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Kidnapping in Mexico Draws Attention to Medical Tourism Industry

Here’s what experts say about the risks and promises of traveling abroad for cost-efficient care.

By Dani Blum and Erik Vance

Last week, four Americans were kidnapped in the Mexican state of Tamaulipas , after crossing the border from Texas. Two were later found dead. A sister of one of the victims said they had gone to Mexico so one of them could get an abdominoplasty, better known as a tummy tuck.

Every year, millions of Americans visit Mexico and other countries to obtain health care, a practice often called medical tourism . The National Exterior Commerce Bank in Mexico estimated that the industry was worth $5 billion before it declined during the coronavirus pandemic. For patients, the motivation is often financial.

“Some of it is a desperate search for access” to medical care, said Felicia Marie Knaul, director of the Institute for Advanced Study of the Americas at the University of Miami.

Many people cross the border for pharmaceuticals at greatly decreased prices from what you pay in the U.S. Others, especially Americans and Canadians in the past two decades, are traveling for surgeries or treatments. The Centers for Disease Control and Prevention says dental care, surgeries, fertility treatments, organ and tissue transplants and cancer treatment are the most common procedures for which people go abroad. Elective procedures are a major component of medical tourism, said Daniel Béland, a professor of political science at McGill University who has studied health policy.

In 2016, the C.D.C. surveyed more than 93,000 people; of those who had left the United States for care during the previous year, Mexico was the most common destination.

But while crossing national borders might be an affordable way to get high-quality care, medical tourism is largely unregulated, and it’s nearly impossible to track outcomes or the scope of procedures Americans obtain in Mexico.

“There are really very few rules,” said David G. Vequist IV, director of the Center for Medical Tourism Research and a professor at the University of the Incarnate Word in San Antonio, Texas. Those that exist are vague, he added, and people are largely “making it up as they go along.”

How many people go to Mexico for treatment?

It’s hard to find solid data on medical tourism, said Valorie Crooks, a professor of geography at Simon Fraser University in Canada who has studied it for over a decade.

She calls the industry a “triple U”: It’s “untracked, untraced and unregulated.”

Most of the Mexican hospitals Americans visit are private and do not report their data to the federal government.

Josef Woodman, the chief executive of Patients Beyond Borders, which serves as an international health care travel consulting agency and patient guide for people seeking care abroad, estimates that about 1.2 million Americans per year travel to Mexico for medical procedures. After a drop in medical tourism during the pandemic, Mr. Woodman said, he’s seen a spike in people seeking out treatment in Mexico as they got vaccinated.

“After the first vax, people just flooded in,” he said.

Complex dental treatments like root canals, veneers and full mouth reconstructions are among the most popular procedures, Mr. Woodman said. Los Algodones, near the California-Arizona border, is known as “ Molar City ” because it caters to this market.

The most common destinations tend to be in Mexican states along the border, like Tamaulipas and Nuevo León, or those with popular beach towns, like Baja California Sur and Quintana Roo, according to Denise Rodriguez, who is studying for a Ph.D. in health geography at the University of Brasília in Brazil and interviewed hundreds of people involved in medical tourism in Los Algodones for her master’s thesis.

By counting the numbers of private hospitals and medical professionals available, she found that Baja California Sur was the state with the most medical tourism.

Why is the industry booming?

Because the overhead costs of running a clinic or health care center in Mexico are much lower, patients typically pay far less than they would for a procedure in the United States, Dr. Crooks said.

One study, which surveyed over 400 people near the U.S.–Mexico border about traveling to obtain health care, found that 92 percent cited lower costs in Mexico as guiding their decision. Andrea Miller, a clinical pharmacist in Arizona who led the study, was struck by just how widespread advertising, and infrastructure, for medical services was in a Mexican border town.

“You look down the street and it’s like, pharmacy, pharmacy, optical clinic, dental clinic, pharmacy, dental clinic,” she said.

Some patients also go abroad to circumvent red tape and restrictions that might stymie them at home, Dr. Crooks said.

“You could be too young or too old for an orthopedic surgery; you could be too small or too big for a bariatric surgery — and then you find a surgeon in another country who’s willing to offer you the treatment,” she said.

Other patients travel to get procedures that are illegal where they live, including abortions .

Money explains only so much, said Ms. Rodriguez, who found that many travelers were simply looking for more personalized care and time with a doctor.

“Why do people come back?” she said. “You are treated like a human being.”

Medical tourism carries risks.

While traveling for health care to certain areas of the world can be dangerous, experts said that for most patients, the risks have more to do with the medical procedure than the journey to obtain it.

Patients embarking on medical tourism seek out care on their own and pay out of pocket, Dr. Crooks added. That may mean their primary-care doctors aren’t informed, potentially leading to problems when patients seek follow-up care at home.

The C.D.C. recommends that patients schedule a consultation with their U.S. health care provider before leaving the country for medical care, said Allison Tayler Walker, lead of the epidemiology and surveillance team in the Travelers’ Health Branch at the agency. The C.D.C. also advises patients to arrange follow-up care ahead of time with the professional who conducts the procedure abroad, as well as with a primary physician in the United States.

There are also specific risks that come with certain interventions — for example, doctors caution against flying too soon after some surgeries, Dr. Béland said, because the procedures can make a person more susceptible to blood clots.

Mr. Woodman recommended seeking out hospitals accredited by Joint Commission International . It’s important for patients to ensure that anyone giving them medical care has received proper training, said Dr. Patricia Turner, executive director of the American College of Surgeons. That includes not just the doctor performing surgery, for example, but also the person administering anesthesia or interpreting X-rays.

Getting any service as complicated as a surgery in another country, with different laws and cultural norms, can be complicated. For instance, someone who receives improper medical care abroad may have little or no legal recourse and may not know what their rights are. And any procedure carries the risk of complications, and in another country, a patient may need to stay longer than expected for follow-up care or to recover, Dr. Crooks cautioned.

