This story is part of the Health Diaries series where we report the struggles and actions of Americans who, despite having insurance, must cross the border into Mexico to get the healthcare they need.
Elizabeth is a 31-year-old single mother who works as a case manager for a foster care agency and longs to create a better life for both her and her daughter. Elizabeth has type 1 diabetes and hypothyroidism, and her health insurance is inadequate for her needs. She must take insulin daily, and a vial costs almost $100. She struggles to pay for medication and other expenses due to her monthly wages—while the cost-of-living increases, her salary remains the same. When Elizabeth asked her bosses to give her access to better insurance, they advised her to join a gym and lose weight, a reaction she found profoundly upsetting.
When Elizabeth moved to Texas, she was thrilled that she could maintain a relationship with her primary care physician in her former state through telemedicine covered by her insurance. She values a doctor who is sympathetic to her needs and with whom she can have an open conversation; she feels that the doctor really sees her as a whole person rather than just seeing her illnesses and blaming her for being overweight. Her insurance also covers vision screenings, allowing her to receive contact lenses and free glasses for herself and her child. Nonetheless, the cost of insulin is an enormous burden, and Elizabeth has turned to care in Mexico, where she feels like she is accepted as a person.
Elizabeth travels to Mexico around five times a year for holidays and to visit family and friends. She has been traveling to Mexico since she was a child when her parents obtained medical care for themselves and her siblings in Mexico. They have always made it a family affair and go out to eat with their extended family; see doctors, optometrists, and dentists; and pick up antibiotics on the way home. It has become a family tradition for them. She explains that now that her aunts are nurses, she will bring her prescriptions, and they will help her find what she needs in Mexico.
Elizabeth is cautious about care in Mexico because her brother had a medical operation that went wrong as a child, leaving him unable to walk and with a speech impediment. Elizabeth gets insulin, antibiotics, pain killers, topical pain cream, pedicures (as medical care for diabetes), allergy medications, chocolates, alcoholic beverages, and food while in Mexico. She has also had dental work including root canals in Mexico. But Elizabeth does not want other care from Mexico—she prefers to use insulin from the United States and only uses the Mexican-sourced insulin when she must. The insulin costs about $50 for 5 vials in Mexico and she likes to keep them in her purse, her room, and her car at all times, just in case. Once, Elizabeth went to her daughter’s out-of-town soccer tournament and was grateful to have her extra insulin because she forgot her main one at home. She is also prescribed medication for her thyroid, but she buys them in the U.S. because they are affordable with her insurance. She does a lot of comparison shopping to make the best choices for her health.
If she had enough money, Elizabeth would not buy any healthcare product or service from Mexico. But costs and availability in the United States, as well as inadequate insurance coverage, have led her to make purchases she would prefer not to make in Mexico.