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Americans Head To Mexico For Cheap Dental Care

Insurance Industry Remains Somewhat Divided On Cross-Border Coverage

Audio

Aired 2/9/11

As more Americans head to Mexico for cheap dental care, some are questioning whether U.S. insurers should cover work in a foreign country, which undercuts the practice of some American dentists.

LOS ALGODONES, MEXICO — The first time Mike Negle walked across the U.S.-Mexico border to Los Algodones, near Yuma, Arizona, he was instantly surrounded by salesmen who screamed they had the best deal, the best offer or the best price. They reminded Negle of hawkers in open markets in the U.S. who sold tomatoes or knock-off designer sunglasses. But these men weren’t selling tomatoes or sunglasses.

Special Feature Flickr Slideshow: Dentistry In Los Algodones, Mexico

In Los Algodones, Mexico, workers lure passers-by into dental offices promising affordable care, including cleanings and root canals.

Los Algodones, Mexico is located approximately 10 miles from Yuma, Arizona.
Enlarge this image

Above: Los Algodones, Mexico is located approximately 10 miles from Yuma, Arizona.

They were selling root canals.

“There’s a guy standing right at the gate by the border,” Negle explained. “He says, ‘I got good dentistry, come with me,’ and he’ll actually walk you over to the dentist and then they’ll give you an estimate."

"And then when you walk out of that door, someone else will grab you up and take you to another dentist down the road, and then maybe they’ll knock 20 bucks off, maybe beat the price by some,” he said.

Tomato markets aside, Negle wasn’t used to doing business like this. Like most Americans, he’d always chosen his doctors and dentists not because of cost, but because of coverage — as in, did his insurance plan cover a provider or not?

Negle drives tractor-trailers. He has since 1984. Over the years, he admits to eating a lot of roadside food and not making a lot of trips to the dentist. So by the time he went to see his dentist in Fargo, North Dakota, he was told it would take $20,000 to quell his many toothaches. Instead, Negle looked for other options.

“Know where to find a good dentist in Mexico?” he asked someone he met on the road.

“Yes. Go to Los Algodones,” she said.

Which he did. Negle made eight trips in six months for a total of four root canals, four crowns, five fillings, a teeth cleaning, a deep cleaning, and laser whitening. He’s not done. Soon, he’ll also get two new implants and a permanent bridge.

This was going to cost $20,000 in the United States. In Mexico, it cost him $3,800. (Story continues below)

Interactive Feature

Comparing The Cost Of Dental Care In The U.S. And Mexico

The reasons for this incredible discrepancy in price are many: It is cheaper to live in Mexico. Mexican dentists don’t have to buy malpractice insurance and they generally don’t have to track down reimbursements from insurance companies. Also, they don’t have as much student debt and don’t have as many regulations.

Essentially, the market sets the bottom line. Which means that along the border, it is a constant race to the bottom to lower and lower prices. One economist, Michael Ellis from New Mexico State University, calls this an example of a "medical maquila," not unlike the factories along the border that produce goods for the U.S. market.

“The medical maquila model has been talked about for the last decade,” Ellis said. “It’s just beginning to take hold, but I think the pressure will build as the boomers retire.”

From Cantinas To Cavities

In Los Algodones, the pressure has spawned a cycle like that in any competitive marketplace: New dentists arrive and do whatever they can to try to attract customers from other dentists. Then the more established dentists try to stop them. Perhaps there is no better example of this than Dr. Bernardo Magaña, a dentist who moved to Los Algodones in 1969.

At the time, Los Algodones was a dusty border town. Magaña remembers that there were no less than 48 cantinas. Still, he sensed that if he put his practice here, people would come, Americans would come. He started advertising on television in the U.S. He became mayor and shut down the cantinas and the brothels. He worked and worked and so they came — not only more American patients, but also more Mexican dentists. The dentists moved into the empty spaces the cantinas and brothels left behind.

And the Americans came; mostly retirees. Some of them were snowbirds wintering in the southwest, while others were U.S. residents who lived near the border. Another group drove down to the area, from as far as the Midwest, in search of cheaper medications, tequila and an economical way to fix their teeth if they lacked dental insurance.