“It’s not necessarily that those risks are higher when you go abroad,” Dr. Crooks said. “But your ability to remedy or address those risks could become more challenging.”

Dani Blum is a reporter for Well. More about Dani Blum

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The 4 kidnapped americans are part of a large wave of u.s. medical tourism in mexico.

Bill Chappell

A Red Cross worker closes the door of an ambulance carrying two Americans found alive after they were abducted in Matamoros, Mexico, last week. Two of four Americans have been found dead, after they were caught in a cartel shootout, officials said Tuesday. AP hide caption

A Red Cross worker closes the door of an ambulance carrying two Americans found alive after they were abducted in Matamoros, Mexico, last week. Two of four Americans have been found dead, after they were caught in a cartel shootout, officials said Tuesday.

The four Americans who were shot at and abducted in Mexico were reportedly visiting for medical tourism — making them part of a booming industry that is vital to Mexico's economy.

"Pre-pandemic, some 1.2 million American citizens traveled to Mexico for elective medical treatment," Josef Woodman, CEO of Patients Beyond Borders , told NPR. His firm publishes a guide to international medical travel.

Latin America

2 surviving americans who were kidnapped in mexico are back in the u.s..

Here's an update on medical tourism, and the recent tragedy:

U.S. medical travel is rising sharply

"Today, the market is recovering rapidly in Mexico, nearly back to its pre-pandemic levels," Woodman said.

Nearly 780,000 people were projected to leave the U.S. for health care in 2022, according to Healthcare.com , citing data from the medical travel website Medical Departures.

Medical tourism in Mexico isn't new, but the recent tragedy put it in the spotlight

Medical tourism in mexico isn't new, but the recent tragedy put it in the spotlight.

That outburst of activity got a big boost in late 2021, when the U.S. relaxed key border restrictions with Mexico.

Costa Rica is the second-most popular destination for U.S. visitors seeking medical care elsewhere, Woodman said. It's a particular draw, he added, for people in the Northeast and Southeast.

Most people travel for dental and cosmetic work

Cosmetic surgeries are just one of the procedures that are far cheaper in Mexico — for years, people have been visiting from the U.S. to get elaborate dental work or cosmetic treatments done, or to pick up antibiotics and other medicines at favorable prices.

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A reason to smile: mexican town is a destination for dental tourism.

Many people also travel to get orthopedic work done, replacing knees or hips for less than half the cost of such procedures in the U.S.

"North American patients travel to Mexico for care primarily to save 50-70% over what they would pay in the United States for an elective treatment," according to Woodman.

Medical tourism does bring risks, experts say

While an element of risk is inherent in many procedures no matter where they're performed, medical tourism can heighten complications, according to the Centers for Disease Control and Prevention.

Potential problems range from the dangers of flying in a pressurized plane cabin too soon after a surgery to the complications of getting follow-up care for a procedure done in another country.

Medical tourism numbers are on the rise in Mexico, after the practice was curtailed by COVID-19 restrictions. Here, foreign patients are seen at the hospital Oasis of Hope in Tijuana in, 2019, in Mexico's Baja California state. Guillermo Arias/AFP via Getty Images hide caption

Medical tourism numbers are on the rise in Mexico, after the practice was curtailed by COVID-19 restrictions. Here, foreign patients are seen at the hospital Oasis of Hope in Tijuana in, 2019, in Mexico's Baja California state.

Some of the most serious warnings from the CDC are for infections, from wound and blood infections to pathogens that might be more common or resistant in the host country than in the U.S.

"Recent examples include surgical site infections caused by nontuberculous mycobacteria in patients who underwent cosmetic surgery in the Dominican Republic," the CDC says, "and Q fever in patients who received fetal sheep cell injections in Germany."

U.S. medical tourists rate Mexico highly

A 2020 research paper that surveyed some 427 Americans crossing the U.S.-Mexico border in California for medical services found that most of the respondents "felt that Mexican health care services are of the same or better quality compared with those in the United States, for a lower cost."

People had come from 29 states across the U.S. to get care in Mexico, with the vast majority driven by cost concerns, according to the paper, published in the Journal of the American Pharmacists Association .

Hit with $7,146 for two hospital bills, a family sought health care in Mexico

The researchers also collected data about the medical tourists themselves, reporting an average age of 64.5 years. Their most common yearly income range was reported to be between $25,001 and $50,000 — but that reflects less than a quarter of the respondents.

More than 400 of the survey's 427 participants said they would undertake more medical tourism in the future, the paper said.

Most of Mexico's hospitals follow U.S. standards

Mexico has worked for years to promote medical tourism to draw patients across the U.S. border. That includes improving its health system and following international standards.

"About 10 years ago, the Mexican federal government licensed the Joint Commission accreditation standards, which are used to accredit U.S. hospitals," as David Vequist, who runs the Center of Medical Tourism Research at the University of the Incarnate Word in San Antonio, told NPR's All Things Considered .

"So most Mexican hospitals are now basically using the same standards we use in hospitals in the United States," Vequist added.

Details of the recent violence are still emerging

At least one of the U.S. citizens who were caught up in the recent tragedy was reportedly going to Mexico for a tummy tuck operation. But the group's vehicle came under fire hours after entering the border city of Matamoros, Mexico, from Brownsville, Texas.

Two of the four died; all are reported to be natives of Lake City, S.C. Their identities have not been released, but relatives have been speaking to NPR and other outlets .

Mexican officials say they believe the four were caught in the middle of a conflict between drug cartels in the state of Tamaulipas — an area that is under a do-not-travel advisory from the U.S. State Department.

