Yesterday, Jim and I went to the IMSS offices in Xalapa to sign up for Mexican health insurance. IMSS stands for Instituto Mexicano del Seguro Social. In Mexico, Social Security doesn't just cover retierment (actually, it covers more in the US, too) but covers health care, worker protecton, long term coverage for problems associated with work, retirment and child welfare. Started in 1943, it has idealistic goals but exists in a poor country. While it is designed for workers and their families, too many people can't find work with employers that are willing to pay for it if they can find regular work at all. Nonetheless, it is a pretty amazing effort, I suspect unique in less-well-off countries, to provide national health insurance as well as the other benefits mentioned above. According to the IMSS web page, it is "the largest social security institution in Latin America, fundamental pillar of the individual and collective well-being of Mexican society and principle redistributor of wealth in Mexico. It is undoubtedly one of the institutions most beloved by Mexicans." In a population of more or less 100 million people, close to 47 million people are covered by the government health insurance program. This is not to deny the huge problems of the poor in this country. The fact that cervical cancer is the fourth largest killer of women in Mexico alone speaks to the deficiencies. But still, the effort is remarkable, all the more so because the coverage actually does mean that close to half the population has access to decent if not fancy care. For people from the US, routine care is so inexpensive that it is practically under the radar for our US insurance deductible. If costs actually exceeded our deductible, our US policy would cover some portion of them. However, when we reach 65 and (hopefully) are covered by Medicare, Medicare will not cover treatment in foreign countries. So we paid $550 for the year for both of us. For the first two years, not everything is covered. But the third year, it is. Thus, if we need extensive treatment here, we will be able to pay for it. As I said it is more basic, but it is generally pretty good. We have friends from the US who have successfully had bypass surgery, been treated after a severe heartattack and been diagnosed and so far successfully treated for cancer, as well as for numerous less threatening conditions. For something requiring extensive and longer-term care, I'd probably want to go be near family in the states, but it is good to know there is decent care available here in case of immediate need.
There is kind of a standard procedure for getting permits, etc. here, and at first it is a bit annoying, but then you start to appreciate it -- and the fact that it actually represents a government efficiency. As for everything else we've had to apply for, you go to the relevant office, in this case IMSS, demonstrate your eligibility and get the first parts of your paperwork. Then you go to the bank, a private bank, to pay for the service. Then you go to the copy-making people, private again, in this case a couple of people with copying machines at the front of a little tienda selling sodas, etc, and get your copies, then you go back upstairs, fill out the rest of your forms and get your card or car sticker or whatever. Note that the banking and the xeroxing is "outsourced." Especially in the cae of the xeroxing, think how enormously efficient this is, how much it saves the government in copy machine costs, paper, bureaucracy associated with government equipment, etc. AND it provides jobs for people who don't have to go through civil service bureaucracy! Plus, they also get IMSS (Jim is going to say, are you sure? I haven't verified it, but I suspect being right across from IMSS, they do. The rates employers pay for workers are different from those expats pay.)
So anyway, we wandered out of the IMSS office into a very disturbing exhibition of paintings in the Carlos Fuentes Library -- main branch of the Xalapa public library. The exhibition was called "Migra" and I wish folks in the US could see it. The artist, extraordinarily skillful, uses a superrealist style -- with exaggeration and surrealist touches -- to portray just what migration to the US costs Mexican workers and their families. It was extremely disturbing. I will try to get some photos.
Photos, by the way will have to wait till next week since John our neighbor and Satellite Dish God is leaving for el campo for four or five days and taking our access to high speed with him. Pictures are impossibly slow to load on dial up.
After this exhibit, we walked across the street on the way to the car and stopped in the gallery under the Agora, the delightful cultural center in the main city park, where we saw what I have to call a whimsical and charming Frida Kahlo-Diego Rivera show which begins outside with two life-sized stuffed figures of the couple sitting on a bench at the entrance. Frida Kahlo and Diego Rivera might at this point seem "been there, done that," but this exhibit had some early and uncharacteristic work from both of them as well as a lovely history-via-personal photos. Frida's bed was hanging at a cockeyed angle from the high ceiling.
Today we have our second group Spanish lesson, this time at our house, with Jim and Mindy and Alberto and Jo. Have to go get ready!