The San Ysidro border crossing in southern California is a busy one – harried border guards wave through crowds of people chattering in Spanish and English as customs officials riffle through their bags.
And while many of those crossing are simply returning home after a long day of work in the US, many others are crossing for another purpose: health care.
On exiting the US, pedestrians making this crossing come face to face with a large pharmacy. About 50 metres from that – a full-service hospital. Along the busy roads snaking out from the border crossing are dozens upon dozens of medical and dental clinics, many with prominent signs in English.
All are catering to a surge in medical tourism brought about by the soaring cost of health care in the US, which pushes millions of people across the Mexican border every year in search of cheaper options.
The US spends about twice as much on health care as other industrialised nations, frequently with worse outcomes, as insurance middle men, hospital bureaucracies and other administrative costs siphon money away from patient care.
'Insurance doesn't do a lot of things'
Ahmed Abu, originally from Kenya, has lived in San Diego for about 20 years.
“I've been going almost, like, 15 years going back and forth to TJ [Tijuana] doing every kind of thing, even taking people there for medical reasons,” Mr Abu tells The National. “I go myself also for fixing my glasses, for the dentist.
“I have health insurance, but this health insurance doesn't do a lot of things.”
As a taxi driver, he has ferried many Californians as well as other people from across the US travelling to Mexico for medical purposes.
About 9 per cent of Americans have no health insurance, and even those with good coverage are often subject to high “co-pays” and deductibles that add thousands of dollars to costs.
Additionally, insurance companies can refuse to cover certain treatments deemed to be “elective”, such as orthodontic care, meaning that millions of Americans must either pay out of pocket or go without care.
In 2021, Americans paid about $433 billion for out-of-pocket medical and dental services.
Mexico, meanwhile, offers private services at much cheaper rates. The roughly one million Americans that travel to Mexico every year save between 40 per cent to 65 per cent on medical and dental procedures, according to Patients Without Borders.
And gaining access to this care is relatively easy – Americans only need a valid passport to enter Mexico on a six-month visa. The Tijuana government also offers passes that allow medical tourists to enter the country via a special lane, expediting the immigration process.
Adina Smith, a long-time resident of San Diego, has travelled to Tijuana several times for dental services.
“I know of about seven people that go [regularly],” she says. “I had heard from my friend what a great experience she had and the affordability of it.
“I had a great impression about the service that I received. The office was very clean and the dentist had great equipment, I never got an infection or anything like that. My dentist and the assistants spoke great English.”
Mia Nica, who is uninsured, has crossed into Mexico several times for medical care.
“Even if I did [have insurance], the cost would have been more accessible [in Mexico],” she tells The National.
“Most of my extended family and friends in California and Arizona go to Mexico, for dental work especially.
“They [the healthcare workers] were respectful, professional, the facilities was clean, the procedures clearly explained and the prices straightforward.”
The quality of service in Mexico is generally quite high – aspiring physicians in Mexican institutions face a rigorous preparation process that culminates in an exam to study a speciality.
And as medical school in Mexico costs only a fraction of what it does in the US, some American students looking to train as doctors end up crossing the border.
Eduardo Tanori, a professor at UC San Diego who helps international medical school graduates prepare for US board exams, told ABC 10News that students trained in Mexico have more than a 90 per cent pass rate.
Cost and quality
Dr Sergio Aviles has been practising orthodontics in Tijuana for almost 50 years.
“There is a lot of movement, there is a lot of money, there is a lot of demand”, especially in Tijuana, he tells The National, explaining that not only do healthcare professionals from all over Mexico come to the city to practise, but from all over the world as well.
“The demand [for health care in Mexico] … is basically due to three factors: the price – really, the most important – the language … and the warmth [of treatment],” he says, with this last referring to the bedside manner of Mexican doctors compared to American ones.
In his opinion, the only difference between quality of care in Mexico and the US is technology.
“They [in the US] have high technological quality but in human quality, Mexican medicine – or that of other countries – might be better,” he says.
