It's an insurance issue, not Mexico vs. USA

Margo · February 3, 2006

Here is my 2 cents on the Dr. Ortiz thread.....

I look at this "situation" as an insurance issue as opposed to a Mexico vs. U.S. doctors issue.

FIRST of all, I will say that I was very, very, very luckily as my insurance company, Humana, covered my surgery....I thank Humana for their wisdom.

Now.....if other insurance companies were as wise, obese individuals with co-morbidites would be able to look for the best doctors IN THE U.S.A. to perform their surgery and PROVIDE AFTERCARE.

Who goes to Mexico for WLS surgery? Those who had to self-pay! If you went to Mexico for your WLS would you have gone to Mexico if your

insurance covered your surgery??!!!

We don't need to argue about Mexico vs. USA, we need to take this energy and fight the insurance companies who do not cover WLS!!!

Just my opinion.....

NewSho · February 3, 2006

Excellent point, Margo.

Well said.

:clap2: I've often thought the most pressing aspect of the Mexico banding is the inability to get insurance companies here to do actually cover this much needed surgery for their members. To me a secondary aspect is the rising cost of health care (even at cash pay prices) here in this country.

Of my friends who went to Mexico, all of them did so after being denied by their insurance companies. And all of them have said they would have preferred to have the surgery closer to home, had it been more affordable.

One pal said even though she had to pay cash, she wish she could have had her surgery locally or even just closer like her mother did - but the USA cash prices were just unaffordable.

I've watched the cash prices of Weight Loss Surgery (WLS) and particularly LapBanding come down in the last few years. As more doctors are trained and as the techniques get more refined perhaps the prices will continue to decrease some (without sacrificing quality, and yes I hope that's possible) and make it more affordable even for those who pay cash.

Both of those issues show serious failings in our health care system's approach to WLS, in my opinion. It's treated like some elective or experimental extra, when for many of us it's the only real option for permanent weight control. This is something we HAVE to address here.

ms_efflorescent · February 3, 2006

If I had been willing to fight with them for a year or so, no doubt my insurance would have paid. But I have the money and know a couple of people who went to my surgeon a couple of years ago and are doing great and have had no complications so I read everything I could and chose him. They recommended him to me after I mentioned lapband to them, not knowing at the time that they had even had the surgery. I hope that I don't end up regretting my decision but I think I would most likely feel that way no matter where I had surgery. I had not found or read LBT prior to surgery or I may not have gone there though.

I am sure that if the insurance company didn't make it so difficult that I would not have gone to Mexico but they also would have had to be willing to pay for me to travel somewhere else to get surgery because the surgeons around my area have no experience and I personally know two people who have had bad experiences with them here.

Serena

one gone dog · February 3, 2006

Thats some really good points and for the most part i agree with you.

and maybe my wife and i are the "odd man out" but we didnt go to Mexico for those reasons. we actually went because of the doctor. for us it was a close call between the one we chose and one in italy and in sweeden.

however i do agree with you as to that is why mexico is used so much.

maybe things will change now that the overall cost has come down in the usa (at least in the pacific northwest) to be very close to that of the mexican prices.

right now i believe (and could be wrong) that the biggest difference is mexico does not make you do the psych exam or pay for the blood work up.

LilAngel · February 3, 2006

This probabaly doesn't come up a lot because it is probably more the exception than the rule. In my case, I went to Mexico because US doctors wouldn't even talk to me or return my phone calls. I was willing to self-pay here (if for nothing else, the convenience of local aftercare), but I was only 80 pounds overweight. Obese, but not obese enough. This is a US standard, so I suppose the doctors were doing as regulated?

I don't want to get into arguing the merits or value of someone my size having the surgey, because it really is such a personal choice. Or even if Mexico was really one of my only options (the option of gaining weight to lose, for example). I was just glad that foreign shores provided an opportunity for me that was not an option here. And so far so good.

As I said, that may the exception, but I just wanted to share my experience.

Thanks.

Penni60 · February 3, 2006

right now i believe (and could be wrong) that the biggest difference is Mexico does not make you do the psych exam or pay for the blood work up.

My surgeon required the blood work up and the psych visits. I was in the facility for a week prior to surgery and had the blood work and the psych visits. So some do require it. And yet he still was an incompetent boob. OOPS SORRY!!

cmr · February 13, 2006

I may have gone to Mexico because insurance wouldn't pay but now, knowing what I know, and having the choice between US and my dr. in Mexico, I still would go with my Mexican dr. I LOVE Dr. de la Garze and I think, even with all the research that I was treated better there than I could have been in Houston. The follow up treatment has been excellent. The only thing that I pay for is my flight. They even put me up in the hospital hotel. He wants me to stay overnight after a fill just to make sure it's not too tight. I am not sure that I would get that kind of care here in Houston.