awhile.

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3 hours ago, gringal said:

None of this is related to the many words spoken above as a result of my outrageous suggestion that public health care was probably not designed to serve the well-off amongst us.

You wrong about this, in Canada's public medicine system, they will not license private clinics, there is no "second tier" like the U.K. The injured elite athletes, corporation executives, and just very rich, fly off to the U.S.A. to places like Mayo Clinic, they want to get back to making money, or bossing people around as soon as possible.

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2 hours ago, CHILLIN said:
34 minutes ago, CHILLIN said:

 

 

 

 

35 minutes ago, CHILLIN said:

You wrong about this, in Canada's public medicine system, they will not license private clinics, there is no "second tier" like the U.K. The injured elite athletes, corporation executives, and just very rich, fly off to the U.S.A. to places like Mayo Clinic, they want to get back to making money, or bossing people around as soon as possible.

I don't think we have a disagreement. I know very little about Canada's health care system and therefore, would not be able to comment on how it works.

I think you misunderstood my point:  Wealthy people in any country, just as you are saying, do not use the public system.  They go to places such as you mentioned.   I am sure the richer people in Mexico do the same thing:  pay for more "upscale" hospitals rather than going to SP or IMSS. Judging from the many large advertisements for medivac transportation to the U.S., some expats prefer being transported back to the U.S. for their serious medical issues rather than use Mexican doctors or hospitals.  Also, they can use their Medicare benefits there, but not here. 

 

 

 

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49 minutes ago, elevator said:

If you had posted your more measured response instead of accusing me of sucking off the poor folks by using SP there would not have been so many words posted. And I have seen the inside of a SP hospital, several.

" sucking off the poor folks" ?? Who writes that kind of English?  That "measured response" was for Chillin's benefit since he and I had a misunderstanding rather than a disagreement.  In your case, the many words amounted to side stepping the basic issue. On that, we do have a disagreement which I'm sure won't be resolved here, in our lifetimes.

Since no one is doing anything illegal by using SP instead of paying out of pocket or obtaining health insurance, it's just a matter of opinion on what's right.  I am not the only person who feels negatively about the mind set of people who can afford private insurance, but who use the SP system, since by simple logic,  every peso spent taking care of them is one less peso available to the system in general, no matter what kind of rationalization is used to justify it.   I've head a few amazing ones on this thread.

To "see the inside of a SP hospital", in this case, meant as a hospitalized patient.  Having surgery and being on a large ward for a week, complete with hospital food, would provide the full experience.   I freely admit that I'm hoping to avoid it.

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To be fair to Gringal, she has no experience living in countries supplying public medicine system. For me, Mexico is the third country I have lived in with public medicine. Alan has lived in Canada, and is well connected to this issue in Mexico. It is certainly contrary to the U.S. medical system which is rated somewhere in the middle as far as delivery of services in so far as public medcine is concerned. Mexico is well on its way to a public medicine system equal to Canada or the U.K.

By the way, there is no way there are large wards like there were in wartime. People are segregated into men, women, children, the dying. Also, food is brought from the outside, or from family members, that is why you have to have someone with you. Sometimes, I get the feeling that many of the foreigners here, not the ones have been absorbed into Mexico, WANT to believe that this is what poor to middle class Mexicans have to suffer, that it makes them feel smug and superior. I sincerely hope that is not true.

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I lived in England and France  so I have plenty of experience with social medecine and I have not seen wards like those I have seen in Chiapas...Actually I have never seen private doctos ´office like I have seen down ther either.. We live next door to a doctor´s consultrio down there and God help you if you have an emergency..

In Tuxtla we had an appointment with a specialist..hours of appointments were totally ignored and a man camein after a 3 hour bus ride..he looked like if he was going to die at any moment. He was moaning and groaning  lying on the floor and was ignored by every one, no one tried to do anything about him or let him go first..it was unreal..we ended up leaving to never go back there..and that was a private place, the publicones are worst, there are hours of line, the places are overcrowded, there are not enough bed or medecine and so on...The lines are long in France and ambulances can get stpped and have a tough time when there are demonstrations, and so on but from what I have seen here I sure would not go to SP unless I could not get help anywhere else.

It maybe wonderful in Jalisco or other places , I do not know but I sure would not go to the ones I have seen in Chiapas.