Dr Sol Klaja, a dentist in Mexico City who treats many American patients every month, agrees.
“The major differences are the use of sedation, the cost and the care,” she adds, saying that the US has an advantage when it comes to technology – but not by much.
“It's the cost and quality of services” that brings Americans to Mexico, she says. The quality is “almost the same, but here is cheaper”.
Dr Francisco Contreras is director, president and chairman of Oasis of Hope Hospital, a cancer treatment centre.
He says that not only do American patients appreciate the warm bedside manner of Mexican doctors, but he also points out that, as malpractice is such a large concern, health professionals in the US are reluctant to explore alternative treatment options.
“A doctor in America is so threatened by lawyers, the patient, they very easily are sued,” Dr Contreras says. “So a doctor talks to the patient or through the patient to the patient's lawyer – and what I mean by that is, especially in cancer, they're gonna give you the worst-case scenario.”
Oasis of Hope and other cancer treatment centres in Tijuana offer alternative approaches to treatment that are either unavailable or not widely used in the US due to Food and Drug Administration restrictions.
“Patients that come from all over the world, especially from Europe or the States, [and] they love that they can actually sit down with a doctor and talk about possibilities of them surviving, and not just that they're going to die,” he says.
Risks
Travelling to Mexico for health care does not come without risks. Undergoing an invasive procedure and then travelling exposes patients to a higher possibility of infection.
In 2019, 11 Americans who had surgery in Tijuana returned home with dangerous antibiotic-resistant infections. Online forums are full of horror stories of quack surgeons flubbing surgery or suspicious generic drugs purchased in sketchy pharmacies causing severe reactions.
And most Mexican border towns, where the highest concentration of medical tourism infrastructure exists, have a high level of criminal activity and violence.
Tijuana is the most dangerous city in Mexico, with 138 homicides per 100,000 people. Mexico as a whole has a homicide rate that is seven times higher than the US, according to the UN.
A group of four Americans seeking health care in Mexico were kidnapped in Matamoros earlier this year. Two were ultimately killed.
Despite this, American medical tourists keep coming.
“At first it can be scary if you don't know your way around and you don't speak the language. However, people are very friendly and everyone I asked help of were more than willing to,” Ms Nica says.
Mr Abu adds: “I never had any issue.
“If you're going there for a medical purpose and you're staying in very nice places, you don't have any issue – no problem.”
Who was Alfred Nobel?
The Nobel Prize was created by wealthy Swedish chemist and entrepreneur Alfred Nobel.
- In his will he dictated that the bulk of his estate should be used to fund "prizes to those who, during the preceding year, have conferred the greatest benefit to humankind".
- Nobel is best known as the inventor of dynamite, but also wrote poetry and drama and could speak Russian, French, English and German by the age of 17. The five original prize categories reflect the interests closest to his heart.
- Nobel died in 1896 but it took until 1901, following a legal battle over his will, before the first prizes were awarded.
Australia squads
ODI: Tim Paine (capt), Aaron Finch (vice-capt), Ashton Agar, Alex Carey, Josh Hazlewood, Travis Head, Nathan Lyon, Glenn Maxwell, Shaun Marsh, Jhye Richardson, Kane Richardson, D’Arcy Short, Billy Stanlake, Marcus Stoinis, Andrew Tye.
T20: Aaron Finch (capt), Alex Carey (vice-capt), Ashton Agar, Travis Head, Nic Maddinson, Glenn Maxwell, Jhye Richardson, Kane Richardson, D’Arcy Short, Billy Stanlake, Marcus Stoinis, Mitchell Swepson, Andrew Tye, Jack Wildermuth.
