Seguro Popular vs IMSS

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Re: Seguro Popular vs IMSS

Post by E-raq on Thu Dec 13, 2012 10:49 am

Trailrunner wrote:Coffeeguy, you clearly have an ax to grind with IMSS. Tired of it. Some of us have good experiences with them and according to a recent GR article they have an 80% satisfaction rate with the Mexican population.

I have a friend in Joco who was just diagnosed with breast cancer by her private obgyn who immediately called IMSS Joco who said to send her right over to the Joco clinic from the obgyn office. She did and was taken in directly to the doc who approved an appt in Tlajomulco the next day for evaluation and to begin pre-op testing. They told her to pack a bag in case. She went up at the crack of dawn, people treated her well, many patients stepped up and helped her navigate the system and translate and she saw docs who scheduled more pre-op testing and allowed her to go home. She has been completing her pre-op this week and will have consult with anesthesiologist the rest is up to him or her. She expects surgery following appt with anesthesiologist's approval. Elapsed time so far? One week.


Frankly my thrombosis operation at IMSS went extremely well. Could not have been better frankly. The surgeon is a genius. We now see him privately, however if either of us needed any angio surgery we'd likely try to see if it could be done at IMSS then transfer to a private, surgery only, hospital for recuperation.

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Re: Seguro Popular vs IMSS

Post by coffeeguy on Thu Dec 13, 2012 5:48 pm

Trailrunner wrote:Coffeeguy, you clearly have an ax to grind with IMSS. Tired of it. Some of us have good experiences with them and according to a recent GR article they have an 80% satisfaction rate with the Mexican population.

I have a friend in Joco who was just diagnosed with breast cancer by her private obgyn who immediately called IMSS Joco who said to send her right over to the Joco clinic from the obgyn office. She did and was taken in directly to the doc who approved an appt in Tlajomulco the next day for evaluation and to begin pre-op testing. They told her to pack a bag in case. She went up at the crack of dawn, people treated her well, many patients stepped up and helped her navigate the system and translate and she saw docs who scheduled more pre-op testing and allowed her to go home. She has been completing her pre-op this week and will have consult with anesthesiologist the rest is up to him or her. She expects surgery following appt with anesthesiologist's approval. Elapsed time so far? One week.

I'm very happy to hear about this and should've been clearer. Our bad experiences have been only with the Chapala clinic and under the administrator who many had problems with there (who I gather may have left). Most likely had we registered in Joco instead we'd have had no problems with coverage. There is no question whatsoever that the Chapala IMSS office has booted a large number of folks out of IMSS who'd paid in diligently for years and used their services either not at all or only for emergencies.

I've also talked to several doctors in the area who've worked for IMSS for years, and they've told me that IMSS hospitals and facilities in Jalisco are among the worst in the IMSS system - due in part to non-participation in IMSS by the wealthy in Guadalajara. Two of them have told me that under no circumstances would they or their families be treated in an IMSS hospital, but admittedly these are folks with the means and connections to make other choices. I am glad IMSS is there for those lucky enough to have kept their coverage but as the recent article in the Guadalajar Reporter pointed out they are going broke very quickly and given the problems in this area I would think they are truly a last resort for most.

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Re: Seguro Popular vs IMSS

Post by Dr. Sam Thelin on Tue Dec 18, 2012 10:19 am

Hello Everyone. I will elaborate more on the Mexican medical system when I get a little more time to finish a flowchart I am writing (yes, it is really that complex) for the Chapala Review’s January 15th ed.

First the “strongest” pain medication we have is “ketorolaco” 30mg I.V. / I.M. and tramadol 100mg I.V. / I.M. Both can be used together, as they are completely different classes of medication with a different mechanism of action. However, tramadol needs to be given slowly to avoid nausea and vomiting, and ketorolaco affects the platelets similar to aspirin (but for less time), and would not be the best choice for someone who is bleeding, has internal injuries, or who will enter surgery soon. We also have “clonixinato de lisina” which does not have the side effects of the other two, and it has been a very good option for most trauma patients, and it can be given with tramadol to lower the pain.

We do not have any class 1 medications (such as morphine) nor do we have legal permission to have them. The process to have that permission is, for us, a 5-step process (that the medical director before me never cared to do – nor the one before her, or the one before the one before her, etc, etc). We have already completed the first step, and will have the second step completed in January. Hopefully within 2 to 6 months we will have done all the required steps and have those medications.

