Border residents turn to Matamoros hospital for affordable healthcare

One morning a few months ago Dora Sanchez's son, Sigifredo, woke with a temperature of 104.8 and a splitting headache.

He also complained of a loss of feeling in his arms and legs. Sanchez rushed her son to the hospital emergency room nearest her home in Mission, where they spent the next four hours being shuttled between waiting rooms.

When the doctor finally arrived he quickly diagnosed Sigifredo with bronchitis and assured Dora there was no need to worry. A cycle of Tylenol would cure her son.

He wrote out a prescription and sent them on their way.

Sigifredo's condition, however, persisted.

Believing the doctor hadn't taken enough time to give a thorough diagnosis, Dora packed her son into the car once more only this time she headed for Centro Medico Internacional in Matamoros.

"When we got there they were waiting for us in the emergency room," Sanchez said. "They got us in immediately and started treating Sigi."
Doctors there diagnosed the boy with pneumonia. Sigifredo was treated, but in the following days he developed a Staph infection that would require surgery to remove his tonsils.

The experience shook Dora's confidence in healthcare in the United States.

With her son in need of immediate care, she elected to have doctors at Centro Medico perform Sigifredo's procedure.

The price tag for his surgery and seven-days of care at CMI was $5,500, but Sanchez paid nothing over her insurance co-pay of $150.

On a separate occasion after her son had an allergic reaction, Sanchez received a $3,800 bill for just three hours treatment at a US hospital.

"US hospitals are too slow, too expensive and treat you like a herd of cattle," Sanchez said. "It's a vicious cycle of people and doctors who abuse the system."

Sanchez joins many local residents who feel alienated by impersonal service, exorbitant physician fees and ancillary charges they claim to see at U.S. hospitals.

An estimated 32 percent of Rio Grande Valley residents sought medical treatment in Mexico, according to a National Institutes of Health-funded study organized by University of Texas Pan American researchers.

And a 2005 US Census Bureau report found that at least 38 percent of border community residents have no health insurance.

Amid this binational landscape where opposing healthcare systems ply their trade side by side, the practice of seeking treatment across the border is common practice.

In addition to culling a greater share of Valley patients, the hospital is hoping to cash in on a multibillion-dollar medical tourism industry.

"Mexico has not been positioned as a destination for medical tourism," said Mauricio Sampayo, director of market strategy for Centro Medico. "Maybe because there is a perception of tequila and burros, but it's an obvious choice because it's so close."

A gleaming 25-bed acute care hospital and surgical facility that more closely resembles a U.S. medical campus than a typical hospital in Matamoros, CMI is the brainchild of brothers Mauricio and Patricio Sampayo.

Born and raised in Matamoros, the Sampayo boys are U.S.-educated.

Mauricio studied at the University of Texas at Austin and later spent 10 years at pharmaceutical giant Eli Lily and Company. Patricio graduated from Harvard.

Built with private investment, both pesos and dollars, the Sampayos had a vision that centered on raising the quality of healthcare services in Matamoros for its citizens.

"Before we started I had never stepped foot in a doctors office in Mexico," Mauricio admitted. "The thought just never occurred to me. When I did it was it was literally embarrassing."

Undersized doctor offices line the streets of downtown Matamoros, and hospitals are congested and ill-equipped to meet the healthcare needs of a city of 700,000.

It was clear to the Sampayos that Matamoros was in need of a hospital, but they knew nothing of administering a hospital let alone building one.

Despite their lack of experience, the Sampayos went ahead with CMI, building on a lot owned by their family. They recruited the city's best doctors, whose only limitations had been access to the latest technology.

The Sampayos spared no expense, spending millions on the same equipment found in US hospitals, including Siemens SOMATOM Sensation CT Scan and Kodak radiology equipment.

In 2005, they brought 18 doctors on board. Today there are 60 doctors and construction is underway on additional offices, which could eventually double the current physician staff.

"There are only two urologists in the state of Tamaulipas, and we've got one of them," Mauricio proudly said of the staff he and his brother assembled.

Even with their sights set firmly on elevating healthcare services in Matamoros, it soon became apparent that patients were trickling across the border as word spread about Centro Medico.

The Sampayos estimate that perhaps 15 percent of their patient base is American.