The specs
Engine: 1.5-litre 4-cylinder petrol
Power: 154bhp
Torque: 250Nm
Transmission: 7-speed automatic with 8-speed sports option
Price: From Dh79,600
On sale: Now
RESULT
Manchester City 1 Sheffield United 0
Man City: Jesus (9')
COMPANY PROFILE
Name: Kumulus Water
Started: 2021
Founders: Iheb Triki and Mohamed Ali Abid
Based: Tunisia
Sector: Water technology
Number of staff: 22
Investment raised: $4 million
LIKELY TEAMS
South Africa
Faf du Plessis (captain), Dean Elgar, Aiden Markram, Hashim Amla, AB de Villiers, Quinton de Kock (wkt), Vernon Philander, Keshav Maharaj, Kagiso Rabada, Morne Morkel, Lungi Ngidi.
India (from)
Virat Kohli (captain), Murali Vijay, Lokesh Rahul, Cheteshwar Pujara, Rohit Sharma, Ajinkya Rahane, Hardik Pandya, Dinesh Karthik (wkt), Ravichandran Ashwin, Bhuvneshwar Kumar, Ishant Sharma, Mohammad Shami, Jasprit Bumrah.
Dhadak 2
Director: Shazia Iqbal
Starring: Siddhant Chaturvedi, Triptii Dimri
Rating: 1/5
WORLD CUP SEMI-FINALS
England v New Zealand
(Saturday, 12pm UAE)
Wales v South Africa
(Sunday, 12pm, UAE)
Polarised public
31% in UK say BBC is biased to left-wing views
19% in UK say BBC is biased to right-wing views
19% in UK say BBC is not biased at all
Source: YouGov
The%C2%A0specs%20
%3Cp%3E%3Cstrong%3EEngine%3A%3C%2Fstrong%3E%204-cylinder%202-litre%3Cbr%3E%3Cstrong%3ETransmission%3A%20%3C%2Fstrong%3E9-speed%20automatic%3Cbr%3E%3Cstrong%3EPower%3A%20%3C%2Fstrong%3E252%20brake%20horsepower%3Cbr%3E%3Cstrong%3ETorque%3A%20%3C%2Fstrong%3E352Nm%3Cbr%3E%3Cstrong%3EPrice%3A%20%3C%2Fstrong%3Efrom%20Dh146%2C700%3Cbr%3E%3Cstrong%3EOn%20sale%3A%20%3C%2Fstrong%3Enow%3C%2Fp%3E%0A
Director: Laxman Utekar
Cast: Vicky Kaushal, Akshaye Khanna, Diana Penty, Vineet Kumar Singh, Rashmika Mandanna
Rating: 1/5
Cinco in numbers
Dh3.7 million
The estimated cost of Victoria Swarovski’s gem-encrusted Michael Cinco wedding gown
46
The number, in kilograms, that Swarovski’s wedding gown weighed.
1,000
The hours it took to create Cinco’s vermillion petal gown, as seen in his atelier [note, is the one he’s playing with in the corner of a room]
50
How many looks Cinco has created in a new collection to celebrate Ballet Philippines’ 50th birthday
3,000
The hours needed to create the butterfly gown worn by Aishwarya Rai to the 2018 Cannes Film Festival.
1.1 million
The number of followers that Michael Cinco’s Instagram account has garnered.
Zayed%20Centre%20for%20Research
%3Cp%3EThe%20Zayed%20Centre%20for%20Research%20is%20a%20partnership%20between%20Great%20Ormond%20Street%20Hospital%2C%20University%20College%20London%20and%20Great%20Ormond%20Street%20Hospital%20Children%E2%80%99s%20Charity%20and%20was%20made%20possible%20thanks%20to%20a%20generous%20%C2%A360%20million%20gift%20in%202014%20from%20Sheikha%20Fatima%20bint%20Mubarak%2C%20Chairwoman%20of%20the%20General%20Women's%20Union%2C%20President%20of%20the%20Supreme%20Council%20for%20Motherhood%20and%20Childhood%2C%20and%20Supreme%20Chairwoman%20of%20the%20Family%20Development%20Foundation.%3C%2Fp%3E%0A
Milestones on the road to union
1970
October 26: Bahrain withdraws from a proposal to create a federation of nine with the seven Trucial States and Qatar.
December: Ahmed Al Suwaidi visits New York to discuss potential UN membership.
