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Dark side of Seguro Popular


HoneyBee
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I know many of you with Seguro Popular have had good experiences when needing their services, this based on passed posts. So let me share with you what I consider a nightmare situation.

About 4 months ago, my former neighbors mom fell and broke a bone in one of her arms. She is Mexican and lives in Guadalajara. The anesthesiologist refused to proceed with the required surgery even thou the Surgeon agreed. The refusal was based on her health condition, she is 87 years old (her children had also signed a waiver in the event she died on the operation table). After six weeks of languishing in pain, her children (9 of them) and myself, chipped in to have a private team carry out the operation using the Seguro Popular facility.

5 days ago she fell again, this time braking a femur. The hospital informed her children that she would have to wait about 6 weeks at the hospital before surgery could be done. My understanding is that she is not considered a priority, and again will be in constant pain. I seriously doubt that she will survive unless private arrangement can be made.

Please note that a share this sad situation as many at lakeside are in their "golden age".

I have private insurance and had considered not renewing because of the expense. I will keep my coverage because frankly, I do not want to be in a similar situation. I had a serious car accident in 1990 so believe me I know what pain can do to you.

As a side note, about a year ago, Dr Sam who was the head doctor at the Red Cross gave a presentation at the LCS open circle. In his chart which was part of a hand out, if you only had Seguro Popular, he wrote "be prepared to die".

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The Seguro Popular is not like private medical insurance. They have a strict formula regarding risk calaculations for elderly and 87 is at a very risky age to go under and have invasive surgery. It is very standard to hear these types of stories [ I personally know of 3 very similar if not exact stories of our friends´ mothers]  and I feel for the family but when the calculations of dying during surgery meet a level of predetermined value they will not and can not opérate on that patient. It seems that the family simply do not know this. Their policy of risk calculations is very complex and 2 surgeon specialists and 2 anesthesiologists are involved in the  evaluation of the patient. If the family wants to have an outside specialist to be involve they allow that also. They may be waiting to see if her strength improves before doing another evaluation to determine what is next which happened to all 3 mothers we know and they did not get operated on, one was 93 and one was 92 and the other was 89. They are all still alive years later now but their bones did not get aligned properly which is what they do during surgery - install titanium screws after aligning the fractures. They are not in pain. There is a way of looking at this if you see fit to do so.

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I feel their pain!  When I was here only about a year (10 years ago)  I fell and broke my hip which was already giving me problems.  I had no insurance, as I was new here, and paid out of pocket for the hip replacement at a major fine hospital with the best surgeons.  The cost, at $10pesos/USD, came to $130,000 pesos, about $13,000 USD.  Please note that that amount would be a copay with US medical insurance, although it is a fortune to Mexicans.  

So, I don't own a home, but have savings for medical emergencies even though I pay into IMSS.  Remember, the fees here are like copays up north.  

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My Mother, who lives in British Columbia and therefore eligible for free public health care, has three bad vertabrae that would normally be operated on. But they say she is too old - 83 years old. Her only option would be to go outside of Canada. I recently was in a local private hospital - two days on saline drip, $1,500 U.S. $500 U.S. per day just for a room - then all the other addons.

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29 minutes ago, CHILLIN said:

My Mother, who lives in British Columbia and therefore eligible for free public health care, has three bad vertabrae that would normally be operated on. But they say she is too old - 83 years old. Her only option would be to go outside of Canada. I recently was in a local private hospital - two days on saline drip, $1,500 U.S. $500 U.S. per day just for a room - then all the other addons.

Sent you a PM

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My husband and I have Seguro Popular as a backup plan and sincerely hope we never have to use it, for all the reasons above.  So far, all our medical needs have been paid out of pocket and we are still ahead.  Why?  Fourteen years ago we moved to Mexico for the long haul, and since Medicare will not pay for care outside the U.S., we canceled Part B.  Multiply the average cost for two people over that period of time and the result is surprising. We have been keeping this money aside as a "medical savings account" and hopefully, we'll be lucky enough to avoid the kind of illnesses that break the bank.  But, there's SP, "just in case".   (aka panic coverage.)  Since there are pre-existing conditions for each of us, private insurance has not been an option.