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How a trip to Mexico for cosmetic surgery turned deadly for US quartet

Deaths of two of four Americans kidnapped in Matamoros place spotlight on cartels’ impunity – and on medical tourism

L atavia “Tay” Washington McGee had scheduled an abdominal operation that many mothers have, and she chose to have the operation done in Mexico , where medical costs are cheaper – and where she had previously gone for other cosmetic procedures.

A cousin and a couple of friends joined her to share the 1,400-mile drive from her home town of Lake City, South Carolina , to Matamoros, Tamaulipas, just south of the US-Mexico frontier.

They arrived in the border city on 3 March, but never made it to the clinic. Members of a violent drug cartel that controls the area mistook the group of Americans as rival traffickers, killed two of them, and kidnapped McGee and one of her friends.

McGee and Eric Williams were rescued within days, and the bodies of her cousin Shaeed Woodard and friend Zindell Brown were later repatriated. On Thursday, five men who allegedly carried out the attack were dumped on a Matamoros street, along with a a surreal letter of apology purportedly from the Gulf cartel.

“We ask the public to be calm,” the letter said in Spanish. “We are committed that the mistakes caused by indiscipline won’t be repeated, and that those responsible pay, no matter who they are.”

The episode prompted calls from prominent conservative American politicians legislation to allow the US military to intervene in Mexico – though the traffickers often arm themselves with guns bought in the US.

It had left many Mexicans puzzled at why this particular case was apparently resolved so quickly in a country where more than 100,000 people are missing and most crimes go unpunished.

And it cast international attention on US medical tourism, in which Americans travel abroad for healthcare they can’t afford at home.

The tummy-tuck surgery sought by McGee generally aims to remove excess skin from the abdomen and tighten the muscles in that part of the body. It is the fourth-most common cosmetic procedure, according to a 2022 report from the American Society of Plastic Surgeons .

It is particularly popular as part of the beauty regimens for Black Americans, mothers and people in their 30s, the society said. All those descriptors match McGee, 33, the mother of six children between the ages of six and 18.But in the US, the procedure alone typically costs more than $6,100. Adding in anesthesia, medication and the operating room, the total cost for a tummy tuck – which is considered major surgery – can balloon to around $20,000.

That’s the point where many Americans start exploring traveling abroad. The CDC warns against such medical tourism, saying infection and post-procedure complications are possible depending on the destination and facility.

Dr Michael Omidi, a plastic surgeon in Los Angeles, told the Guardian that US providers usually won’t work with patients who travelled abroad to be operated on and then suffered complications – for fear of becoming liable for the entire procedure.

Yet the fact is other countries can offer substantial savings to US patients willing to assume the risks.

In early 2020, Americans could on average save 40% to 60% by having major surgery done in Mexico, according to a report from the consumer watchdog Patients Beyond Borders. Those figures have only increased amid US inflation and spiralling insurance companies’ deductibles, co-pays and exclusions, said the group’s chief executive officer, Josef Woodman.

Potential clients can minimize the risks by seeking out certified providers in certain resort areas, larger border cities like Tijuana, and the country’s capital, Mexico City, Woodman said.

Woodman said that though it was not possible to identify every Mexican community with providers capable of consistently providing a good outcome, his group does know of several.

“Unfortunately,” he added, “Matamoros isn’t among them.”

Furthermore, the US state department had admonished Americans against traveling there, citing the organized crime and violence in the region.

Riding in a white minivan, McGee, Williams, Woodard and Brown – described by loved ones as fiercely close to each other – crossed into Matamoros from Brownsville, Texas, during the day on 3 March.

As the four friends drove through the city, looking for the clinic, their white minivan suddenly came under gunfire from heavily armed men in body armor, who pursued them in a pickup truck.

Woodard and Brown were killed, as was Arely Servando, a 33-year-old Mexican church worker standing on the street a block and a half away.

Williams was shot in the legs but survived. McGee was physically unharmed, but – along with her companions – was dragged into the back of the attackers’ truck at gunpoint.

For four days, the group’s fate was unknown. US federal agents offered a reward of $50,000, and then on Tuesday, Mexican authorities announced they had found McGee and Williams – plus the bodies of Woodard and Brown – in a wooden shack in a rural area 15 miles east of Matamoros.

Police arrested a man guarding the Americans, who investigators suspect were mistaken for rival traffickers. On Thursday, the five men apparently dumped on a Matamoros street by the Gulf cartel itself were arrested on charges of aggravated kidnapping and homicide.

In South Carolina, McGee’s mother, Barbara Burgess, told ABC News that her daughter’s rescue was evidence for her that “there is a God”. But, Burgess added , her daughter was devastated at seeing two of the people she loved as they “died in front of her”.

Williams’s wife Michelle, said she had no idea her husband was going to Mexico, but told the South Carolina news outlet WBTW she had an overwhelming “sense of relief” that he was expected to make a full recovery after undergoing surgery for the bullet wounds to his legs.

But she added: “My heart is breaking for the other two families that don’t get to say the same.”

Brown’s sister, Zalandria, told the Associated Press that her brother had only joined his friends reluctantly after repeatedly warning them against the trip.

“Zindell [was] like my shadow,” she told CNN . “He [was] like my son … my hipbone.”

Separately, according to CNN , Woodard’s father told reporters his son would’ve turned 34 on Thursday. “I’ve tried to make sense out of it and tried to be strong about it,” he said. “It just was a senseless crime.”

The South Carolina senator Republican Lindsey Graham called for legislation to classify Mexican drug cartels as terrorists, and threatened to “unleash the fury and the might of the United States.”

He made no mention that much of the violence in Mexico – which has stringent gun restrictions – is fuelled by drug sales within the United States and perpetrated with guns bought legally in the US before being smuggled across the border. Graham has repeatedly voted against substantial gun control measures in the US.

