Lack Of Insurance Drives El Paso, Texas, Residents Across The Mexican Border For Healthcare

Results from this study are published in the February issue of the Journal of the National Medical Association.

“This is the first report on the patterns of cross-border purchase of health care and medications from a random sample of persons living in El Paso [Texas] and Ciudad Juarez [Mexico], ” said Victor Cardenas, M.D., Ph.D., M.P.H, associate professor of epidemiology at the UT School of Public Health. Other study investigators were Jose Rivera, Pharm.D, director of The University of Texas at Austin Cooperative Pharmacy Program at El Paso; and Melchor Ortiz, Ph.D., professor of biostatistics at the UT School of Public Health.

According to the authors, cross-border medication shopping and medical attention can present health dangers, including medications laced with toxic substances that are banned in the U.S. market; incorrect medications or dosage prescribed by unqualified personnel; and counterfeit medications. The U.S. Food and Drug Administration (FDA) and Texas State Board of Pharmacy do not have any strict regulations against cross-border medication and U.S. Customs typically allows the entry of limited quantities of medications, Cardenas said.

The study found while 33 percent travel from El Paso to Ciudad Juarez, only 5.2 percent travel from Ciudad Juarez to El Paso seeking more affordable and easily accessible medication and health care services.

According to an estimate of the Pan-American Health Organization, 11.5 million people lived in counties along the U.S-Mexico border in 2000.  There are an estimated 2.3 million people living in El Paso and Ciudad Juarez, making it the largest bi-national metropolitan area in the U.S., according to the City of El Paso.

“The border region is underinsured and underserved in terms of healthcare provision. It is a major concern that clearly plays a role in the cross-border healthcare phenomenon,” Cardenas said.  He believes the lack of health insurance among El Paso residents is directly associated with crossing the border to purchase easily accessible prescription medications and healthcare services at lower costs.

Pharmacies and health care providers openly advertise their bilingual services to visiting U.S. residents. However, Rivera said many people receive their diagnosis and prescription at the pharmacy counter by nonprofessionals.

“This [study] is a mirror of what happens across the entire U.S.-Mexico border. The three main reasons people travel across border lines are affordable medications and services; savings on doctors’ fees by using a pharmacy attendant as a doctor; and the attentiveness of bilingual pharmacy attendants who can answer questions in depth for patients,” Rivera said.

According to Mexico’s National Institute of Statistics, Geography and Informatics, 62.3 percent of Ciudad Juarez residents are enrolled in government insurance plans, which provide them with more overall access to healthcare. Cardenas’ study found that 59.6 percent of El Paso residents and 82.8 percent of Ciudad Juarez residents were insured.

The study also found that Ciudad Juarez residents without insurance were three times more likely to travel to the U.S. to receive medical attention and purchase medications. Cardenas said that Ciudad Juarez residents who crossed the border were more educated, had more purchasing power and were not enrolled in government insurance plans. More men than women traveled to the U.S. to purchase medications with cash. 

Cardenas believes increasing the access to affordable health care in the United States would prevent most of the cross-border purchase of medications and use of medical services in Mexico.

The study was supported by funds from the Paso del Norte Health Foundation and received support from the University of Texas Health Science Center at Houston’s School of Public Health.