All kinds of people started making money from this. Besides the Mexican dentists, there was also the American newspapers that suddenly had more advertisers, and the local Quechan Indians, who built a huge parking lot — akin to what you might find outside of a large stadium — so Americans can park right next to the border and walk into Mexico.

Everyone seemed to be making money — except, of course, American dentists. Dentist Howard Sorensen practices in Yuma, Arizona and resents the advertising strategy of his Mexican competitors.

“I almost see it as predatory,” he said. “You went across the border, you see how they almost grab you and pass out cards. And they come across to Arizona and they advertise in our phone books, on our T.V. and our radio.”

The problem with this, Sorensen said, is that Mexican dentists aren’t licensed to practice in the United States. And if they aren’t licensed here, they shouldn’t be able to advertise here.

“If you create an unethical system, people are going to be unethical,” Sorensen said. “It is just the nature of human nature. Really they are all trying to make a dollar and they are going to make dollar, that is the bottom line.”

To this, Magaña acknowledged: “We don’t mix. We don’t have anything to do with one another. There is a total wall between the dentists in Yuma and the dentists in Los Alogodenes.”

The tension has been there for decades. At various points, Mexican dentists have even threatened legal action when they considered the remarks made by American dentists against them to be libelous, Magaña said.

Fortunately, for Magaña, this did not deter patients from coming to Los Algodones. It also didn’t deter more dentists from doing the same. And these new dentists, hundreds of them, were there to compete for the same American tourists Magaña had worked so hard to attract. For years, Magaña had been undercutting American dentists. Now, new and cheaper Mexican dentists are undercutting him.

These new dentists hired hawkers, dressed them up in scrubs and sent them right to the border, near Magaña’s office. The hawkers call themselves promoters.

Jorge Cruz, who belongs to an elite professional dental association with Magaña, has another name for them — jaladores, which means pullers.

“It is just that they are not that honest,” Cruz said. “You can try it yourself. You can take one of my cards, and they are going to say they don’t know where I am, I don’t know him, he is dead, he killed a patient. But I’ve got a better doctor.”

This is a downside of a competitive system without much regulation. You get hawkers driving down prices and making up their own rules. One hawker tells tourists she has a dentist who studied at Harvard–which he did, but only for one week in the continuing education department.

Dentists like Cruz and Magaña are in fact so irked by this that they are trying to lobby the local government to regulate the promoters and prohibit them from hawking on the street. One promoter, Jesus Daniel, said they just can’t stand the competition.

“See the big guys — like Magaña — all these guys got the money, so they want to shut us down,” Daniel said.

The dentist he works for is far from the border — in Los Algodones terms, this might mean only four blocks — with little foot traffic.

“See [Magaña] wants to say, forget all these little guys,” Daniel said. “They want everything for themselves and that’s not right because everyone has got to eat.”

So far, competition for American patients in Los Algodones and Yuma has played out as small town dramas. But economist Michael Ellis said in the years to come, American medical workers should be prepared to compete even more with their Mexican counterparts along the border.

“The world has gotten small enough that there will be more and more global competition for healthcare,” Ellis said. “It is proximate competition right across this little demarcation that we call the U.S.- Mexico border.”

Already some American insurance providers have decided to expand their coverage into Mexico, offering in-network dentists and doctors whose rates for services are as much as 70 percent cheaper than those in the United States. For its part, some tourism officials in Mexico are working on an online and print directory, like one that lists certified doctors and dentists in Baja California, so that Americans can find Mexican providers easier.

Even Negle, the truck driver with the new root canals and fillings, wants a piece.

He recently persuaded the owner of his trucking company in Minnesota to send all 140 of their drivers down to Mexico. It might even be his next full-time business venture, exact business name still to be decided — maybe Happy Smiles Vacations.

“Or something like that,” he said recently in the courtyard of his dentists’ hotel.

Of course, he plans on taking a commission for every new American patient he brings to his favorite Los Algodones dentist. He’s asking for 20 percent.

American Insurance Policies Are Also Heading South

A few weeks ago, Kevin Earle was working quietly in his office at the Arizona Dental Association in Phoenix when a new message arrived in his email inbox. He found it both startling and upsetting. The message was from a dentist, also upset, all over an attached health insurance plan that covers school teachers and other public employees in Yuma.

