Wednesday, February 9, 2011
While escalating costs may characterize the American health care system, a different trend is playing out in the Mexican border town of Los Algodones. There competition is so fierce, dentists will outbid each other to attract American patients. And now some American insurance policies are following suit and American dentists are not happy about it.
You probably know someone who goes to a dentist in Mexico. Dental visits have become a booming industry in some border cities. And while Tijuana dentists used to be attractive mainly to San Diegans without dental insurance, now some US insurers are extending their coverage to dental practices south of the border.
A series of reports from the Fronteras desk, a regional public media project, is examining how cross-border dental care is making dentistry more competitive in the border states and creating big questions for US insurance companies.
Devin Browne is a reporter with The Fronteras Desk at KJZZ in Phoenix.
Jude Joffe-Block is a reporter with The Fronteras Desk at KNPR Nevada Public Radio.
CAVANAUGH: I'm Maureen Cavanaugh and you're listening to These Days on KPBS. You probably know someone who goes to I dentist in Mexico. Dental visits have become a booming industry in some border city, and while Tijuana dentists used to be attracted mainly to San Diegans without dental insurance, now some U.S. insurers are extending their coverage to dental practices south of the border. A series of reports from the fronteras desk, a size regional public media project is examining how cross border dental care is -- making dentistry more competitive in the border states. And creating big questions for U.S. insurance companies. I'd like to welcome my guests, Jude Joffe-Block is a reporter with the fronteras desk, at KNPR, at Nevada public radio. Good morning, Jude.
JOFFE-BLOCK: Good morning.
CAVANAUGH: We're also hoping to welcome Devon Brown, a reporter with the fronteras desk in Phoenix, we'll see if we can't get Devon thickening the line. Jude, [CHECK AUDIO] the main reason for Americans to go to a dentist in Mexico is the price. So how much cheaper is dental work in if Mexico.
JOFFE-BLOCK: Well, we heard evidence that it could be as much as 70 percent cheaper. [CHECK AUDIO] root canals, bridges, and the estimate he got in the U.S. was $20,000, and in Mexico, he paid about 38 Monday dollars. And like a lot of people we met, Mike only had limited dental insurance in the States, and so he was actually -- I mean this would have been paying out of pocket, so that was the -- the price was a really big deal, and a lot of the folks we met really talked about not having dental insurance or being thickening Medicare and having only very, very limited coverage.
CAVANAUGH: Jude, why is it so much cheaper to have your teeth fix indeed Mexico?
JOFFE-BLOCK: Well, that's a lot of reasons. It's cheaper to do business in Mexico because the cost of living is lower, Mexican dentists don't have to make as much money to live well, and they don't want have to pay their employees as much relative to a dentist in the states. And they also don't have some of the same over head costs that American dentists might have. We talked to a dentist thickening the other side of the border in Yuma, and he said that about 70 percent of his business went into over head, and that's not only about employees and rent, that also includes his dental school loans issue I mean, going to dental school in the U.S. is significantly more expensive than in Mexico where higher education is publicly subsidized.
JOFFE-BLOCK: He also talked about having to pay for malpractice insurance, which our legal system where we can sue a dentist is different. You don't quite have those same rights in Mexico. So malpractice insurance doesn't come into play as much there. And then the Yuma dentist talked also about compliance with safety regulations like insuring that he was in compliance with like OSHA, that that also cost him money.
CAVANAUGH: Devon brown is on the line with us now. [CHECK AUDIO].
BROWN: Hi, good morning.
CAVANAUGH: Your series profiles a Mexican town across the border from Mexico, it's called Los Algodones. [CHECK AUDIO].
BROWN: There are thousands -- 400 dentists in eight blocks. And it definitely did in not always -- it was not always this way, and many of the long time dentists that we first interviewed said when they first arrived, in the rate 60s and '70s, the streets were lined with cantinas and brothels.
CAVANAUGH: Now it's lined with dentists.
