Updated 2018

The scam is as old as the hotels lining the beaches of Acapulco, where it might have been invented.

A guest is staying at a resort and has stomach pains. Being a foreigner and without a local doctor, when the pains worsen, he asks the resort if they have a doctor on call. A doctor arrives with all the gracious bedside manner you expect from a Mexican doctor (that is to say extremely caring). The pain seems a little unusual, he says. Maybe it should be checked out. Since the visitor does not have a car, the doctor offers to take him to the clinic himself.

He enters a nicely-appointed professional clinic for a sonogram, and sure enough, the pain is the appendix, the technician says, tapping at the film. While not a radiologist, the patient has no reason not to believe him.

In the car on the way to the hospital the doctor has selected, the foreigner begins to wonder out loud what this will cost. After a long pause, the doctor gives him the cost.

This last part is where the scam begins, with the doctor testing the waters for how deep his patient’s wallet is.  The tourist has no way of knowing if the price quoted is a normal fee in a foreign country. He remains silent.

Since his regular insurance doesn’t cover him in another country, he will be charged on his credit card, beginning with a 50,000 peso “deposit,” a common practice in most hospitals. 

It seems odd to him that the doctor would have such an exact figure before he’s even checked into the hospital.  Once checked in, he is introduced to one other doctor (who turns out not to be the doctor who performs the surgery. Details, details).

The surgery takes place. Whereas in the United States, insurance often won’t cover even an overnight stay in the hospital for an appendectomy if performed in the morning, in Mexico the patient stays in the hospital for two nights, not terrifically worrisome because a hospital stay in Mexico usually ranges around $130 a night.

On the morning of his check out, the patient is presented with a bill, which is (surprise, surprise) exactly the same amount quoted in his ride to the hospital, and more than three times what a Mexican would pay for the same surgery in the same hospital.  

Being billed exactly the same amount as quoted by the primary doctor could only lead the patient to believe the figure was passed on the hospital administrators who prepared the bill as being the fee the patient is willing to pay, the amount fielded by the general doctor in the care ride, a hugely inflated price.

As you may have guessed by now if you’ve read previous blogs, the patient was me. The fact that Clinica del Mar would charge me three times what they would a Mexican patient did not surprise me. I totally expected that.

As a Mexican friend puts it, "Mexican rip-offs are just a cheap copies of American ones." True that. U.S. healthcare fraud cases often involve millions of dollars.  

Considering the shenanigans going on in American health care; $645 band-aids and $86,000 a year cancer drugs, one can hardly be shocked to find medical opportunism in a Mexican hospital or clinic.

I was able to circumvent some of the cost because I had a Mexican friend with extensive local medical contacts who was able to get what fees were normally charged at that hospital for that exact surgery.

Being a native of the city with a lot of contacts, she was also able to bring to light the fact the primary doctor who brought me to the clinic was the ex-wife of the doctor I’d met before surgery. Such cooperation is not illegal but certainly, raises more questions, questions I'll never be able to answer.

Four people from the hospital came in to present me with my bill the morning of my discharge. Armed with the information gathered by my friend, I was able to reduce it substantially. I admit that I buckled and paid twice, rather than three times, the normal fee. It was a fraction of what the same surgery would cost in the U.S, but in the U.S., my insurance would have covered it.

Trusting my doctor and the surgery being so common, and being in pain, I didn't have many questions, nor was anything really explained to me before the surgery after I checked in. Later I learned that doctors are required by international law to explain the procedure and possible outcomes in your language. While it's not unusual for the rule to be ignored, know that you can insist.  

None of this was the scary part.

I had no illusions about having any recourse to disputing the bill I'd signed off on after I left the hospital. Banks can doing nothing for you. 

However, attorneys are inexpensive in Mexico. I thought it would be worth 600 pesos to have the medical records (which were of course in Spanish) examined.  

My attorney, who is also a doctor, found many irregularities in the itemized bill, including my being billed for cancer drugs, the cost of an extra surgeon in the operating room (hospitals in the U.S. pull that too) and an extra night’s stay (I suspected that already).

As he explained, the collusion between resort doctors and local clinics has been going on for decades.  He first became familiar with it in Acapulco decades ago, with doctors and the resorts themselves getting kick-backs. Any resort town catering to Canadians or Americans would be a ripe territory.  This sort of corruption in Mexico is hardly breaking news.

That’s still not the scary part.

The scary part was the letter from the doctor who documented the surgery. The letter included a page of symptoms I never had. If fact, according to my attorney, it was likely I didn’t need the surgery at all.  