As with many American insurance plans, the policy excludes coverage for dental services provided outside of the United States. But there was something else, which Earle has memorized by now.

“To my knowledge,” Earle said, “the statement in the benefit plan says that it excludes coverage for services provided outside the United States and in parentheses it says, ‘except in Mexico.’ Closed parentheses. That’s the way it reads.”

There are actually commas, not parentheses, in the benefits plan. But his point remains the same: public employees in Yuma are insured at the same rate whether they see a dentist in the U.S. or in Mexico.

To this, Earle said: “That concerns us. First of all we’re talking about public monies that are being expended to the benefit of public employees, for services that may be provided by a provider that doesn’t meet the same standards as that in the United States. And I question why that exception is in their provider directory.”

For years, dentists in Arizona have begrudgingly watched their patients leave, then go across the border for care that costs much less. Before they were ever unhappy about American taxpayer dollars doing the same thing, they were unhappy about this. So unhappy, in fact, that in 2008 they asked the biggest dental insurance provider in the state, Delta Dental of Arizona, to put together a brochure designed to inform the Americans in exodus. Why, the brochure asked, would you seek dental care in a country where you are afraid to drink the water?

The brochure -- “Trouble in Paradise: The untold story of Dental Tourism” -- was, predictably, poorly received in Mexico. In response, many Mexican dentists wrote letters to the insurance company’s chairman of the board, Dr. Wesley A. Harper, requesting that he “present a correcting statement and… immediately cease and desist the distribution of this pamphlet full of false allegations.” The letter closed with a threat of legal action. The brochure was removed from the website of Delta Dental of Arizona in early 2009.

“It was a bunch of lies they were just telling over there I know they are just losing their customers,” said Jorge Cruz, a dentist in Los Algodones. “But why don’t they compete with lowering their prices or by giving a better service? That is a better way to go.”

Furthermore, Cruz was struck by what seemed to him an incredible irony: At the same time Delta Dental of Arizona was circulating its brochure warning their American subscribers of Mexican dentists, they were reimbursing Cruz’s patients, at an out of network rate, for the care he provided in Mexico.

“Yes, isn’t it ironic?” asked Cruz. “Because Delta is paying me to see their patients, so it doesn’t make no sense because in the end they’re using us to provide them a service to their patients and they know they’re paying us less than they would pay to an American dentist.”

The American insurance industry remains somewhat divided on the issue of cross-border coverage.

Delta Dental of California, for example, includes dentists in at least six practices in Tijuana as part of their provider network. Their reaction to Arizona’s Delta brochure was to “disown it.” In addition, California Delta’s CEO, Gary Radine, sent a letter to the president of the Mexican Dental Association denouncing the actions of Arizona’s Delta Dental.

Part of the reason why these two insurance companies — and they are two, separate insurance companies — are on opposite sides of the debate has largely to do with who runs each company.

Dentists are eight of the 13 members of the Arizona Delta Dental board of directors. California’s Delta Dental is run by other stakeholders. They include the people who purchase insurance plans for large companies or consortium, like the one in Yuma for school teachers and other public employees.

One of the purchasers of the Yuma plan, Debra Hedrick, said that their plan lets employees choose for themselves. They can see a dentist in Mexico, often for less. Or, if they want, see a dentist in the U.S. that often costs more.

“A dentist is a dentist is a dentist,” she said.

Earle, from the Arizona Dental Association, does not think so. He has already contacted three state legislators who represent Yuma to ask them to introduce a bill that would prohibit any American public employee from using their benefits for care in Mexico.

Comments

Avatar for user 'JonBoy'

JonBoy | February 9, 2011 at 9:55 a.m. ― 3 years, 9 months ago

I personally been to Tijuana about 6 times for dental work and it went great. At first I went to a nicer more modern looking dentist there and then I went to one of the less pretty looking places and the prices are even better. For example $20 for consultation, xray and to have a old filling removed and refilled with with porceline. A crown at the nicer place was $300 but the other new place I just found is $150 :)

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Avatar for user 'Missionaccomplished'

Missionaccomplished | February 9, 2011 at 10:37 a.m. ― 3 years, 9 months ago

I've been going there for long time and in the last couple of years switched dentists, but only because I considered the first one too "old school." Both are trustworthy and do fine jobs. The female dentist does a better job as far as a cleaning is concerned. The Governor's brother is a periodonist and also did a good job but he is now in poltics and he often did not meet his appointments on time so that was a bit frustrating. I used to have a good plan out of Pennsylvania over 10 years ago. Now I have Safeguard which I haven't used in a while because it is a lousy plan. I get the impression that in the US dental treatment is often turned into a racket. You sometimes end up doing things that you really didn't need.