However, with all its drawbacks,  I give Mexico high praise for providing SP coverage for everyone who wants it, even including us expats. 

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I may have this wrong, but in the U.S.A. they would just get you addicted to opoids - a patient and codependent for life. Very difficult to obtain opoids here. Why? Because Mexican doctors consider opoids only in the final stage of triage. They feel like they have surrendered, and failed their oath.

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15 minutes ago, CHILLIN said:

I may have this wrong, but in the U.S.A. they would just get you addicted to opoids - a patient and codependent for life. Very difficult to obtain opoids here. Why? Because Mexican doctors consider opoids only in the final stage of triage. They feel like they have surrendered, and failed their oath.

Not so.  My regular doctor has prescribed such medications for pain on more than one occasion. More than one orthopedic surgeon I've seen has suggested heavy duty pain meds for life as the only alternative to serious surgery. Because I don't want the end result of addiction to anything, they've been rarely and very temporarily used. I don't know what they do in the U.S.A.

 

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Some may find this informative: http://www.soniadiaz.mx/health-care.html

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This might be a good place to mention that Seguro Popular is real stingy with painkillers. The most you will get is generic Tylenol. You are expected to provide your own. I have only guessed the reasons why, but powerful painkillers are only issued at triage level 6 - palliative care, meaning you are not expected to live much longer. Dra. Anna at the Chapala Seguro clinic is a specialist in palliative care. If you look up "compassion" and "public service" in the dictionary - her name will be there.

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I am on Tramadal, and because of some persons apparently being addicted up North, I can only get a months worth at a time up North, where with all other meds I take, I can get up to three months in advance, paid for by my insurance company.

There are thee sizes of Tramadol, 50 MG, 100 MG and 200 MG. I was told that up north only the 50 MG is instant release and that  the others are controlled relief over 12 or 24 hours I can not remember

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8 hours ago, CHILLIN said:

This might be a good place to mention that Seguro Popular is real stingy with painkillers. The most you will get is generic Tylenol. You are expected to provide your own. I have only guessed the reasons why, but powerful painkillers are only issued at triage level 6 - palliative care, meaning you are not expected to live much longer. Dra. Anna at the Chapala Seguro clinic is a specialist in palliative care. If you look up "compassion" and "public service" in the dictionary - her name will be there.

I asked one of my sister in laws, a Psychiatrist, why the socialized medcine here doesn´t give people strong pain killers. Her answer was that when finished a surgery the policy is to let the patient feel the pain not numb the pain. It was because if you are moving around and acting like nothing is wrong you might pull the stiches or worse if something happens under the stress and then the time taken to restich you or readmit you back into the hospital would interfer with the scheduling and cost time and money and possibly leave you with scar tissue or worse - depends on the procedure. If you lay in bed and hurt you will stay there and heal.  :blink:

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5 minutes ago, AlanMexicali said:

I asked one of my sister in laws. a Psychiatrist, why the socialized mediine doesn´t like to give people strong pain killers. Her answer was that when finished a surgery the policy is to let the patient feel the pain not numb the pain. It was because if you are moving around and acting like nothing is wtrong you might pull the stiches or worst if somethong happens under the stress and then the time taken to restich you or readmit would interfer with the scheduling and cost time and money and possibly leave you with scar tissue or worst - depeds on the procedure. If you lay in bed and hurt you will stay there and heal.

If I had a painful surgery and your sister was the nurse, she would feel the pain also. My grip will the indicator of my pain.

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7 minutes ago, AngusMactavish said:

If I had a painful surgery and your sister was the nurse, she would feel the pain also. My grip will the indicator of my pain.

You would be on a morphine drip for awhile so you wouldn´t feel a thing right after they operate.