Along with the letter of false symptoms, he pointed out that appendectomies are usually performed right away, whereas mine was not scheduled for eight hours after checking in. 

Mexican doctors, in general, have excellent reputations among expats. While I would expect billing opportunism, that a doctor would fabricate a page of symptoms is utterly terrifying.

At least it wasn’t a kidney. But lying on a medical document adds a whole new and frightening prospect to getting sick (or even being examined) in Mexico, or at least in Mazatlán.

Quite possibly the corruption stems not strictly from the doctors, but the hospital and clinic owners, people who haven’t dedicated a good deal of their lives learning how to care for patients nor taken any pesky Hippocratic oaths.  Clinics are frequently shut down in Mexico.

Owners of clinics and hospitals could be of any “business” background. Doctors are complicit if they falsify diagnoses but who knows what pressure they might be under from above to make money for the clinic (not unheard of in American hospitals either)?

As common as stomach pains are, the need for an appendectomy would be easy to fake and such a common surgery wouldn’t have many risks. No one needs their appendix.

I will never know.  Even if the surgery was necessary, there’s not a doubt about the collusion and inflated fees.

Mexperience.com, a reputable "how-to" online resource on Mexico describes all the favorite retirement destinations for Americans, usually including details on the quality of healthcare facilities along with weather and other attributes.

Rather mysteriously, in spite of Mazatlán having at least three major hospitals including a new and modern one, Mexperience tells readers to go to Guadalajara (six hours away) for their healthcare needs in the site’s description of Mazatlán.

You might be surprised by my telling this story given the previous positive blogs I wrote about the experience. The point of the earlier blogs was to give credit to my Mexican friends, who stayed in my room both nights and did the research that enabled me to have a little leverage when I checked out.

Nurses were kind and competent. The room ample enough for overnight guests. I don’t want to discredit the entire Mexican healthcare system over a few rotten apples or a few scams.

Hospitals and specialists in Guadalajara, Mexico’s second-largest city, have excellent reputations for world-class care. People living in popular expat retirement destinations such as San Miguel de Allende, Lake Chapala, Guanajuato, and Mazatlán are often advised to go to Guadalajara for more serious medical care. Monterrey and Mexico City along with Guadalajara are considered the hubs for top-flight hospitals and treatment.

 Many expats choose cities surrounding these cities in which to retire. Over the next few months, I’ll be traveling to Guadalajara to research the healthcare processes and facilities in that city and talk to expats about their experiences for future blogs.

The lesson here is to know your way around the healthcare system you choose ahead of any need. The time to find your doctors is before you need them, especially in Mexico. 

My biggest mistake was not realizing how inexpensive travel insurance was. Somewhere along the way, I had gotten the impression it was prohibitive, probably because it can be if the coverage is wrapped around coverage for flight mishaps and cancellations.

When you are only purchasing coverage for health emergencies, it's substantially less. Coverage for six months in Mexico (180-day limit) would have only cost me $105.  With coverage, I would have been given the name of the providers in the network. I don't know if this clinic would have been in the network or not, and the same scam would have still occurred if it was, but at least I would not have had to pay for it.

Related links:  

To get you started, Monica Paxon has written a great general guide, "The English Speaker's Guide to Medical Care in Mexico." 

For an idea of the money involved in American Medical fraud, you can look at information by the National Healthcare Anti-Fraud Association.

Next up: Dental costs in the U.S., as you may have noticed if you don't have dental insurance, have sky-rocketed, and little behind that and what Mexico has to offer.

This story details a woman "held hostage" by a Nuevo Vallarta hospital until she coughed up $30,000. 

Most recent: The cost of living in America's greatest cities is going up, up.  The adventure of a foreign country can provide spice without the price.

Kerry Baker is a partner with Ventanas Mexico and author of two books, the "Interactive Guide to Learning Spanish Free Online" and "If Only I Had a Place," on renting in Mexico, which includes a listing of rentals concierges for each popular expat area (contact me for Guadalajara, recently added). 

The Interactive Guide to Learning Spanish Free Online offers you the means to create new study plans every day, from over 800 online sources (300 were researched).  

The guide was written specifically for expats and those considering retiring to a Spanish-speaking country. 

Being an interactive book, you can study on either side of your journey from your laptop, e-reader to tablet like a Kindle Fire,  tools that are a must for anyone who can't haul books around. 

Speaking the language helps you make native friends and saves you money. Learning a second language has been proven to be one of the best ways to protect the brain. Why not get started today?