HLSA Seminar Series - US-Mexico Cross-Border Health Visitors: How Mexican border cities in the state of Baja California address unmet healthcare needs from US residents
Arturo Vargas Bustamante is an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. He has a broad background in health policy, with specific training and expertise in health equity research. His research investigates unexplored or underexplored topics on access to health care, predominantly among Latinos/Hispanics and immigrants in the United States. He also specializes in the comparative analyses of health care delivery systems in Latin American countries. The outcomes of his research have had direct policy applications, particularly since they estimate the share of disparities that can be attributed to socioeconomic and demographic factors and the corresponding part associated to health system variables, such as usual source of care and insurance status. Professor Vargas Bustamante holds a Ph.D. in Public Policy, an M.A. in Economics and an M.P.P. all from UC-Berkeley. As part of his professional experience, he worked as a consultant for the Inter-American Development Bank and for the California Program on Access to Care. Before he worked for the Health Care Financing Administration of the Mexican Ministry of Health.
Abstract: Millions of uninsured and underinsured individuals in the United States (U.S) face considerable barriers to care access. To address some of them, many cross the southern border with Mexico to utilize lower-cost healthcare. With expanded health insurance coverage in the U.S after the passage of the Affordable Care Act (ACA), it has been questioned whether better access to care in the U.S would lead to a reduced demand for cross-border care in Mexico. This paper uses 2010 and 2013 data from international travelers into Baja California (Mexico) to examine how Mexican border cities address the unmet healthcare needs from U.S residents. We argue that changes in health insurance entitlements under the ACA are unlikely to change the incentives to make use of health services south of the border. The recent repeal of the ACA health insurance mandate could even strengthen these incentives to seek care abroad. This study shows that healthcare supply in Mexico sometimes complements and others substitutes healthcare available to medical travelers in the U.S since healthcare rendered in Mexico is rarely covered in the U.S or it is less expensive and of better quality from the patient perspective. Baja California offers services to both insured and uninsured U.S residents. Different cities in the Mexican border specialize in particular services for medical travelers. We find that cross-border visitors to Baja California cities are more likely to be of Latino origin and to lack health insurance in the U.S. However, the share of non-Latino visitors increased in 2013 compared to 2010. Healthcare supply in Baja California for cross-border patients focuses on services that are rarely covered by US health insurance plans, such as dental services or long-term care. We conclude that affordability, cultural familiarity, perceived quality of care in Mexico, and geographic proximity, regardless of insurance coverage in the US, continue to be comparative advantages for healthcare providers in Mexican border cities.