Crossing the Border for Cheaper Care
看病太貴 美國人墨國就醫
By Jennifer Medina
MEXICALI, Mexico – Tourists often come to Mexican border towns looking for some kind of illicit adventure, trotting among the bars, strip joints and seedy motels that dot the streets. Here, though, the visitors are searching for something more basic: a root canal they can afford or surgery they have been putting off for months.
觀光客來到美墨邊界上的墨西哥城鎮，通常不外乎想從事各種違法的冒險活動。他們流連於街上隨處可見的酒吧、脫衣舞吧與低級汽車旅館之間。然而在墨西哥下加利福尼亞州首府墨西卡利市，觀光客尋找的卻是更基本的東西：負擔得起的牙齒根管治療，或者是已經拖了好幾個月，早就該動了的手術。
Mexicali has adopted medical care as its primary tourist lure, and it has been attracting a growing number of health care commuters from California and other nearby states. Hospitals offer operations for gastric bypass, liposuction and chronic back pain. Dentists promise that extractions, fillings and whitening can all be done for less money. And ophthalmologists advertise laser surgery and routine exams.
墨西卡利已經把醫療照護列為最主要的觀光賣點，近年來開始對美國加州與鄰近各州尋求各種醫療服務的民眾產生吸引力。這些人通勤就醫，而且人數越來越多。醫院提供的服務項目包括胃繞道手術、抽脂及慢性背部疼痛治療。牙醫保證拔牙、補牙、牙齒美白等手術全可搞定，而且收費比較低。眼科醫師則為雷射手術與例行性檢查大打廣告。
Thousands of people are crossing the Mexican border in search of care they can better afford. The influx has grown over the last several years. Many are uninsured Mexicans who have made their lives in the United States and desperately need affordable care, but the flow increasingly includes a smaller group of middle-class patients from all over the country looking for deals on elective surgeries that most medical insurance will not cover.
民眾數以千計自美國越界來到墨西哥，尋求比較負擔得起的醫療服務，人數過去幾年且不斷增加。這些人當中許多是在美國討生活卻沒有健保的墨西哥人，他們非常需要負擔得起的醫療服務，最近則有越來越多來自全美各地的中產階級夾雜其間。這些人前來墨西哥，是為了以較低的花費動一些美國醫療保險大多不涵蓋的手術。
“At first, I was like, Mexicali, where is that?” said Stephanie Rusky, a 26-year-old social worker from Perkins, Oklahoma, who paid roughly $8,000 for some liposuction, a breast lift and a tummy tuck (a combination known as a “mommy makeover”) that would have cost about twice that in the United States. “But I asked every question I could think of and eventually felt really comfortable with it.”
來自奧克拉荷馬州伯金斯市的26歲社工史蒂芬妮‧拉斯基說：「我最初的反應是，墨西卡利究竟在哪裡？」她以大約8000美元的代價做了抽脂、胸部上提與腹部塑型（3者合稱「媽咪塑身術」）；在美國，這些手術的收費必定是此數的兩倍。她說：「我提出自己想得到的每一個問題，最後覺得十分放心。」
Such sentiments are sweet music to the ears of Omar Dipp, who oversees tourism for this city.
聽在督導墨西卡利市觀光的狄普耳裡，這種感受有如美妙的音符。
“There’s a huge market for this,” Mr. Dipp said. “We just have to package it the right way. Everyone benefits: the hotels, the restaurants, the local economy. We give them a reason to come, and they will be here.”
狄普說：「這個市場非常大。我們必須以恰當的方式包裝。各方都是受益者，包括旅館、餐廳與在地經濟。只要我們讓他們覺得來這裡有道理，他們就一定會來。」
Last year, more than 150,000 patients came to Mexicali, pumping more than $8 million into the city’s economy, officials said. There are some dozen hospitals that regularly treat Americans, and many have hired a special administrator to coordinate their medical and travel plans. With nearly 100 medical offices in a six-block radius, the city hopes to create a special medical zone by improving streets and sidewalks and adding more tourist services.
