By Jodi Magallanes, Truth Staff
Perfecto Garcia has seen and heard enough about two nations' distinct health-care systems to decide he wants little part of either.
Mexico's government-run health care system is dysfunctional, and the United States' is exorbitantly expensive. So he and his roommates have come up with their own health plan.
"It's just forbidden for us to get sick," Garcia said.
The system just south of the border is a patchwork of federally funded clinics and hospitals to which workers pay in and then can access at low cost. But those health-care centers, and the ones which exist to serve the poor, are understaffed and underfunded. Long wait times for appointments, even sometimes in urgent cases, further puts people off of seeking medical care.
In Garcia's town, for example, there are three federal clinics plus one for emergencies, which are expected to serve about 60,000 people.
Privatized health care is available and provides quicker, more attentive care with better resources. But the cost is beyond the economic possibilities of the average Mexican citizen. As a result, many reject institutional health care entirely until a situation becomes too painful or intrusive to ignore.
That's what Vernita Todd, director of Heart City Health Care Center, sees.
"What we find in our health center is that most (immigrants) present with an urgent matter. They tend to avoid routine care," she said. "People don't have the money to pay for preventative care."
Mexican immigrants also aren't as accustomed to seeking preventive medical care as Americans have become.
"The life we live there doesn't allow for it," Garcia explained. A work week is typically six, sometimes seven days long and features 10-hour shifts. There's no time to seek medical attention for minor matters. So culture and finances collaborate to encourage Mexicans to get their health care primarily from area emergency rooms once they arrive in the U.S.
The situation concerns Todd, she said, because emergency rooms treat immediate and severe symptoms but are not the component of the U.S. health-care system designed to spend time getting to the root of a complicated health problem, coordinate follow-up care, effectively encourage lifestyle changes or perform preventive care.
"When they're sick and they come to us, we teach them how to not keep getting sick," Todd explained as the value of utilizing clinics and family doctors.
Heart City sees many adult Hispanics with chronic concerns whose complications have advanced the situation to an a dire level. They are frequently on the verge of renal failure, kidney failure or amputation because of neglect of diabetic conditions, or have severely high blood pressure.
Francisco Carrillo, an acquaintance of Garcia's, feels another reason Mexican immigrants tend to put off seeing a doctor here is because they don't receive the kind of treatment they are used to.
"Many of my friends, they say, 'They didn't cure me. They didn't give me anything (to take),' so they don't go back."
Health insurance can offset the cost of preventive and emergency health care, if a person can afford the premiums. And, of course, if it's offered. Garcia said no one at his company has mentioned the availability of health-care benefits to him.
"Parents don't, children do," tend to have health insurance once they immigrate to this area, Todd said. Sometimes employers do not offer health insurance, or the employee's part-time employment status makes him or her ineligible.
Or they are faced with a dilemma which crosses ethnic lines: their company offers health insurance but the high premiums are too much for them to afford. If they can afford some insurance, it's not uncommon for the gap to be so large that they still can't afford routine or preventive care.
The U.S.-born children of immigrants have the same legal right to Medicare and other publicly funded health programs like Indiana's SCHIP program as other citizens, part of the reason they tend to enjoy a higher rate of health insurance coverage than their parents, Todd said. These programs' identity requirements make enrolling their undocumented parents or any other undocumented adult much more difficult than enrolling a citizen child.
Even at income-based clinics like Heart City, a least a small payment is required, which can also dissuade cash-strapped potential patients. But going to the emergency room doesn't have the same effect, because payment is postponed.
"I call it the Scarlett O'Hara syndrome: 'I won't think about that right now.' You know you don't get the bill when you walk in the door. And they know 'They can't turn me away.' But that cuts across ethnic groups too," Todd said.
She feels another deterrent to health care for illegal residents is the fear of being asked status-related questions at a doctor's office. While instances of repercussions for doing so area extremely rare, the political climate tends to exacerbate hidden fears of interacting with Anglos and established institutions like the health-care system.
"They don't want to draw attention to themselves," Todd said.
For others, there is a comfort issue. The limited number of clinics and doctors who speak Spanish discourages newer residents.
"A lot of times we have maybe an 8-year-old translating for an adult. That's not right," Todd said. So Heart City keeps makes sure someone on its mostly bilingual staff is available at all times to interpret.
But one of several bright spots in the Hispanic community's health-care habits is that it tends to have fewer smokers than the general Anglo and African-American populations, Todd said.
Garcia's household also practices healthy eating habits, including eschewing canned fruits and vegetables for fresh produce and drinking lots of water. A hint of olive oil, which reduces cholesterol, is used whenever possible in place of other types of cooking oil. Roommate Bernardo Gutierrez runs during the warmer weather, and all are infrequent drinkers.
Nevertheless, Garcia did take advantage of the lower cost of health care in Mexico to have a blood pressure and cholesterol check done the last time he visited. Everything was within normal range, thank goodness.
"If I get sick here, then I'll have to go back to Mexico. That's better than paying $15,000 or $20,000 for them to cure me here. I'd rather just die," Garcia said.