With an advertising campaign, which includes new aper and billboard ads, the brothers believe there is ample opportunity to double that figure within the next five years.

The number of Americans traveling abroad for healthcare grows every year.

Estimates vary widely, though in 2005 the American Academy of Orhopedic Surgeons reported that as many 500,000 sought care overseas.

The medical tourism industry is forecast to grow to 40 million trips and $40 billion by 2010, according to Tourism Research and Marketing.

"A significant number of Valley patients can't afford treatment," Mauricio said. "If they can't pay it's a lose-lose across the board. But, bring them here where it's affordable for the patient and at least we'd be making something. It's a win-win across the board for the hospital, doctor and patient."

But, for many Americans the option of seeking treatment in Mexico is mired in a cloud of uncertainty as the question of what happens if something goes wrong lingers. There are as many stories praising personalized attention as those of wrongful diagnosis and shoddy treatment.

Most large insurers have shown a reluctance to extend coverage abroad, though a few, such as the Minneapolis-based UnitedHealth International, now offer overseas coverage. Centro Medico has an in network agreement with Blue Cross and Blue Shield.

Mauricio said the question of legal recourse has rarely been an issue for patients at his facility.

"In the event they ask we explain that in Mexico two-thirds of medical malpractice complaints are resolved via arbitration not litigation, and 72 percent of these complaints were resolved by assuming commitment for continuing medical treatment or by broadening the stages of medical care," he said. "This is one of the primary reasons why CMI can offer world class healthcare in Mexico at affordable prices."

The chief executive officers of two of Brownsville's larger hospitals have taken a more-the-merrier approach to the rise of facilities like Centro Medico.

"Having a choice in healthcare options is always good, and Brownsville's proximity to the border increases these choices," said Leslie Bingham, CEO of Valley Baptist Medical Center-Brownsville. "Additionally, we believe the quality of healthcare in the US sets the
standard for other nations."

David Handley, CEO of Valley Regional Medical Center, agreed with Bingham's assessment. "It boils down to patient choice," Handley said. "Patients weigh the cost and quality and make a decision from there. I welcome the competition."

Dangling the carrot of cost savings is common practice among medical facilities courting American citizens.

The northeastern Mexican city of Monterrey is casting itself as healthcare city and the preferred medical tourism destination in Mexico.

But, where Monterrey has resources to advertise in markets beyond Texas, CMI has proximity to Rio Grande Valley patients.

"I think it makes a lot of sense," said Elena Bastida, director of UTPA's Center on Aging and Health. "If it offers more or less the same product for a lot less money I think it's very attractive."

As is often the case, Bastida said, the presence or absence of money plays a significant role in how the quality of medical care is perceived.

According to a 2005 study on the disparities of healthcare on the US-Mexico border, nearly all those without insurance who sought treatment in Mexico said care there was superior.

Conversely, 75 percent of those with insurance believed treatment in the US is better, while 25 percent said healthcare was roughly the same on both side of the border.

The data suggests that hospitals are not the priority.

"Don't be fooled," Bastida said. "Money dictates reasoning more than quality."

Yet families with the lowest household incomes are as unlikely to seek Mexican healthcare as the wealthiest.

The most frequent users of Mexican healthcare live above the poverty line, but lack insurance.

And as more patients have favorable experiences, the Sampayos are betting on word of mouth to spread the message about CMI to cities across the state.

Rancho Viejo resident Liz Hainley Rusteberg is among those impressed with what Centro Medico offers.

After Hainley injured her knee skiing in Beaver Creek, Colorado she needed an MRI to determine the extent of the damage.

In Brownsville, the scan cost $1,500.

Although Hainley would have only paid the $500 deductible required by her health insurance company, she found out that the same MRI at Centro Medico cost just $100.

"I don't just have $500 here and $500 there to throw around," she said.

The decision was a simple one to make. She had the scan performed at CMI where the doctors translated and forwarded the results to her surgeon in San Antonio.

She is scheduled to have her anterior cruciate ligament and meniscus repaired later this month.

"I can tell you I've have had an MRI here and there and it's the exact same thing," she said. "I would never get an MRI in Brownsville again."
anelsen@brownsvilleherlad.com