市政府官員說，去年，前來墨西卡利尋求醫療服務的病人超過15萬人次，為當地帶來800多萬美元的經濟收益。其中數十家醫療院所經常可以看到美國人的蹤影，許多院所設有一名專責行政人員，為病人打點醫療與全部行程。墨西卡利市在一個以6個街區為半徑的範圍內，就有將近100間診所；市政當局打算整建街道與人行道，同時增加更多為觀光客服務的項目，進而打造醫療特區。
In strip malls and office buildings here, there are far more medical offices than anything else. Hotels offer special rates for patients, and the local tourism office has begun subsidizing van rides from Las Vegas, roughly 515 kilometers north, to bring in those who would rather avoid the drive themselves. And this year, the government opened a special lane to allow medical tourists to bypass most of the wait on the Mexican side of the border, which can often take as long as three hours.
墨西卡利零售商場與辦公大樓內的診間數量遠多於其他用途的設施。飯店為病人提供優惠價，市政府觀光局則開始為來自北方約515公里處賭城拉斯維加斯的客人，提供小巴士接送服務，以滿足不願自行開車者的需求。今年，墨西哥政府特別開闢另外一條車道，使醫療觀光客得以省下墨西哥境內的邊界等候時間。一般情況下，邊界等候可能得耗費3個小時。
Juan Salas drove nearly three hours from his home in Desert Hot Springs, California, to have his daughter Abigail, 11, fitted for braces. While he has medical insurance through his job as a restaurant supplier, it does not cover dental work. Saving thousands of dollars will make up for the round trip of at least five hours he will soon be making a couple of times a month, he said.
薩拉斯從他位於加州沙漠熱泉市的家開車將近3小時才抵達墨西卡利，為的是讓11歲的女兒艾碧嘉兒能配矯正牙套。他因為擔任餐館供應商而享有醫療保險，牙科手術卻不給付。他說，他很快就得每個月數趟，每趟至少5個小時載送女兒來回美墨之間，但能省下幾千美元還是值得。
Mr. Salas’s wife, Araceli, said that her family had come here for medical care since she was a child.
薩拉斯的妻子艾拉雪莉說，打從她小時候起，她的家人就一直來墨西卡利就醫。
When their eldest daughter was struggling with seizures, their local doctor could not see her for weeks. They came here to see a doctor who offered not only new medication but also his cellphone number so they could call him for follow-up questions.
兩人的長女癲癇發作時，他們居住地的醫師曾經數星期無法為她看診。他們轉來墨西卡利尋醫，這兒的醫生不但提供新的藥物，還給了他們他的手機門號，讓他們有需要隨時來電詢問。
“We were talking about our daughter’s life, so we wanted help right away and we had it,” Ms. Salas said.
薩拉斯說：「我們談論的可是我們女兒的性命。在那種情況下我們需要的是即時的協助，而我們也確實得到了。」
Here, many Mexicans talk with pride about the easy access they have to their doctors, sending them frequent text messages with questions and expecting calls back within minutes.
住在墨西卡利的許多墨西哥人提到他們獲得醫師服務有多麼方便，無不面露得色。他們經常以簡訊向醫生提出各種問題，通常幾分鐘內就能得到答覆。
None of the hospitals in Mexicali have been certified by American medical accreditation teams.
墨西卡利的醫院還沒有任何一家取得美國醫療評鑑團隊的認證。
Carlo Bonfante, an owner of Hospital de la Familia, where Ms. Rusky was a patient, said that the most popular operations were gastric bypass and gastric band surgery, but that he hoped more people would begin coming for primary care.
拉斯基就醫的「家庭醫院」院長龐凡德表示，最熱門的手術項目是胃繞道與胃束帶手術，然而他希望能夠有更多的人前來接受基本的醫療服務。
“The people who live a few miles away from here but in another country can’t afford the care,” Mr. Bonfante said, “so we will provide it for them for less, whatever they need.”
龐凡德說：「離我們只有幾哩遠，卻住在另一國家的人們負擔不起醫療服務。所以不管他們有什麼需要，我們都願以較低的收費為他們提供服務。」
原文參照：
http://www.nytimes.com/2012/06/28/health/mexicali-lures-american-tourists-with-medical-care.html
Slideshow: Tourists Seek Medical Care in Mexico
http://www.nytimes.com/slideshow/2012/06/26/us/20120626_MEDICAL.html
2012-07-24聯合報/G9版/UNITEDDAILYNEWS 陳世欽譯 原文參見紐時週報十一版上
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