1971
March 1: Alex Douglas Hume, Conservative foreign secretary confirms that Britain will leave the Gulf and “strongly supports” the creation of a Union of Arab Emirates.
July 12: Historic meeting at which Sheikh Zayed and Sheikh Rashid make a binding agreement to create what will become the UAE.
July 18: It is announced that the UAE will be formed from six emirates, with a proposed constitution signed. RAK is not yet part of the agreement.
August 6: The fifth anniversary of Sheikh Zayed becoming Ruler of Abu Dhabi, with official celebrations deferred until later in the year.
August 15: Bahrain becomes independent.
September 3: Qatar becomes independent.
November 23-25: Meeting with Sheikh Zayed and Sheikh Rashid and senior British officials to fix December 2 as date of creation of the UAE.
November 29: At 5.30pm Iranian forces seize the Greater and Lesser Tunbs by force.
November 30: Despite a power sharing agreement, Tehran takes full control of Abu Musa.
November 31: UK officials visit all six participating Emirates to formally end the Trucial States treaties
December 2: 11am, Dubai. New Supreme Council formally elects Sheikh Zayed as President. Treaty of Friendship signed with the UK. 11.30am. Flag raising ceremony at Union House and Al Manhal Palace in Abu Dhabi witnessed by Sheikh Khalifa, then Crown Prince of Abu Dhabi.
December 6: Arab League formally admits the UAE. The first British Ambassador presents his credentials to Sheikh Zayed.
December 9: UAE joins the United Nations.
White hydrogen: Naturally occurring hydrogen
Chromite: Hard, metallic mineral containing iron oxide and chromium oxide
Ultramafic rocks: Dark-coloured rocks rich in magnesium or iron with very low silica content
Ophiolite: A section of the earth’s crust, which is oceanic in nature that has since been uplifted and exposed on land
Olivine: A commonly occurring magnesium iron silicate mineral that derives its name for its olive-green yellow-green colour
Secret Pigeon Service: Operation Colomba, Resistance and the Struggle to Liberate Europe
Gordon Corera, Harper Collins
The%20specs
%3Cp%3E%3Cstrong%3EEngine%3A%20%3C%2Fstrong%3E2.9-litre%20twin-turbo%20V6%0D%3Cbr%3E%3Cstrong%3ETransmission%3A%20%3C%2Fstrong%3E8-speed%20auto%0D%3Cbr%3E%3Cstrong%3EPower%3A%20%3C%2Fstrong%3E536hp%20(including%20138hp%20e-motor)%0D%3Cbr%3E%3Cstrong%3ETorque%3A%20%3C%2Fstrong%3E750Nm%20(including%20400Nm%20e-motor)%0D%3Cbr%3E%3Cstrong%3EPrice%3A%20%3C%2Fstrong%3EFrom%20Dh1%2C380%2C000%0D%3Cbr%3E%3Cstrong%3EOn%20sale%3A%20%3C%2Fstrong%3Enow%3C%2Fp%3E%0A
BEACH SOCCER WORLD CUP
Group A
Paraguay
Japan
Switzerland
USA
Group B
Uruguay
Mexico
Italy
Tahiti
Group C
Belarus
UAE
Senegal
Russia
Group D
Brazil
Oman
Portugal
Nigeria
FA CUP FINAL
Manchester City 6
(D Silva 26', Sterling 38', 81', 87', De Bruyne 61', Jesus 68')
Watford 0
Man of the match: Bernardo Silva (Manchester City)
Zayed Sustainability Prize
KILLING OF QASSEM SULEIMANI
Specs
Engine: Duel electric motors
Power: 659hp
Torque: 1075Nm
On sale: Available for pre-order now
Price: On request
UAE currency: the story behind the money in your pockets
Brief scores:
QPR 0
Watford 1
Capoue 45' 1
Race results:
1. Thani Al Qemzi (UAE) Team Abu Dhabi: 46.44 min