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25 minutes ago, AlanMexicali said:

I asked one of my sister in laws, a Psychiatrist, why the socialized medcine here doesn´t give people strong pain killers. Her answer was that when finished a surgery the policy is to let the patient feel the pain not numb the pain. It was because if you are moving around and acting like nothing is wrong you might pull the stiches or worse if something happens under the stress and then the time taken to restich you or readmit you back into the hospital would interfer with the scheduling and cost time and money and possibly leave you with scar tissue or worse - depeds on the procedure. If you lay in bed and hurt you will stay there and heal.  :blink:

The logic is impeccable; however, it's a bit too merciless for my taste.  I'll be hoarding my pain pills!!

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2 hours ago, CHILLIN said:

This might be a good place to mention that Seguro Popular is real stingy with painkillers. The most you will get is generic Tylenol. You are expected to provide your own. I have only guessed the reasons why, but powerful painkillers are only issued at triage level 6 - palliative care, meaning you are not expected to live much longer. Dra. Anna at the Chapala Seguro clinic is a specialist in palliative care. If you look up "compassion" and "public service" in the dictionary - her name will be there.

I got Tylenol after an emergency appendectomy in a private clinic in Mexico. LOL. Fortunately it was sufficient for me, maybe not others. Traditional procedure, not laparoscopic. 

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I think modeeper is trying to communicate that Mexico has a history of stoicism. This is a complicated philosophy if you want it to be, but internalizing pain is a trait. Many Native Americans also share this stoicism. This is a clip from one of my favourite movies "Smoke Signals" when two entirely different personalities go off the rez. "How to be a real Indian" very funny.

https://www.youtube.com/watch?v=uwcJaUaVfR0

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That's an interesting theory, Alan, but I don't buy it for a second. The entire country, having moved into something resembling the 21st century, is refusing pain meds in order to protect stitches and bones? Nah.

Pete, Tramadol is of course easily available here. My psicatica was SO bad, I needed them. Unfortunately, whatever effect they had was minimal, because of the type of nerve pain. I did notice, however, that a couple of hours after gobbling say two 50mg tabs I felt pretty serene. Not high, but more that of "life is really good, isn't it?" And it takes a lot to affect me.

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4 hours ago, AlanMexicali said:

I asked one of my sister in laws, a Psychiatrist, why the socialized medcine here doesn´t give people strong pain killers. Her answer was that when finished a surgery the policy is to let the patient feel the pain not numb the pain. It was because if you are moving around and acting like nothing is wrong you might pull the stiches or worse if something happens under the stress and then the time taken to restich you or readmit you back into the hospital would interfer with the scheduling and cost time and money and possibly leave you with scar tissue or worse - depeds on the procedure. If you lay in bed and hurt you will stay there and heal.  :blink:

I was sent home from surgery with 1 weeks supply of very heavy duty pain killer. Dilaudid. I took one pill and not another. Your sister in law is correct for so many people. I lived with the pain. In a way I called my pain Joe my friend, and I healed quite well. When on pain killer after other surgeries I did too much, thinking I was fine and I wasn't , just numb. I paid the price. And when one is on pain killer for a week or so and doctor says no more you go cold turkey. Thats why so many people try and buy it illegally. I read an article that spoke of 75% of the medication taken in the world is by Americans.  If that is correct, something is definitely wrong.

 

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6 hours ago, johanson said:

I am on Tramadal, and because of some persons apparently being addicted up North, I can only get a months worth at a time up North, where with all other meds I take, I can get up to three months in advance, paid for by my insurance company.

There are thee sizes of Tramadol, 50 MG, 100 MG and 200 MG. I was told that up north only the 50 MG is instant release and that  the others are controlled relief over 12 or 24 hours I can not remember

Pete where do you get the 200mg?

 

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Sadly, I have no idea. I have a friend whose younger wife runs a pharmacy and when at breakfast, lakeside,  last fall, she went to some site on her Cell Phone and told me the strengths that were available in Mexico. This was from some Mexican "app" on her cell phone.

I have only used the 50s I obtained from my NOB Doc. And usually only two each evening before going to bed.. After a pleasant email from a friend, (He is a retired Doc and read my post), I am going to try to back down to one starting tonight, and see if I can. I had tried in the past twice and each time failed. But that was a while back.

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