Monday, March 29, 2010

I filled my purse with drugs in Mexico

I've been sick for a couple of weeks.  ...  coughing all day long, and all night too.  My head never unstuffed, lying down frequently.  At 3:30 on a Thursday afternoon I decided I needed to see a doctor and so I got on a bus and rode for 15 minutes to the big 2 story modern IMSS  clinic.  I'd never been there before, but since I'm now enrolled in the public healthcare system by virtue of my husband teaching part-time at a Mexican university, I thought it was time to check it out.  All  I knew before showing up was we'd been assigned  to consultory #10.

The IMMS (Institututo Mexicano de Seguro Social) building on Camelinas in Morelia is a hospital sized,  two story modern building.  Inside, both floors have one huge central hallway.  Examining rooms run along either wall.  In front of each room is a counter manned by a receptionist.  The rooms are numbered and there are chairs in 3 rows in front of each room with seating for about 20.  At  #10 consultorio all the seats were full and the receptionist told me that to get an appt. that afternoon I should have shown up between 1 and 1:30.  I'm sorry, I said, can I get an appointment for tomorrow?  That wasn't necessary, I just needed to  go to a different receptionist upstairs and get a special exception appointment and wait to see one of the two overflow doctors.   I found the proper desk on the second floor, made my pitch, was added to a roster  and reported back to receptionist  #10.  She showed  me  the area where I'd be waiting with about 30 other people who were also special exceptions (many of the 30 were together... a parent and kid, an adult with an elder, etc.)  Then she took me to a room and left me with  a nurse sitting behind a metal desk.  I sat down in front of her while she examined my credential which is really a little booklet with my photo and address.  She flipped through the pages.  Have you had a tetanus shot lately?  I'm up to date on that.  Pap-smear, breast exam?  It's been a couple of years.  Would you like to have them today while you wait for your other appointment?  Okay....  Let's also check your blood sugar -- here's a little jab in your finger.  Oh, good result.

After I had been examined and had redressed, she handed me a complimentary toothbrush and some condoms and wrote my vital statistics in my booklet and also the date to come back for my pap smear results.

I went to sit in the overflow waiting area and read my book.  I had no delusions that I'd be seen soon.  Some people seemed to have very long consults!  But  after an hour and a half during which time I read and conversed with the young man next to me in English about his low sperm count,  the receptionist from consultory #10 came to find me.  All #10 patients had been seen for the day so I could see that doctor.  I explained my symptoms and showed the doctor the medications I'd been taking that hadn't been working to stop the cough or clear my head.  He examined me and concured with my own opinion that I had a nasty allergy, probably spring related.  He prescribed a cough syrup, an antibiotic because my passages were inflamed and were becoming infected,  loratadine, plus one other thing I've never heard of.  He told me not to go barefoot, not to drink cold beverages, and to avoid chills and sent me on my way.

The IMSS pharmacy is in the same building and I gave my presciptions to the pharmacist.  In about a minute he piled 10 little boxes and bottles (2 containers for each of the meds plus 3 bottles of loratadine tablets) on the counter and disappeared.  I stood there waiting for him to come back until Mr. Low Sperm Count noticed me and came to explain that the medications were mine and I should take them from the counter.   I couldn't really believe that.  But he showed me some of the boxes of pills in his pants pockets. So I slid all the medications into my purse on top of the toothbrush and the condoms and walked out feeling a little like a kid on Halloween.

It's been four days now since my IMSS visit and I'm feeling less congested and sleeping better.  But I'm still not over the shock of the public healthcare experience.  I'm never going to see a bill.  As one of those Americans who, with my husband who has a chronic health condition, has written monthly checks of $800 for health insurance that had a co-payment so high that in recent years my check-ups were out-of-pocket expenses as were any prescriptions, who has been denied reimbursement for a major medical emergency, whose every thought of illness was a thought of financial crisis.... to suddenly find myself  having my preventative care needs ascertained and served and to be given free medications ... and to think it's because my husband is teaching Part-Time -- it's pretty hard to fathom.

Not that things were bad here before we joined the public health system.  It's always been reasonable and easy to see a doctor.   Even to see a specialist, you don't usually need an appointment.  Over the last ten winters we've seen a gynecologist, a urologist, internist, sports doctor, ear nose and throat doctors... we've never paid more than $50 for a consultation, and to see our neighborhood GP it costs $15.  Dental care is a fraction of what is paid in the US.  In fact many middle class and upper class Mexicans who belong to IMSS don't bother to use it.  They don't like the wait and the crowd, they'd rather pay on the open market and many buy private health insurance so they can use the non-IMSS hospitals like Star Medica .  But for me IMSS was like a visit to an exciting new world.  I can't imagine not going back.