BROWN: Now, it's lined with dentists. And there are all these other factors that people are willing to feed the boom. You had Americans on the other side of the boarder who were willing to advise for these Mexican dentists. The [CHECK AUDIO] and you also have this really sort of unique situation that the such one Indians, their reservation is on the other side of the boarder, and they built this [CHECK AUDIO].
BROWN: Park their car, and they don't have to worry, they don't want have to worry about Mexican car insurers and they can just walk right across the street and get their teeth cleaned, and feel safe that their car is protected and fine.
CAVANAUGH: Right now, Devon, there are actually now generations of Mexican dentists competing with each other in this town, Los Algondones, but it pales in comparison to how much the U.S. dentists are competing with this dental tourism to Mexico.
BROWN: It's true. We've spoken with a number of dentists in Arizona who are yeah, not so happy with watching an American exodus over this. They've made a lot of efforts over the years to say, [CHECK AUDIO] down falls of Mexican dental tourism, and probably the most notable in 2008, in conjunction with Delta Dental of Arizona, they put together this brochure, it was called trouble in pair days, the untold story of dental tourism. And it kind of, you know, sort of lists all these things that Mexican dentists found very offensive. [CHECK AUDIO] mesh dentists have, and it ended up and we have a clip from him [CHECK AUDIO] [CHECK AUDIO].
NEW SPEAKER: It was a bunch of lies they were just telling over there. I know they're just loosing their customers, but when they're compete with lowering their places or giving a better service, that's the way to [CHECK AUDIO].
CAVANAUGH: Delta dental here in California covers some dental practices in Tijuana, and I'm wording why and, is it the same in other states Devon?
BROWN: It's the same in other states. We talked to Delta dental, there are different delta dental its, [CHECK AUDIO] Arizona, so I know is this confusing and complicated. But we spoke to all of the delta dentals that operate along the border. Actually, California is delta owned Texas's [CHECK AUDIO] their response was, we're trying to offer this service to people, maybe Mexican marshals that live in the United States, or maybe that you feel more comfortable seeing a dentist in Tijuana, or in a setting that fools [CHECK AUDIO] we are putting together a package for the American tourists. That was not what we found. And they were quite unhappy, California's delta was very unhappy with the brochure. The man that I spoke with California's delta said they had to quote disown it. [CHECK AUDIO] we had nothing to do with this, we want to put a lot of distance between ourselves and Arizona, and one of the reasons is that the CEO of delta of California actually owns a separate insurance company in Mexico called Dentegra, and that's -- so they're kind of creating a whole 'nother model down this.
BROWN: For Mexicans mainly in Mexico City, etc. So --
CAVANAUGH: One of the things that the delta dental organization in Arizona is railing against is the fact that some public employees in Yuma are getting insurance coverage for visiting Mexican dentists. And I know that you have a little -- a bite from Kevin Earl of the California dental association.
NEW SPEAKER: That concerns us. First of all, we're talking about public moneys that are being extended to the benefit public employees for services that may be provided by a provider that doesn't meet the same standards in the United States.
CAVANAUGH: So Jude, are people expecting this dental tourism to keep growing?
JOFFE-BLOCK: Well, we essentiality talked to some experts who thought it would. You know, that as the baby boomers grow older and need even more coverage that this could be something that we're seeing increasingly maybe for specialized services like dentistry or other kind of one off kind of services where it would make sense to travel. I mean, I think that having your primary care doctor, that's something that can't be replaced, I mean, unless you do live in hay place like San Diego, right there by the border, and certainly the Baja California government is trying to do everything it can to draw more Americans, and actually they have a new directory coming out this month that's really going to Los Angeles all of the licensed doctors and dentists in Baja California to make it that much easier for Americans to find medical practitioners they can trust.
CAVANAUGH: That's fascinating. I want thank you both so much, Jude Joffe-Block, and Devon Brown, two reporters from the fronteras desk. And I want everybody to know that their series on cross-border dental care continues tomorrow on Morning Edition right here on KPBS FM. If you'd like to comment, please go on-line, KPBS.org/thesedays. Coming up, veterans are getting training as sustainable farmers. That's next as These Days continues here on KPBS.