Such double standards only fuel a weary sense of outrage among Mexicans distraught at the violence and impunity dogging their country.

Thousands of Mexicans are kidnapped in their country annually, and authorities rarely try to rescue them or arrest those responsible. Some are eventually returned after payment of a ransom; many simply disappear without trace.

In this case, a taskforce involving the Mexican military, national guard and state police swung into action.

A video on Twitter posted by the Tamaulipas businessman Roberto Lee captured the reaction of many south of the border.

“It makes us feel like we need to be citizens of another country for our government to care about us,” said Lee. “We learned one thing – that the government can produce results, but it’s not producing them for Matamoros.”

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Kidnapping of Americans in Mexico puts spotlight on "medical tourism"

By Aimee Picchi

March 7, 2023 / 3:42 PM EST / MoneyWatch

The kidnapping of four U.S. citizens who traveled to Mexico last week is putting the spotlight on "medical tourism," or when people travel to other countries to receive medical care or buy prescription drugs, often at lower prices. 

Mexican President Andrés Manuel López Obrador said Monday that the Americans had crossed the border to buy medicine and ended up caught in the crossfire between two armed groups. Separately, Zalandria Brown, of Florence, South Carolina, told The Associated Press her younger brother, Zindell Brown, was one of the four kidnapping victims and that one of them planned to undergo "tummy tuck" cosmetic surgery in Mexico. 

The number of Americans traveling abroad for medical and dental care has surged in recent decades. Although that practice is deemed " risky " by the Centers for Disease Control and Prevention, the agency's concerns focus on medical issues, such as the risk of buying counterfeit medications or getting treatment from an unqualified professional, rather than on crime.

Violent crime targeting people who leave the U.S. to seek care is extremely rare, said Josef Woodman, CEO of Patients Beyond Borders, a medical tourism group. Instead, the risks typically involve failing to do sufficient research to find certified physicians and clinics in other countries, which could increase the risk of substandard care, he said.

Attacks "almost never happens to a medical traveler," Woodman said. "People who travel to get medical care usually get picked up at the airport by the better clinics and hospitals and they are shuttled to their hotels."

He added, "The [medical] risks are for people who don't shop for quality."

About 1.2 million Americans traveled to other nations for medical care prior to the pandemic, an increase from about 150,000 almost two decades earlier, Woodman said. The pandemic temporarily put a halt to medical tourism when borders were closed, but it has since rebounded, he added. 

About one-quarter of American medical tourists travel to South America for treatment, with another roughly 20% traveling to Central America, according to a 2015 study from the U.S. International Trade Commission (USITC). Other popular destinations include Asian countries such as Thailand, Singapore and South Korea, according to Patients Without Borders.

Additionally, about 1 million Californians travel to Mexico every year to buy cheaper medicine, the USITC study found.

"Tummy tuck" in Mexico

Still, the kidnapping in Mexico highlights broader questions about the risks of traveling for surgery, said Dr. Bruce Hermann, a board-certified plastic surgeon in Dallas, Texas. Americans should be cautious about traveling for surgery — even within the U.S. — because patients often are unable to attend follow-up appointments with their surgeons, raising the risk they will run into trouble if they develop complications.

"I have a consult today who had a tummy tuck in Mexico and now has a bad infection," Hermann said. "She may need additional surgery." 

He added, "If you are considering having plastic surgery, don't take it lightly. It's something we see all the time on social media, so we think it's easy — but this is surgery."

50% cheaper 

Elective surgeries are increasingly fueling medical tourism because the prices outside the U.S. can be 50% to 80% cheaper than domestically, according to Patients Beyond Borders. A full facelift in the U.S. costs more than $10,000, according to 2020 data from the organization. In Mexico the cost is about half, at $5,150. 

Some medical tourists are traveling abroad for dental surgery, with about 77 million people in the U.S.  lacking  dental coverage. And even those who have dental insurance find that it doesn't cover much, often failing to pay for expensive work such as implants or crowns. 

A dental implant in Mexico typically costs about $1,650, compared with $3,400 in the U.S., according to 2020 data from his organization.

"It's cost, cost and cost — that's why Americans travel" for medical treatment, Woodman said.

Aimee Picchi is the associate managing editor for CBS MoneyWatch, where she covers business and personal finance. She previously worked at Bloomberg News and has written for national news outlets including USA Today and Consumer Reports.

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Mexico kidnappings put a spotlight on medical tourism

The kidnapping of four Americans who reportedly traveled to Mexico so one could undergo a “tummy tuck” has cast a spotlight on the booming medical-tourism business south of the U.S. border, where dental procedures, cosmetic surgeries, fertility treatments and even veterinary care are typically cheaper than those in the United States.

The attack in Matamoros on Friday, which resulted in two deaths and was described by the medical tourism industry as a rare incident of violence, has not appeared to deter American patients, according to Mexican tourism officials, travel agencies and medical providers.

Before sunrise Wednesday, Evelyn Ballard walked across the bridge from Brownsville, Tex., to Matamoros, where she was scheduled for liposuction.

News of the deaths made her nervous, she said, but she was reluctant to cancel her appointment. She said she is saving about $1,000 by getting the procedure done in Mexico, even after factoring in the costs of hotel and airfare from her hometown of Houma, La. She had already paid the cost of the surgery and did not want to risk losing her money.

“We took precautions before we actually came, getting rid of a lot of things that could be hijacked or even cost us our lives,” said Ballard, who left her jewelry behind.

Alfredo Pedraza, the president of the Health Tourism Committee of Matamoros, called the attack on the Americans “an isolated case” that he hoped would not damage the region’s health industry.