I.M.S.S. or Seguro Popular? If anyone thinks that Seguro Popular in the Guadalajara area is in any way comparable to IMSS, it is not. In areas such as Ciudad Guzman, Tamazula, Tepatitlan, etc., there are regional hospitals that area associated with Seguro Popular, and you may even have a better chance of having faster (but not better) care than with IMSS simply because of location to the hospital, and lower number of patients in the area. However, for the 1-hour radius around Guadalajara, every uninsured and Seguro Popular patient goes to the same place for major medical situations:

Hospital Civil "Fray Antonio Alcalde" (Viejo)
Calle Hospital #278 (urgencias adultos) Calle Hospital #310
Calle Coronel Calderón #777 (urgencias pediatría)
Colonia Centro

or to:

Hospital Civil "Dr. Juan I. Menchaca" (Nuevo)
Salador de Quevedo y Zubieta #750, S.L.

Or maybe for trauma, one of two Cruz Verdes that offer trauma surgery.


If you have IMSS, you have access to several full-service hospitals such as: Centro Medico, hospital 180, hospital 110, hospital 46, hospital 14, hospital 89, hospital 45, as well as at least 30 other IMSS clinics.

IMSS = More capacity, more beds, and more services.
Seguro Popular = Less services, less capacity.

My advice: Get IMSS if you can. Keep in mind that they may deny you coverage or cancel you for any pre-existing condition, or any new condition. Go to your private doctor first to get general blood work (cholesterol, glucose, etc), chest x-ray, and you blood pressure checked. Make sure ALL is good, or under control BEFORE you apply and submit to the physical. Make sure everything is under control for any “check up” with them BEFORE you go. Never, NEVER use them for treating minor conditions. Your 142/92 mm/Hg can be treated by your private doctor. Save your IMSS for cancer, stroke, heart attack, or major accidents.

Plan B. Get Seguro Popular. It will cover many useful things, but never expect it to cover you in an emergency event. You have higher odds of dying while waiting for emergency service than being treated rapidly. Remember that a 10-year-old girl with 35% of her body burned, and a 45-year-old drunk with a knife in his abdomen have a higher probability of survival if treated rapidly than a 75-year-old male with acute chest pain. They will always be ahead of you on the triage list. If there are 2583 patients and 742 beds, do not think you will get one of them. Buy extra private insurance, and/or have a private doctor with the connections to get you into a private hospital (and have the money to pay).


Dr. Sam Thelin
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Re: Seguro Popular vs IMSS

Post by ferret on Tue Dec 18, 2012 11:54 am

Dr. Thelin...AWESOME post! Thank you for taking the time and welcome!

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Re: Seguro Popular vs IMSS

Post by E-raq on Tue Dec 18, 2012 12:33 pm

ferret wrote:Dr. Thelin...AWESOME post! Thank you for taking the time and welcome!


Just super, and another welcome to the forum. This is of tremendous help to us since generally speaking information is spotty, at best.

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Re: Seguro Popular vs IMSS

Post by coffeeguy on Tue Dec 18, 2012 1:33 pm

That is the best post on this subject I have ever read, anywhere, and I thank you so much for taking time that I am sure is in scarce supply to share the information. Thanks so much!

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Re: Seguro Popular vs IMSS

Post by CanuckBob on Tue Dec 18, 2012 3:40 pm

Welcome to the forum Dr. Thelin. Mucho gracias for the excellent information.

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Re: Seguro Popular vs IMSS

Post by Dr. Sam Thelin on Tue Dec 18, 2012 4:01 pm

Thanks. I will write about S.A.M.U. and all the emergency options next chance I get. I will have to see if I can insert a .jpg flowchart here, or attach a .pdf file to explain it well.

Here is a basic Wiki page on it, but the info only tells what it is, not how it works for us here. http://es.wikipedia.org/wiki/SAMU


Last edited by Dr. Sam Thelin on Tue Dec 18, 2012 4:02 pm; edited 1 time in total (Reason for editing : kant spel)

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Re: Seguro Popular vs IMSS

Post by Bandol on Tue Dec 18, 2012 4:19 pm

Dr Sam, can you recommend two or three private hospitals in Guadalajara that give good quality care at a cheap price? I'm not talking about places such as Puerto de Hierro or San Javier but those within the means of ordinary people. Thank you.

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Re: Seguro Popular vs IMSS

Post by Trailrunner on Tue Dec 18, 2012 10:25 pm

Great post, Sam. Thanks.

