The US-Mexico border crossing at Tijuana, Mexico. The US's "dental refugees" flock to Mexico in the thousands every day, seeking affordable care.Philippe Turpin / Photononstop / Getty Images
January 23, 2019
The Trump administration is trying to convey panic that there’s an immediate crisis on the southern border, pointing to caravans of desperate people who have traveled thousands of miles.
It’s true that Latin and Central Americans are coming to the US fleeing violence and poverty, much of it caused by destructive US trade policy over the course of decades. But there’s another massive “border crossing” phenomenon afoot — and Trump has not said a word about it. We’re talking about thousands of US citizens crossing the border each day in search of affordable health care.
At just one checkpoint in Yuma, Arizona, up to 6,000 Americans cross the border every day and enter the bustling Mexican town of Los Algodones, seeking heath care.
Unlike the Trump administration that seeks to build a wall between the countries, Los Algodones welcomes Americans seeking dental care with open arms.
Los Algodones has to be seen to believed. There are more dentists per capita than anywhere else in the world. It seems like every square foot of public space wall is covered with advertisements promising quality and affordable dental care, vision care and prescription drugs. The community’s economy is built to serve the flood of “dental refugees” — mostly senior citizens from the US and Canada seeking major dental care they cannot afford in their own countries, even with insurance.
The statistics are jarring. Approximately 74 million people in the US have no dental insurance, according to the National Association of Dental Plans. To put those numbers into perspective, that’s nearly a quarter of the population, or roughly twice the number that lacks health insurance overall.
But the problem is much larger than people lacking dental insurance. Dental insurance is not really insurance. It’s nothing like health or auto insurance, for example.
Most dental plans don’t cover much at all beyond regular check-ups, cleaning, X-rays and fillings. Beyond that, patients are expected to fork over much of the cost of large but common procedures like crowns, root canals and implants. Dental plans also generally pay a maximum of $1,500 annually, a number that’s hardly changed in 50 years. And $1,500 doesn’t go far when you consider the cost of major dental work. The cost of a single crown can be as much as $2,000 and the cost of an implant can run $5,000 a tooth. It’s not uncommon for seniors to need a set of four implants and several crowns, so you can see the costs can quickly get prohibitive.
One of the reasons dental care is so expensive in the United States is insurance. “The number one most complicated aspect of running a dental office, bar none, is dealing with dental insurance. You wouldn’t believe how long it takes to get through to a rep, make sure the patient does have benefits, calculate a copay,” dentist Dr. M told CBS News.
Another cost for US dentists is malpractice insurance, which is not required in Mexico. The insurance process is so frustrating, some dentists in the US don’t accept it. If you are paying entirely out-of-pocket, your dentist might give you a discount. Unfortunately, dentists who don’t accept insurance usually demand higher fees. So if you need costly dental care, you’re basically out of options.
Which brings us back to the small town of Los Algodones, or as the locals and visiting patients have affectionately come to call it, “Molar City.” Just seven miles across the border from Yuma, Arizona, visitors looking for dental care are bombarded with a vast array of dental ads, billboards and street vendors offering deals. According to Mayor Christian Camacho, up to 6,000 dental refugees make their way to Los Algodones every day in the temperate season between Thanksgiving and March.
The costs savings are hard to debate. Dental work in Mexico is on average two-thirds less than in the US and customers may save 80 percent or more on some costly operations. Those savings derive partially from Mexico’s less expensive real estate and labor costs, but also, Mexico’s dentists don’t graduate with a ton of student debt.
The government provides basically tuition-free education. “When we get out of school, we have to pay the government, but we do it by one year of free service, and that’s it,” Miguel Ibarreche of the Sani Dental Group, one of Mexico’s largest dental clinic companies, told NPR.
If you casually compare the magnitude of border crossings, the crisis of the US’s for-profit healthcare system becomes apparent. According to US Customs and Border Protection, border crossings of Mexican and Central American refugees — the border crossings Trump and Fox News rage about 24/7 — ranged from 20,000 to roughly 60,000 people per month in 2018. In Los Algodones alone, nearly five times as many American dental refugees are going the opposite way. To get an idea of the absurdity, one could argue there are more people currently fleeing the US’s health care system than refugees seeking asylum from extreme violence and state terror in Central America.
It would be irresponsible to not also remark on the vastly different border crossing experiences between the two groups. Central American refugees trek across hundreds of miles of unforgiving desert, vulnerable to exploitation and violence from human smugglers and at risk of family separation, cruel treatment and death in custody of US border agents. By contrast, US citizens seeking health care can park in Yuma for $5, walk across the border, get the help they need and come back for dinner.
Still, the consequences of a health care crisis are playing out on the southern border. They’re the result of our overpriced and inaccessible health care system, along with staggering college debt. Meanwhile, our immigration policy allows desperate US citizens to get the help they need while denying it to those coming the other way.