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Avatar for user 'djewel73'

djewel73 | May 30, 2011 at 9:51 p.m. ― 3 years, 6 months ago

My cousin has had a lot of dental work done in Mexico to include veneers whihc would have cost him a small fortune if done in the US. Ive personally had over 14k in Dental work done in the states (probaably being conservative) but Ive also had a dentist who takes payments and he knows Ill pay him.. Dental insurance is a bloody joke in the US.. It covers little to nothing and costs too much vs payouts and caps (Delta Dental on avg when Ive had it would cover usually 1000 a year in dental work at 50% for major issues so a couple crowns would max it out quick) I had to have 6 crowns done in one section due to issues from an old underbite/overbite issue (top and bottom on Left side) utlimately he did 8 but only charged me for 6 because the 2 were ones that he'd previously done nad it wa seasier just re do them.. That being said Im moving to AZ likely the end of this year and my old DDS will no longer be an option and I can guarantee Ill be going to Mexico to get my Dental work done. Its just as high quality wihtout the asinine prices charged in America.. And contrary to peoples believes oral health can affect our overal wellness as well and I feel should be covered like other expenses in medical care. Poor oral health can be traced to warning signs of other diseases and can even contribute to cardiac and other health issues people dont even realize it. Dental health has been never considered a priority yet it should be. I speak this as a licensed nurse with some knowledge of the subject..

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Avatar for user 'InformativeNews'

InformativeNews | December 16, 2011 at 1:33 p.m. ― 2 years, 11 months ago

Complaints pour in... Cancun Cosmetic Dentistry Dental Maya Dr. German Arzate. Global t.v. B.C. Canada along with the Dental Association of British Columbia warn dental tourists. Ex patients returning home with shoddy dental work.
www.globaltvbc.com Dental tourism Mexico interviews with ex- patients aired Nov 29- 30, Dec 1st,2011.
www.bcdental.org Located under patient education.

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Avatar for user 'Sandy'

Sandy | February 1, 2012 at 1:47 a.m. ― 2 years, 9 months ago

I took my child to Tijuana to have orthodontic treatment. Dr. Daniel Cerillo Lara of Tijuana destroyed my childs teeth. My child lost 10 teeth to this man and now needs implants to replace teeth. I dont recommend anyone take there children to this man or any orthodontic dentist in Tijuana. It was not worth the cost to my family.

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Avatar for user 'Sandy'

Sandy | February 11, 2012 at 7:05 p.m. ― 2 years, 9 months ago

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Avatar for user 'Sandy'

Sandy | February 21, 2012 at 11:55 a.m. ― 2 years, 9 months ago

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Sandy | March 1, 2012 at 7:25 p.m. ― 2 years, 8 months ago

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Sandy | March 2, 2012 at 5:23 a.m. ― 2 years, 8 months ago

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Sandy | March 4, 2012 at 4:57 a.m. ― 2 years, 8 months ago

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Sandy | March 8, 2012 at 8:40 a.m. ― 2 years, 8 months ago

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Sandy | March 10, 2012 at 10:39 a.m. ― 2 years, 8 months ago

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Avatar for user 'Len'

Len | March 10, 2012 at 12:19 p.m. ― 2 years, 8 months ago

@Sandy. Could you please repeat the story? Some of us are slow.

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Sandy | March 15, 2012 at 3:38 p.m. ― 2 years, 8 months ago

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Avatar for user 'MexicoDentists'

MexicoDentists | August 17, 2012 at 6:06 a.m. ― 2 years, 3 months ago

In the story Los Algodones is decribed as having once been a dusty border town. It's still a dusty border town today. There are no beaches, no palm trees, no all-inclusive resorts. There's absolutely nothing that could be described as a tourist attraction, and yet people travel to go there, just to see a dentist that they hope will be decent.