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Re: Seguro Popular vs IMSS

Post by joec on Tue Dec 18, 2012 11:52 pm

Dr. Sam - Thank you for the post. My neighbor has Seguro Popular so I copied and pasted your post and sent it to them via email.

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Re: Seguro Popular vs IMSS

Post by Hensley on Wed Dec 19, 2012 1:19 pm

I disagree with this comment:
Never, NEVER use them for treating minor conditions.

You should get to know them and have a great relationship with them. We brought donuts to everyone in the clinic yesterday.

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Re: Seguro Popular vs IMSS

Post by Dr. Sam Thelin on Wed Dec 19, 2012 3:39 pm

There seem to be 3 classes of private hospitals. The upper level like San Javier, the older but good ones like Hospial Bernadette, then the smaller ones that some of the poorer Mexicans use when they cannot get into Hospital Civil. One is Hospital de la Luz. I know nothing about it, and will have to investigate a few more of the smaller hospitals and get back with you.

Bandol wrote:Dr Sam, can you recommend two or three private hospitals in Guadalajara that give good quality care at a cheap price? I'm not talking about places such as Puerto de Hierro or San Javier but those within the means of ordinary people. Thank you.

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Re: Seguro Popular vs IMSS

Post by Dr. Sam Thelin on Wed Dec 19, 2012 3:45 pm

I disagree with you disagreeing with my comment :P

True story:

Healthy American buys IMSS coverage.
Heathy American "builds a great relationship" with them.
IMSS clinic notes blood pressure as 140/85 mm/Hg
IMSS records patient as having hypertension
IMSS denies patient renewal based on "pre-existing condition" of hypertension that they diagnosed.
Patient lost that nice fuzzy "great relationship" with IMSS.


Hensley wrote:I disagree with this comment:
Never, NEVER use them for treating minor conditions.

You should get to know them and have a great relationship with them. We brought donuts to everyone in the clinic yesterday.

Dr. Sam Thelin
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Re: Seguro Popular vs IMSS

Post by joyfull on Wed Dec 19, 2012 6:08 pm

Dr. Sam Thelin wrote:I disagree with you disagreeing with my comment :That makes a lot of sense Dr.Sam. Why give them a chance to find something wrong during a visit for "something small." then when you need them for "something big" they deny it because of that. Smart thinking.

True story:

Healthy American buys IMSS coverage.
Heathy American "builds a great relationship" with them.
IMSS clinic notes blood pressure as 140/85 mm/Hg
IMSS records patient as having hypertension
IMSS denies patient renewal based on "pre-existing condition" of hypertension that they diagnosed.
Patient lost that nice fuzzy "great relationship" with IMSS.


Hensley wrote:I disagree with this comment:
Never, NEVER use them for treating minor conditions.

You should get to know them and have a great relationship with them. We brought donuts to everyone in the clinic yesterday.

joyfull
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Re: Seguro Popular vs IMSS

Post by coffeeguy on Thu Dec 20, 2012 12:09 pm

So Dr. Sam's newest post gets us back to the "rock and a hard place" choices folks with limited means seem to be dealing with here. Seguro Popular has only 2 hospitals but you can enroll for free and have access anywhere you travel in the country (whatever good "access" may be); IMSS has more facilities but locally has worked very hard to deny coverage to expats (including many who have paid in for years) and is going broke on a national level.

Two comments made by a long-time resident on TOB may also deserve discussion:

Seguro Popular has agreements with private hospitals and clinics, so if you can pay a little you can be sent to a hospital like San Javier at a discounted price. If someone has paid $300 a year for IMSS and say after 10 years he is bumped out of IMSS, that $3000 would pay for a lot of private care at an SP affiliated private hospital. One person said he had a gallbladder removed at a private clinic, the appointment handled by his SP doctor, and the GB surgery cost him $1000 dollars instead of $3000.

If you have any money at all, you can be referred to a private hospital that works with SP. The University of Guadalajara works with SP, San Javier, numerous private doctors and clinics. With IMSS you take a real chance that when you need it, you will be denied service. If you travel and become ill, you will be told to return to where you are registered with IMSS. SP covers you throughout Mexico.

You never know what claim of a preexisting condition IMSS will say you have when you need care, but it has happened to people who had IMSS for years and when they needed. it they lost their coverage.

Mexico is trying to take people out of IMSS and place them into SP


My questions for anyone who truly knows are: is it true that it's worth registering with SP in order to have access to discounted rates at private hospitals, and in the event of serious trauma injury or a cardiac event or other life-threatening situation what are the best private hospitals in Guad.?

coffeeguy
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