He works in one of the “health clusters” that have become popular along the Mexican border; his includes two hospitals and numerous doctor’s and dentist’s offices, labs and other services. For enhanced security, the cluster offers a free shuttle for patients crossing the Texas border. But, Pedraza noted, many Americans arrive in Matamoros by private car so they can also shop and dine at restaurants.

“It’s even very common for them to bring their animals to the vet here,” Pedraza said. “It’s a cycle we’ve had for many years.”

What we know about Matamoros and the kidnapped Americans

Indeed, the influx of American medical tourists is so common that at the San Diego-Tijuana border, there’s a dedicated traffic lane that was designed to speed such visitors back to the United States.

Americans commonly look to other countries for dental care, surgeries, fertility treatments, organ transplants and cancer care, according to the Centers for Disease Control and Prevention. Mexico is the most popular destination, accounting for over 40 percent of medical tourism trips, according to a 2016 survey from the Centers for Disease Control and Prevention.

The survey found that prevalence of medical tourism was higher among Hispanics and people without health insurance.

Residents of the United States took 1.2 million trips to Mexico for medical and dental care in 2019, lured by substantially lower costs, improving quality of care and sometimes a better patient experience than they can get at home, said Josef Woodman, founder of Patients Beyond Borders, a North Carolina-based consulting firm for the medical tourism industry.

According to data collected by Patients Beyond Borders , a tooth implant with an acrylic crown that would cost $3,400 in the United States is priced at an average of $1,650 in Mexico. A coronary artery bypass priced at $73,000 in the United States would cost $27,300 in Mexico.

In the days since the kidnappings in Matamoros, Woodman said, he has been inundated by calls and emails from people interested in seeking medical care across the border. None expressed concern about violence.

“The risks are just astronomically low,” Woodman said.

While the risk of violence does have an impact on Mexico’s tourism economy , medical tourism is a thriving industry that INEGI, the statistics agency for the Mexican government, calculated brought in over $137 million in 2021, the latest figure available.

About 65 to 70 percent of cross-border trips are for dental care, Woodman said. One Mexican city, Los Algodones, located near Yuma, Ariz., is known as “Molar City” for the 300 dental offices there. Another 15 percent of visits are for cosmetic care, and 5 percent are for bariatric or weight-loss surgeries, he said. The remaining 10 percent are for a wide variety of procedures, led by orthopedic care.

The data do not include Mexican nationals living in the United States who often return to their home country for medical care, he said.

It’s difficult to pinpoint precise numbers, since they encompass everything from residents of U.S. border areas who cross frequently for routine visits — checkups, the flu, sprained ankles — to people seeking major surgery for cancer, hip replacements or organ transplants.

Some Mexican states also include the relatives who accompany the patient in their “medical tourism.”

Video appears to show violent kidnapping of four Americans in Mexico

A few companies are trying to put distance between their business and the tragedy, both figuratively and literally.

Each month, roughly 25 to 30 My Medical Vacations customers from the United States and Canada travel for weight-loss surgery, cosmetic procedures, fertility treatments, sports injuries, hip replacements and other services, according to Andres Jurado, co-founder and chief executive of the all-inclusive medical travel company.

His company brings clients to Cancún, one of Mexico’s most popular tourism destinations, while “the place where this happened is really far away from where we are,” Jurado said. “It is the same distance between Houston and Chicago.”

David Mora, chief executive of Health & Wellness Bazaar , a medical provider network that arranges all-inclusive trips for procedures in Tijuana, said clients have contacted them with safety concerns, but none have canceled.

“Interestingly enough, we’ve seen a big increase in our website visitors,” Mora said, “quite possibly because of the news that was broken this week and the medical tourism being all over the internet.”

While Woodman said the pandemic cut medical tourism visits to Mexico by at least 50 percent in 2020, the strains the coronavirus placed on the U.S. medical system, coupled with inflation, are leading many people to look outside the country again.

“This is the perfect storm,” said David Vequist, founder of the Center for Medical Tourism Research in San Antonio.

Large numbers of Americans who put off preventive care during the pandemic are now seeking treatment for conditions that have progressed, only to find that health care has become more expensive.

“People are being literally driven to look for alternatives,” Vequist said. “Those factors led somebody from South Carolina to cross the border to a place the State Department has on the highest level of threat,” he said, referring to the group that was kidnapped.

They went to Mexico for surgery. They came back with a deadly superbug.

The international markets keep shifting, and new opportunities open up.

Mexico is increasingly a destination for surrogacy, which was commonly provided in Ukraine before Russia’s invasion.

Pamela Parker, an OB/GYN who worked until recently in Texas’s Rio Grande Valley, said young women routinely crossed the border for abortion pills after the state enacted a near-total ban on the procedures in 2021.

Long covid has also prompted people to travel in search of experimental treatments, including apheresis, or “blood washing,” to eliminate clots that have been associated with prolonged symptoms.

But there can be risks in the care itself . The 2016 CDC study found that 5 percent of medical tourists reported complications from treatments they received abroad, and 67 percent sought care upon returning to the United States.

The CDC — which lists the potential for infection, antibiotic resistance, poor quality care and communications challenges, in addition to the elevated risk of thrombosis from air travel — recommends that patients consult with their U.S. provider before leaving and arrange follow-up care both abroad and upon their return.

Jonathan Edelheit, chief executive of the Medical Tourism Association, a nonprofit portal for prospective patients, providers, employers and insurance companies, emphasized the importance of doing research and being prepared to fly to specialized destinations instead of simply crossing the border.

“There is a huge mix of quality from average to poor services across the border,” said Edelheit, who recommended that travelers work through accredited agencies rather than signing up for the cheapest deal available online. He advises looking for certification with Global Healthcare Accreditation, which has developed international standards for medical tourism and publishes a list of hospitals it accredits internationally. Some Mexican hospitals are accredited by the Joint Commission International.

