Pubdate: Mon, 07 Jul 2008 Source: El Paso Times (TX) Copyright: 2008 El Paso Times Contact: http://www.elpasotimes.com/ Details: http://www.mapinc.org/media/829 Author: Brandi Grissom DRUG BATTLES MAY FORCE MORE TO SEEK CARE IN TEXAS AUSTIN -- Rosemary Guerrero used to visit her doctor in Juarez regularly, making the trip from her home on El Paso's East Side across the bridge for treatment and to take her 14-year-old son for checkups. The family can't afford health insurance and the doctor's visits and medications south of the border were a lot less expensive, Guerrero said. But as the death toll from drug battles in Juarez has mounted in recent months, Guerrero said, the family has stopped crossing the border. "Since everything that's happening in Juarez, we did a big U-turn," she said. Health experts and state lawmakers this week said they are worried that increased security measures borderwide and violence in Mexico could force more poor border residents to rely on an already strained health care system in Texas. And some may even forgo expensive but necessary medical treatment altogether, they said. "It's always the poor, the underinsured, they get caught in the middle," said Dr. Robert Anders, dean of the University of Texas at El Paso School of Nursing. Residents on the Texas-Mexico border are among the least insured in the nation. Nearly 35 percent of the population in border counties was uninsured in 2003, according to data from the University of Texas Medical Branch. Although few studies have been done to document just how many border residents cross into Mexico for health care, border health experts said, anecdotal evidence and regional surveys indicate it is a common practice. Anders said he surveyed 278 El Pasoans last year before the escalation of violence in Juarez. About 18 percent said they obtained health care only in Mexico. Another 18 percent said they sought treatment both in the U.S. and in Mexico. "The people crossing over are typically those who just don't have the resources," Anders said. A study of 1,000 households in Laredo found that about 41 percent used some kind of health resource in Mexico, said Jon Law, program officer for the Center for Border Health Research at the Paso del Norte Health Foundation. "What we know is that there's a good percentage of people" who cross for health care, Law said. "It's just a matter of it may be different from community to community, and security concerns may affect people's willingness to cross." At a Capitol hearing on health care last week, Dr. Ben Raimer, University of Texas Medical Branch senior vice president for health policy and legislative affairs, told lawmakers he worried how the state's health system would cope with many new patients if border residents stop crossing into Mexico. Raimer said the cost to comply with security requirements for documents like passports to cross could deter poor border residents who have few alternatives for affordable health care. A regular passport costs $100 for an adult and $85 for a child. Passport cards, which can be used only at land and sea crossings, cost $45 for adults and $35 for children. "Even though it might not sound like a lot to some of us in this room," Raimer said, "it's a lot." And, he said, doctors and specialists on the border are already in short supply. Data provided by Raimer to lawmakers showed that non-border Texas areas averaged about 70 physicians per 100,000 people in 2007. On the border, the ratio was about 50 per 100,000. "Do we have enough doctors to take care of all the needs should those individuals not be able cross the border?" he asked. Guerrero said her family was ready to pay the additional cost for passports to cross the border easily before shootings, stabbings and kidnappings became daily occurrences in Juarez. "It is scary," she said. For now, Guerrero said, family members in Juarez bring her the prescription drugs she needs. She is working on a payment arrangement to see a doctor in El Paso. And she is trying to get her young son enrolled in the state-federal Children's Health Insurance Program, which provides low-cost health care for families that can't afford insurance but don't qualify for Medicaid. "That's our only way out," she said. If many more people decide not to seek health care in Mexico, El Paso County Attorney Jose Rodriguez said it could place an even larger burden on public facilities like Thomason Hospital. When people can't afford preventive care or treatment for existing conditions, said Rodriguez, chairman of the Texas Border Coalition's health care committee, they often wind up in emergency rooms. More health-care costs for uninsured patients at Thomason means potentially higher tax bills for county property owners who support the hospital. "I would expect that's going to be one of the unfortunate side effects," Rodriguez said. Lawmakers said they would work to address security concerns to ensure that legal U.S. residents can cross easily to and from Mexico. State Rep. Joe Pickett, D-El Paso, said he went to Juarez to have his appendix removed before he "became an honorable state representative with health insurance." The increased security requirements, he said, have made it difficult for legal U.S. residents to cross the border now. "There is a tremendous need there, and we'll talk to our federal government about cross-border issues" said state Rep. Dan Gattis, R-Georgetown. "I don't know that they'll listen, but we'll talk to them." Until the violence subsides, Guerrero said she would continue getting her medicines from family in Mexico and waiting on the response to the insurance application for her son. But she said she hoped the government would do something to make health care less expensive so her family didn't have to leave the country to afford treatment. "To be honest," Guerrero said, "I wish there was more help here because it's not just us." - --- MAP posted-by: Larry Seguin