Only being able to speak for Mexico, where I lived in 1999 while doing research, I don't see a country that has much empathy for those in poverty or other types of distress. If people have money they pay their way into health. Otherwise it's a lost cause. There isn't much talk of endowment funds, charitable foundations or social service for that matter.
Of course this is not saying that the United States is that far ahead.
Health Care Lost in Translation
Consulates Try to Help Their Nationals Get the Basics
By Marcela Sanchez
Washington Post Staff Writer
Monday, November 19, 2007; B03
With a comprehensive immigration overhaul now perhaps years away, Latin American governments concerned with the well-being of their nationals living in this country are taking on an equally thorny issue: the U.S. health-care system.
In Washington, some foreign consulates are providing eye exams and medical tests in addition to the traditional passport renewals and marriage registrations.
The Salvadoran consulate, which serves the largest immigrant group in the Washington area, began offering "Estaciones de Salud" (Health Stations) two years ago. The Mexican consulate followed suit last year, offering similar health services that it hopes to expand to its 47 consulates throughout the United States by year's end.
"My health is important," said Luz de MarÂ¿a MejÂ¿a, 34, a nanny and restaurant worker who came to the United States four years ago without papers. She found navigating the health-care system "extremely complicated" and has turned to the Salvadoran consulate for help.
JosÂ¿ Rigoberto MartÂ¿nez, a burly, 48-year-old carpenter with a temporary work permit, said he believes that immigrants tend to neglect their health.
"If we have a headache but there is work, we work," he said.
While waiting to get his blood pressure checked, MartÂ¿nez said he has never received medical treatment, other than a few visits to a chiropractor. He stopped seeing the chiropractor because getting time off work and justifying $45 a visit proved prohibitive.
Seventy-five percent of the more than 3,600 Salvadorans and Mexicans who received medical attention at their consulates in Washington this year had not had a medical checkup in the past three years, said German Valbuena, director of the local Hispanic Institute for Blindness Prevention, the lead agency running both consulates' health programs.
Salvadoran Consul General Ana Margarita ChÂ¿vez said that soon after arriving in Washington, she fell ill and realized how expensive health care is in the United States. On average, 50 people a week received health services last year at the consulate. Those services normally include a referral to a health center or clinic that offers care regardless of the patient's economic or immigration status.
Mexico's secretary of health, JosÂ¿ Â¿ngel CÂ¿rdova, said in a telephone interview that his government wants Mexican nationals in this country to have the "peace of mind of having access to basic health services."
As part of his government's goal of providing universal health care by 2010, CÂ¿rdova said he hopes to provide "health care to all Mexicans regardless of where they are."
"The migratory phenomenon has been growing [around the world], and it is something we will be grappling with for some time. I believe there should be agreements among countries to guarantee a basic service such as health," CÂ¿rdova said.
Although U.S. authorities might not share CÂ¿rdova's goal of universal health care, they don't deny the universality of the problem.
"From our perspective, there is no border in terms of health anymore," said William Steiger, director of the Office of Global Health Affairs at the U.S. Department of Health and Human Services. "We know that not just immigrants but travelers in this age of globalization can represent a challenge because they can bring diseases and export them as well."
Steiger cited recent measles cases brought to the United States by Japanese boys coming for the Little League World Series.
As part of efforts to protect Americans, Steiger said the department is responsible for the health of refugee populations within the United States and focuses efforts overseas on preventing diseases from reaching U.S. territory. Those efforts, he added, are not unique to the United States. Other countries are just as interested in ensuring that disease does not reach their populations.
"Good health is a positive-sum game for all us," he said.
Steiger and CÂ¿rdova said the United States and Mexico are beginning to explore some innovative ideas, such as a binational health plan that would provide coverage to Americans living in Mexico and Mexicans living in this country.
Aware that there are many more Mexicans here than Americans there, CÂ¿rdova suggested that a plan could fully cover U.S. citizens in Mexico but would offer only primary care to Mexicans here. After all, he said, most Mexican immigrants are young and healthy, and primary health care covers 85 percent of diseases. Those with more serious problems could be sent to Mexico for treatment, he said.
Often employed in low-wage jobs in small service- or trade-sector firms, Latin American immigrants are less likely to receive health benefits than the average resident of the United States. This might be a large factor in the rise in the number of the uninsured. In 2003, immigrants represented more than one of every four uninsured individuals in the United States, according to the Employee Benefit Research Institute.
In a 2005 report, the institute said that "immigrants accounted for about one-third of the increase in the uninsured between 1994 and 1998." But after the 1996 welfare reform that restricted access to public assistance programs to immigrants with more than five years of legal residency, "immigrants accounted for 86 percent of the growth in the uninsured between 1998 and 2003," the report said.