Medical tourists who vet destinations carefully can find high-quality care in many places in Mexico, said Edelheit, who is preparing to accompany a relative for care.

Travelers can use online platforms such as the Better Business Bureau “to make sure you have insights from real travel patients that have gone through similar travel journeys recently,” Jose Pedro S. Garcia, a spokesman for the medical tourism facilitator MedicalMex, said in an email.

Garcia emphasized that travelers should check advisories from the U.S. State Department for the specific destinations in which they’re seeking procedures, as safety concerns differ significantly from state to state, city to city, and even neighborhood to neighborhood. They should also ask medical travel operators where the treatment will take place, what travel logistics the company is providing and what safety precautions are in place for clients.

If things do go wrong, there is little recourse for anyone who receives substandard care outside the United States.

“It would be extraordinary difficult to collect damages,” Vequist said.

Officials who work in medical tourism in Tamaulipas said they had never heard of an incident like the one involving the kidnapped Americans.

“I think it’s the first case we’ve had of this type, in which someone comes for a medical reason and this kind of thing happens,” said Ricardo Vilet, director of tourism promotion for the state.

He said that in most border cities, the facilities involved in medical tourism — doctor’s offices, dental clinics, pharmacies — are located close to the bridges linking the two countries. “You don’t have to go very far into the state or city,” he said.

Estela Moreno, the president of the Business Council of Medical Tourism in Reynosa, said her hospital sends a special vehicle to pick up medical tourists as soon as they cross the international foot bridge from McAllen, Tex.

“They don’t even have to bring their car,” she said. “We have found a mechanism to make people feel safe. They’ll get to their destination. Everything is under control.”

Federal security forces guard the medical district, in addition to state and local police, she added.

“I’ve spent 12 or 13 years transferring patients here,” she said. “We’ve never even had a stolen wallet.”

A previous version of this article incorrectly said there is a dedicated traffic lane designed to speed medical tourists into Mexico. The lane is northbound into the United States. The article has been corrected.

Alejandra Ibarra Chaoul in Mexico City and Rich Matthews contributed to this report.

Cheap cosmetic surgery in Mexico comes with risks beyond the operating table

At a fraction of the cost and just across the border, cosmetic surgery in Mexico has lured many U.S. citizens who might otherwise not be able to afford such procedures.

But in their pursuit of discounted flat stomachs, sculpted noses and wrinkle-free skin, patients often overlook, or are unaware of, the dangers they face — including risks before they even get to the operating table.

Reality television shows like “Botched” have shown the unsightly results of aesthetic procedures gone awry, including those done for cheap in countries with more lax medical regulations. Now, the violent kidnapping of four Americans that ended with two dead is highlighting other potential perils of medical tourism. 

The group was abducted Friday in Matamoros in the Mexican state of Tamaulipas. The city, on the other side of the border from Brownsville, Texas, is one of the most crime-riddled areas of Mexico, where drug cartels and turf wars pose persistent threats.

It is not clear if the Americans, who had gone to Mexico so one of them could have a cosmetic medical procedure , were aware of the area’s notoriety. The U.S. State Department has said U.S. citizens should not travel there, citing violence, including kidnapping and armed robbery.

But the four were hardly the only ones to go there. Jasmine Wilson, 28, who traveled to Matamoros from Washington, D.C., in October 2022, said she had no idea that traveling to the Mexican city was risky, but said she had extensively researched the safety record of her surgeon there, who she came across via social media. His Facebook page, with over 30,000 followers, showcased before-and-after patient transformation photos and glowing reviews about his safety protocols.

“We literally had no problems,” she said.

While lower cost attracts many Americans to Mexico, it isn’t the only reason they come, said Dr. Nain Maldonado, a cosmetic surgeon who runs a private practice at a top clinic in Cancun. Many are frustrated with other aspects of the U.S. health care system, including difficulties getting appointments and feeling like their time with doctors is rushed once they do get in to see them.

“When I talk with my patients coming from the States, they are surprised how the doctors are coming to see them, talking with them, even during the appointments after the surgery or the next day,” he said. “I think it is easier to talk with your doctor here in Mexico.”

The amount of Americans who come to him for cosmetic procedures has grown so much in recent years that Americans and Canadians together now comprise 40% to 50% of his clientele, he said.

Maldonado said his patients also feel they get better results in Mexico than they would at home. 

But not everyone who goes to Mexico comes out of surgery happy. 

Before leaving for their operations, patients are often “creating this grandeur in their head of what they’re going to get,” said Dr. Filberto Rodriguez, a cosmetic surgeon who has practiced for over a decade in South Texas. He said he has nearly 30 patients a month who seek care from him after they have complaints about or complications from procedures in Mexico. 

He said he has noticed that the dream of affordable, accessible surgery can cause patients to downplay warnings about the areas they are traveling to and the deadly complications their procedures can carry.

“Is that a risk that you’re willing to take to save just a couple thousand dollars? I know people say you sound like such a snob when you say, ‘Oh my God, it’s only a couple thousand dollars you’re saving,’” he said. “It’s your life.”

Mexico welcomes many medical tourists not just for cosmetic surgery, but for other health care needs, including dental and pharmaceutical treatments, according to David Vequist IV, founder and director of the Center for Medical Tourism Research at the University of the Incarnate Word in San Antonio. In addition to the lower price, they go because they have a belief that they’re getting comparable or better care than they would at home.

“People tend to travel for what they perceive to be value. In other words, it’s not just the price, but it’s the price plus what they consider to be an acceptable level of quality,” Vequist said.

Estimates of how many medical tourists travel to Mexico vary. Patients Beyond Borders, an international health care travel publishing and consulting firm, said that pre-pandemic, some 1.2 million American citizens traveled to Mexico in 2019 for elective medical treatment — mostly cosmetic, complex dentistry and bariatric treatments.

