November 24, 1999

Health and Medical Care in San Diego and Baja California: Prospects for Collaboration

How can the most important of all human needs —health care— best be managed in our cross-border region? Health-care issues in the San Diego/Baja California region have recently emerged at the forefront of heated debate. How do the challenges of access on one side of the border affect health services and resources on the other? What can be done to clarify the legal rights of individuals needing emergency care and to improve regional access to trauma care? Are the public health systems effectively controlling communicable diseases? What is the role of private sector involvement in Baja California's health insurance industry? How might community-based organizations contribute to expanded health-care access on either side of the border?

As in many policy arenas, the U.S./Mexico border creates both challenges and opportunities for the development of health-care services. A high percentage of San Diego's population lacks health insurance, resulting in both uncompensated emergency care in San Diego and utilization of Baja California's less expensive health system and pharmacies. While health care is guaranteed by law in Baja California, the inadequately funded public health facilities subject patients to long waits for treatment and may not offer the latest technology or medications. More affluent Baja Californians often pay for medical services in San Diego. The less affluent, pushed by desperation to seek treatment unavailable at home, may go to extreme measures to obtain care north of the border. Others, particularly U.S. retirees and dependents resident in Baja California, may prefer to use medical services south of the border but are unable to obtain coverage under medicare or U.S.-based health insurance policies. It is clear that as a result of both increased binational residency and gaps in access to care, some residents of both San Diego and Baja California seek medical services on the other side of the border.

The public policy implications of this binational health-care region are not entirely clear. For this reason, San Diego Dialogue will host a Forum Fronterizo on Dec. 10 at the Sheraton San Diego Hotel and Marina, at 12:45 p.m.-2:30 p.m. to consider the most pressing issue of access to health services and medical care in the San Diego/Baja California region. The keynote speaker, Dr. Eduardo González Pier, a health economist and director of planning in the Mexican Institute for Social Security (Mexico's largest health-service provider), will discuss recent reforms in the Mexican health care sector. His presentation will highlight opportunities for the development of innovative services aimed at addressing the region's unique challenges. A panel of regional experts from the public and private sector will then address local perspectives. Marcela Merino, executive director of Fronteras Unidas Pro Salud; Dr. George Flores, public health officer for San Diego County, and Pablo Schneider, executive vice president of Blue Cross and Blue Shield de Mexico, will discuss the use of telemedicine for emergency and specialized health services, improved regulatory mechanisms in Baja California, revised cross-border health insurance regulations in California, portability of public and private health coverage across the border, cooperation in medical education and training, and establishment of a trauma center in Baja California. They will also explore potential policy actions for creating stronger ties among the public sector, community-based non-profits and private health insurance and health-care providers.

For additional information, please call (858) 534-8638.

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