The better way is to visit a pre-screened dentist in a holiday destination. The advantages are: 1) you visit a dentist who's been pre-screened for compliant with North American standards for credentials, competence and track-record and 2) you get to enjoy a stay in a beautiful beach side tourist destination.

There's a company, Holiday Dental Inc., that's done all the ground work to ensure Americans are able to visit a dentist they can be confident in, a dentist that's been rigorously assessed and is located in a place that's actually enjoyable to visit.

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Avatar for user 'Shonya'

Shonya | November 7, 2013 at 2:31 p.m. ― 1 year ago

I used a Tijuana dentist on the referral of Hal Huggins' organization, Applied Healing. Within weeks of returning home, fillings began to fall out. Those that haven't have decay at the seams. American dentist says they weren't done right. Dentist's name was Ezekiel Lagos. He blames me (or should I say, my body: malabsorption). Not possible in 3 weeks. Be careful and do your homework before you go. I thought I could trust Applied Healing, but definitely not. I'm having to have them all redone here, and have now spent more than I would have had I had them done right the first time. There probably are some good dentists down there, just try to find out who the good ones are and stay away from any you read bad stories about.

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Avatar for user 'LindaK'

LindaK | November 22, 2013 at 3:11 p.m. ― 1 year ago

My hubby and I went to a dentist in Los Algodones and we've been very satisfied with his work. We made actually our bad expierences in the US with a partial that didn't fit, cost a fortune and took even months to get it done. A friend of us recommended this dentist and that's what i would suggest to everyone, to go to a dentist -US or Mexico- friends can recommend you.

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Avatar for user 'rjhouchin'

rjhouchin | January 29, 2014 at 3:41 p.m. ― 10 months ago

I am reasonably certain there are some good dentists in Mexico. Having practiced dentistry in Southern California since 1978, I have seen a LOT of patients who had their dentistry done south of the border. 100% of what I have personally seen did NOT meet the minimum standard of care. Much of it was outright harmful. I cannot guarantee that you get what you pay for but I can absolutely guarantee you Do NOT get what you do NOT pay for. You can buy a Lincoln Navigator and you can buy a Yugo. They are substantially different in price and nobody would argue they are equivalent automobiles with a straight face. Anyone who is so uninformed as to argue that a Dentist is a Dentist is a Dentist probably does not know the actual difference between a dentist and a gardener.

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Avatar for user 'thompsonrichard'

thompsonrichard | January 29, 2014 at 4:39 p.m. ― 10 months ago

The VA provides dental services only to formers POW; so, obviously, there's going to be an huge Tijuana dental market next to a town with hundreds of thousands of discharged servicemembers.
My dentist 6th floor half-block east of Revoluccion on Primera Dr Mendoza filled my cavity with porcelain last week. Actually I've been going to him for years. This last time I brought a pair of progressive-lens glasses. (Again, the VA doesn't dispense progressive lens). I'd been told by lenscrafters that I'd need new frames which was
manifest. They wanted me to pay $75 for the prescription (but of course the VA does that). Then they wanted big bucks for the progressive featherweight lens. I brought several old frames and Dr Mendoza walked me over to an optometrist who fitted my progressive lens in the most similar frames. I can't tell how the exact fit was made but it was made by the optometrist they saved me $500!
My brother had jaw reconstruction. Dr Mendoza refered him to Dr Ramizez at Los Angeles Hospital in downtown TJ. After the surgery it took more than a year before Dr Mendoza was ready to do the the four implants. My brother owns a Paso Robles grove and he asked me to present Dr Mendoza/Dr Ramirez with some wine six months later.

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Avatar for user 'Peking_Duck_SD'

Peking_Duck_SD | January 29, 2014 at 8:34 p.m. ― 10 months ago

I'd rather go to a Dentist in Tijuana than some parts of the U.S., take for example Mississippi.

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Avatar for user 'BrendaHarris'

BrendaHarris | May 26, 2014 at 12:04 a.m. ― 6 months ago

If your looking for Low Cost Best Dental Bridge Mexico placidway.com is what you are looking for. PlacidWay is designed as the ultimate resource for the health and wellness tourism industry, more commonly known as medical tourism.

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