And many times, these surgeries are successful, said ​​Dr. Alex Sobel, president of the American Academy of Cosmetic Surgery. 

“We tend to hear and see about the bad outcomes,” he said. But “cosmetic surgery is a tremendously international community, with great surgeons and researchers all over.” 

The discounts overseas can be significant: Sobel said he has heard of procedures costing up to 80% less in Mexico.

That is because surgeons have lower costs overall in Mexico, savings they pass on to patients, Vequist said. That includes everything from lower costs for property and pharmaceutical drugs to lower salaries for medical staff, such as nurses and anesthesiology providers. 

Rodriguez said it’s also due in part to the exchange rate and not having as stringent regulations to adhere to as surgeons in the U.S.

Ransoms and other risks 

But the safety of the medical practices are separate from the safety of the areas Americans journey through to get them. The State Department has warned that in the Mexican state where Matamoros is, criminals target passengers in cars and buses and demand ransoms . 

Wilson, who had three procedures there in October, said she didn’t feel endangered. She attributed her sense of security to a spot she had booked at a post-surgical recovery center in Harlingen, Texas, which facilitated transportation to and from her operation.

A mother of four, she said she was pleased with the seamless cosmetic enhancements she received to address loose skin around her stomach area caused by diastasis recti, a condition that involves the separation of the abdominal muscles during pregnancy.

Wilson was shocked by the recent kidnappings. Nonetheless, she said she would not hesitate to undergo procedures again in Matamoros, as long as she used the same transportation method.

More coverage of the deadly Mexico abduction

• Mexico kidnapping was ‘difficult to prevent’ despite known dangers in border regions
• Video shows kidnapped Americans put in pickup
• 2 Americans dead and 2 found alive in Mexico kidnapping, official says
• Woman in group of kidnapped U.S. citizens was in Mexico for cosmetic procedure, official says

Dr. Jennyfer Cocco, a plastic surgeon in Dallas, said there is nothing wrong with seeking the best price “as long as you know what you are getting into.” 

She said there are surgeons in Mexico who are certified according to American standards and certifications can be checked on the American Society for Plastic Surgeons’ website. 

“My advice would be any American that travels internationally needs to look at the State Department warnings about what areas are safe and what types of issues are going on,” Vequist said. “Right now unfortunately in Mexico, there are several regions, states and cities that have State Department warnings.”

CORRECTION (March 9, 2023, 8:52 a.m. ET): A previous version of this article misstated the name of an international health care travel publishing and consulting firm. It is Patients Beyond Borders, not Patients Without Borders.

Elizabeth Chuck is a reporter for NBC News who focuses on health and mental health, particularly issues that affect women and children.

Suzanne Gamboa is a national reporter for NBC Latino and NBCNews.com

Uwa Ede-Osifo is a news associate for NBC News.

Why do people in the U.S. cross the border into Mexico for health care?

Two Americans  have been found dead and two alive after they were abducted while traveling to Mexico in an incident that is raising questions about   whether people in the U.S. are at risk when they cross the border to access health care.

The four U.S. citizens vanished Friday in an attack carried out by multiple gunmen in the northern Mexico border city of Matamoros, the FBI said. The city in Tamaulipas state is just south of Brownsville, Texas, across the Rio Grande. It's one of many places along the U.S.-Mexico border where Americans flock to save money on medical care.

Details about the four Americans' trip remained sparse Tuesday, but one relative told The Associated Press they had traveled to Mexico for tummy tuck surgery. Travel for medical treatment and even surgery is not uncommon along the border.

"Medical tourism has been a very big part of the border communities for many, many, many years," said Ricardo Ainslie, a professor at the University of Texas at Austin and director of research and education at the health care partnership AMPATH Mexico. "It's primarily driven by the fact that it's easy to get appointments and that it's much less expensive."

Why do people in the U.S. cross into Mexico for health care?

About 1.2 million people in the U.S. traveled to Mexico for medical, dental or other health care services each year before the COVID-19 pandemic, said Josef Woodman, CEO of Chapel Hill, North Carolina-based Patients Beyond Borders, citing another consultant's estimates.

Woodman estimates U.S. residents getting medical care in Mexico can save 40% to 60% off the cost of similar procedures or operations at U.S. hospitals or clinics. 

"People in the United States need access to cost-effective medical care," Woodman said. '"The U.S. has priced itself out of the market."

People who are not insured can access cheap care in Mexico, said Kathleen Staudt, a professor emeritus at the University of Texas at El Paso. She noted that some people living in the U.S. may already have insurance coverage in Mexico. Meanwhile, some nonprofits in Mexico offer low-cost private insurance, she said.

Consumers often travel to Mexico to seek elective care such as weight loss or cosmetic surgery that might not be covered by their health insurance, said Irving Stackpole, a Newport, Rhode Island-based medical tourism consultant.

Others choose services like purchasing eyeglasses or getting prescriptions filled at pharmacies, Stackpole said.

"As soon as you cross the border, there are all kinds of pharmacies on the main streets," Staudt said. Many of those pharmacies have doctors on staff, she said.

Ainslie pointed to the ease of access to prescription drugs, including pain medications and antibiotics.

"You can get things in Mexico just by going into a pharmacy. You don't need a doctor's prescription," said Ainslie, whose friends in California have been getting dental care in Tijuana for years.

Why the American group went to Mexico

Information about the four kidnapped Americans was limited Tuesday. Mexican President Andrés Manuel López Obrador said Monday that the group was in the country for medicine.

Zalandria Brown of Florence, South Carolina, told The Associated Press she was in contact with the FBI after learning her younger brother, Zindell Brown, is one of the four victims. She said her brother, who lives in Myrtle Beach, and two friends had accompanied a third friend who was going to Mexico for a tummy tuck.