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2 hours ago, CHILLIN said:

To be fair to Gringal, she has no experience living in countries supplying public medicine system. For me, Mexico is the third country I have lived in with public medicine. Alan has lived in Canada, and is well connected to this issue in Mexico. It is certainly contrary to the U.S. medical system which is rated somewhere in the middle as far as delivery of services in so far as public medcine is concerned. Mexico is well on its way to a public medicine system equal to Canada or the U.K.

By the way, there is no way there are large wards like there were in wartime. People are segregated into men, women, children, the dying. Also, food is brought from the outside, or from family members, that is why you have to have someone with you. Sometimes, I get the feeling that many of the foreigners here, not the ones have been absorbed into Mexico, WANT to believe that this is what poor to middle class Mexicans have to suffer, that it makes them feel smug and superior. I sincerely hope that is not true.

 I've lived here over a dozen years and make a point of avoiding  the "smug and superior" types who live here. That includes both foreign expats and Mexicans who feel a sense of entitlement resulting in plain bad manners and lack of consideration for others.

Getting back to the point:  In the U.S.,  I was very aware of the conditions existing in the public or "general" hospitals, which are taxpayer supported and serve those who can't pay. I worked in one of those big city hospitals in the admitting department for a time and saw the conditions first hand. BMH's experience in Chiapas was probably different than one would find in Guadalajara, but it's a case of doing the best they can with what they have to work with.

Chillin:  "Also, food is brought from the outside, or from family members, that is why you have to have someone with you. "

"Have to have"? What if one doesn't have?  We have a number of elderly people living here who don't have such a support person.

 And no, it is not like wartime wards, but it's not private or semi-private either.

Canadians say that system has room for improvement when patients often have long waits for surgery, etc.  Otherwise, it's such a good system in general that they head back north in time to keep their coverage.  Thus, the term "snowbirds".

I hope that no one is sincerely claiming that the SP hospitals are as desirable a place to be treated as the high priced private ones. Why?  It is what it is. Mexico is clearly trying to provide care for all residents and that is a good thing. 

 

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Well BMH is leaving out an important point, the little of the story that they have shared, that their AXA private insurance offered to Medivac our beloved Hound Dog to Ciudad de Mexico, but he declined it and regretted the choice.

Here is link to the Prospera program that El Presidente was referring to. This program, and its derivatives, have now spread to over 50 countries, mostly Latin America and Caribbean.

http://www.worldbank.org/en/news/feature/2014/11/19/un-modelo-de-mexico-para-el-mundo

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3 minutes ago, CHILLIN said:

Well BMH is leaving out an important point, the little of the story that they have shared, that their AXA private insurance offered to Medivac our beloved Hound Dog to Ciudad de Mexico, but he declined it and regretted the choice.

Here is link to the Prospera program that El Presidente was referring to. This program, and its derivatives, have now spread to over 50 countries, mostly Latin America and Caribbean.

http://www.worldbank.org/en/news/feature/2014/11/19/un-modelo-de-mexico-para-el-mundo

What BMH shared which is germane to this discussion is what the conditions were in Chiapas in the public hospital, so what they finally decided to do about it is beside the point.

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What I am saying is that my GP, a specialist, probably paid very well, is also a Seguro Popular ER doctor, recognising me as a middle class, gringo retiree, had no problem recommending me to any Seguros Popular hospital in Guadalajara, our their outreach center in Jocotepec.

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Chillin you are very good at finding all kinds of things on the internet, I just work with people who are part of the Prospera program... There is a huge difference between what the article is saying and reality.. I was in the clinic picking up a woman this May  and I know what the situation is , it seems that  , as usual, there is a major discrepency betwwen the feel good article and reality. They decide on many things..and many things fall through the craks... 

I heard they are many difernt levels of care in the SP system so stay out of Chiapas if you want a nice hospital.. Except for Tuxtla and Tapachula the hospitals are not a place I would recommend. 

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19 minutes ago, CHILLIN said:

What I am saying is that my GP, a specialist, probably paid very well, is also a Seguro Popular ER doctor, recognising me as a middle class, gringo retiree, had no problem recommending me to any Seguros Popular hospital in Guadalajara, our their outreach center in Jocotepec.

So is mine, in putting time in with IMSS, but he promised to try to find a small but well reputed private hospital if I needed it.  Each to his/her own.

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