2. Peter Morin (FRA) CTIC F1 Shenzhen China Team: 0.91sec
3. Sami Selio (FIN) Mad-Croc Baba Racing Team: 31.43sec
Oppenheimer
%3Cp%3E%3Cstrong%3EDirector%3A%20%3C%2Fstrong%3EChristopher%20Nolan%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EStars%3A%20%3C%2Fstrong%3ECillian%20Murphy%2C%20Emily%20Blunt%2C%20Robert%20Downey%20Jr%2C%20Florence%20Pugh%2C%20Matt%20Damon%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ERating%3A%20%3C%2Fstrong%3E5%2F5%3Cbr%3E%3C%2Fp%3E%0A
PROVISIONAL FIXTURE LIST
Premier League
Wednesday, June 17 (Kick-offs uae times) Aston Villa v Sheffield United 9pm; Manchester City v Arsenal 11pm
Friday, June 19 Norwich v Southampton 9pm; Tottenham v Manchester United 11pm
Saturday, June 20 Watford v Leicester 3.30pm; Brighton v Arsenal 6pm; West Ham v Wolves 8.30pm; Bournemouth v Crystal Palace 10.45pm
Sunday, June 21 Newcastle v Sheffield United 2pm; Aston Villa v Chelsea 7.30pm; Everton v Liverpool 10pm
Monday, June 22 Manchester City v Burnley 11pm (Sky)
Tuesday, June 23 Southampton v Arsenal 9pm; Tottenham v West Ham 11.15pm
Wednesday, June 24 Manchester United v Sheffield United 9pm; Newcastle v Aston Villa 9pm; Norwich v Everton 9pm; Liverpool v Crystal Palace 11.15pm
Thursday, June 25 Burnley v Watford 9pm; Leicester v Brighton 9pm; Chelsea v Manchester City 11.15pm; Wolves v Bournemouth 11.15pm
Sunday June 28 Aston Villa vs Wolves 3pm; Watford vs Southampton 7.30pm
Monday June 29 Crystal Palace vs Burnley 11pm
Tuesday June 30 Brighton vs Manchester United 9pm; Sheffield United vs Tottenham 11.15pm
Wednesday July 1 Bournemouth vs Newcastle 9pm; Everton vs Leicester 9pm; West Ham vs Chelsea 11.15pm
Thursday July 2 Arsenal vs Norwich 9pm; Manchester City vs Liverpool 11.15pm
MATCH INFO
Azerbaijan 0
Wales 2 (Moore 10', Wilson 34')
More on animal trafficking
Mercedes-AMG GT 63 S E Performance: the specs
Engine: 4.0-litre twin-turbo V8 plus rear-mounted electric motor
Power: 843hp at N/A rpm
Torque: 1470Nm N/A rpm
Transmission: 9-speed auto
Fuel consumption: 8.6L/100km
On sale: October to December
Price: From Dh875,000 (estimate)
Who is Allegra Stratton?
- Previously worked at The Guardian, BBC’s Newsnight programme and ITV News
- Took up a public relations role for Chancellor Rishi Sunak in April 2020
- In October 2020 she was hired to lead No 10’s planned daily televised press briefings
- The idea was later scrapped and she was appointed spokeswoman for Cop26
- Ms Stratton, 41, is married to James Forsyth, the political editor of The Spectator
- She has strong connections to the Conservative establishment
- Mr Sunak served as best man at her 2011 wedding to Mr Forsyth
The biog
Favourite food: Fish and seafood
Favourite hobby: Socialising with friends
Favourite quote: You only get out what you put in!
Favourite country to visit: Italy
Favourite film: Lock Stock and Two Smoking Barrels.
Family: We all have one!
MATCH INFO
Europa League final
Who: Marseille v Atletico Madrid
Where: Parc OL, Lyon, France
When: Wednesday, 10.45pm kick off (UAE)
TV: BeIN Sports
MATCH INFO
Manchester City 3 (Sterling 46', De Bruyne 65', Gundogan 70')
Aston Villa 0
Red card: Fernandinho (Manchester City)
Man of the Match: Raheem Sterling (Manchester City)
