Over the several years I’ve been writing this blog, I don’t think I’ve dedicated a post to healthcare, but it is one of the questions I frequently get asked when talking about becoming an ex-pat. After spending almost 14 years struggling to develop products that improve the U.S. healthcare system, I’ve definitely formed a lot of opinions on that system and its multitudinous issues. Granted, when you work in it, you get exposed to a lot of horror stories, but I was also a consumer of it and experienced some of those challenges firsthand. I don’t think anyone would argue with me that the U.S. healthcare system isn’t broken. Recently moving to a new country and experiencing a different system, will put all that ridiculousness in perspective. Since I have just returned from the dentist, I thought I would compare some recent dental experiences both in the U.S. and here to illustrate the differences I saw.

While there have been many times I have been uninsured in the US (usually because I have been between jobs – which is another issue in itself), I am uninsured down here by choice. This definitely goes against my pragmatic side and worst case scenario-ing, and I honestly don’t know if it is the right path. I am still mulling over whether I want to find some type of international coverage with a high deductible, but for now we are completely out-of-pocket.

Let’s start this story with some PHI. My teeth have always been pretty bad. I do take good care of them (floss and brush at least once a day), but between a night-time teeth grinding habit I picked up while working in tech and what I can determine are probably just bad genes, I’ve had a lot of dental work done over the years. Last year, I noticed that one of my crowns was loose, achy and had some localized swelling in the gum below. I had a good dentist in Oakland, but since I was living in San Francisco and working in Foster City with not a lot of spare time from the long commute, I picked the highest rated dentist near my work to get it checked out. They had over 4.5 stars and very satisfied customers, so I assumed their care was decent.

When the dentist (owner of the practice) tried to pop off the crown, the whole tooth broke off just below the crown leaving a jagged, bloody mess where my tooth was. I understand that fractures sometimes can’t be detected via x-rays (at least that was what they told me), so I’m not faulting the dentist for breaking my tooth the rest of the way, just for what happened next. They filled a cavity (very poorly it turns out) and sent me home with nothing but 3 upsells which I’d already refused previously – teeth whitening, mouthguard and braces – and a referral to see a specialist for an implant. If I took them up on their “offers” I would be looking at north of $8k – possibly even more as I didn’t even call the implant specialist. That night, my tongue got mauled by the rough tooth and when I called in to see if they could at least put a cap on it, I could feel the shrug through the phone when they told me to get some silicone ear plugs to cover it. Sigh…

Sounds like a great opportunity to try out the Mexican dental system, no? Well that’s exactly what I did. On a referral from a neighbor, we traveled to a dentist in La Paz to get it checked out. She took a look and said that I’d need to see a specialist which was no surprise. What was a surprise is that she got me into the specialist that day. He took a look with his sophisticated camera equipment – this cool x-ray machine that immediately projected an image on the screen in front of me – determined that the root canal was perfectly fine and put a post in right then and there and capped the tooth. That cost me a whopping $75 USD.

Due to COVID, I’d been living with that cap for about a year and finally went back to my dentist to get the crown. She took the mold and ordered the crown and made an appointment for the next week to get it installed. Simple. The crown cost $6000 MXN ($300 USD), cleaning $400 MXN ($20 USD) and fixing the filling that my last dentist had mucked up was $800 MXN ($40 USD) pesos. That is a total of $435 USD – SO MUCH LESS than I would have paid even with insurance in the US.

Also, there were a couple other things that I preferred about my Mexican experience. No upsells. They do what needs to be done. Speed – the amount of time (minus the drives to La Paz) took a total of about 1.5 hours including that first post installation. Quality – the results are great.

One more thing that I noticed that may or may not be good for everyone, but something I liked, you must be an advocate for your own health. You direct the care. While your practitioners will tell you their medical opinion, you are in charge of what you get done and there isn’t any pressure to do something you don’t feel is necessary. I think this is important as I found myself trusting my doctors too much in the US, despite the fact that I was very familiar with the downfalls of the fee-for-service model of reimbursement. In retrospect, this sometimes lead to unnecessary procedures and costs.

The verdict is that I am extremely happy with the care I received and also excited that I can get my semi-annual cleanings for $20. I haven’t had medical care yet, but I have heard it is similar. Luckily, we are both in pretty good health at the moment so haven’t had to delve into that system, but I am feeling positive after my dental experiences.