Brown said the group was extremely close and they all made the trip in part to help split up the driving duties. They were aware of the dangers in Mexico, she added, and her brother had expressed some misgivings, the Associated Press reported. "Zindell kept saying, 'We shouldn’t go down,'" Brown said.

What U.S. officials say about safety in the region

The State Department advises Americans not to travel to Tamaulipas , citing organized crime activity, including gunbattles, murder, armed robbery, carjacking, kidnapping, forced disappearances, extortion and sexual assault.

"Criminal groups target public and private passenger buses, as well as private automobiles traveling through Tamaulipas, often taking passengers and demanding ransom payments," the department says.

Woodman said Matamoros is "not on our radar screen as a medical travel destination" but added people might seek less expensive prescription drugs there. "It's a horrible tragedy," Woodman said. "But it's also a cautionary tale."

Do your research before traveling to Mexico for health care

U.S. consumers should do their homework before choosing a doctor or clinic in Mexico, Woodman said. People should ask for a clinic's credentials as well as avoid choosing the lowest-cost provider.

Consumers should also ask clinics or doctors how often they have done particular procedures and ask to speak with patients who have used the clinic before, Stackpole said.

Researchers at the University of California, Los Angeles, found single pills sold as oxycodone and Adderall at pharmacies in four northern Mexico cities often had illicit fentanyl, methamphetamine or heroin.

Though the researchers declined to name the cities or the pharmacies, they were located in tourist areas with English advertisements for erectile dysfunction medications and painkillers. Researchers tested only single pills, not prescriptions sold in bottles. Researchers said consumers should be aware these single pills might by spiked with drugs that can be harmful. 

"The risk is that someone who doesn't have an opioid tolerance is really at risk of having an overdose which can be fatal," said Chelsea Shover, an assistant professor-in-residence at UCLA David Geffen School of Medicine.

Woodman said the tragedy should not discourage others from seeking care in Mexico.

"Everybody is really saddened by it," Woodman said. "It's something that's really, really given us a lot of pause. How do we keep our patients safe? And the answer is, for something like that, it's such a freak (occurrence) that you just can't."

• Kidnapping updates: 2 kidnapped Americans found dead, 2 others alive after abduction near Mexico border, officials say
• Dying to lose weight: The lucrative ties between border surgeries and U.S. middlemen

Mexico's medical tourism business brings more than a million Americans to the country each year. They often find superior care — for a fraction of the cost.

• Medical tourism is drawing attention after the kidnapping of four Americans in Mexico last week.
• Some 1.2 million Americans seek medical treatment in Mexico each year — mostly due to lower costs.
• One expert said it's possible to participate in medical tourism safely, but people have to research carefully.

News of the kidnapping of four Americans in Mexico has drawn new attention to the phenomenon of medical tourism, a hugely profitable industry that draws millions of Americans each year, despite well-publicized risks to health and safety.

On March 3, four Americans were abducted shortly after crossing the Mexican border from Brownsville, Texas, into Matamoros, Tamaulipas. The group was fired upon and kidnapped by armed gunmen, and two of the Americans were later found dead, according to the FBI .

A friend of the group, Cheryl Orange, has told media outlets that the group entered Mexico so that one of them could undergo cosmetic surgery . That patient is one of the estimated 1.2 million Americans to travel to Mexico seeking medical treatment each year, according to the organization Patients Beyond Borders . 

Patients Beyond Borders has calculated that, on average, Americans can expect to save 40% to 65% on medical treatments in Mexico. Cosmetic surgery is among the most popular treatments Americans seek out in foreign countries, according to the group, along with cardiovascular, orthopedic, and even cancer treatments. 

One 2020 survey of American medical tourists in Mexico found that dental procedures were the most sought-after medical service, and 92% of the people surveyed cited cost as the reason they participated in medical tourism. 

Related stories

Lydia Gan, who heads the Medical Tourism Research Center at the University of North Carolina at Pembroke, said medical tourists can face great risks traveling abroad for procedures if they fail to properly research the countries and medical facilities they're visiting.

Gan said the Mexico kidnapping should be viewed as an "isolated case." The greatest risk medical tourists face is "not knowing your environment," she told Insider.

When selecting travel destinations, Gan recommended people always review the State Department's travel advisories about the areas they're visiting. Currently, the State Department has issued a "do not travel" advisory to the Mexican state of Tamaulipas due to the heightened risks of crime and kidnapping.

Gan, herself, has traveled to Tijuana, Mexico, for medical treatment and said she felt "very safe" due to the extensive research and precautions she took before traveling.

"Typically, if I go to a country for treatment, I spend about a month doing research on the country, and definitely have a contact person there that I can work with," Gan said. 

She said Americans can even seek out medical tourism travel agents to further reduce their risk. These organizations can arrange travel for patients between airports, medical clinics or hospitals, and hotels, and can even assist in seeking out accredited doctors and hospitals.

Gan said Americans can find superior care to what they'd receive in the US — for a fraction of the cost. She said patients should seek out medical facilities that are accredited by the Joint Commission International to ensure they are on par with American standards of care.

"A lot of these hospitals have doctors that are US or UK board certified, and have been trained in the US or the UK," Gan said. "The nurse-to-patient ratio is usually 1:1, and you get more attention. You're not just a statistic. People just have to do their homework."

• Main content

Medical tourism in spotlight after Mexico kidnapping

Washington (AFP) – As reports swirl around the recent kidnapping in Mexico of four Americans, two of whom were killed, one detail has drawn particular attention -- they had crossed the border for a medical procedure.

Issued on: 09/03/2023 - 03:40 Modified: 09/03/2023 - 03:42

The revelation threw a spotlight on the steady stream of so-called medical tourism from the United States to its southern neighbor, as Americans cross the border seeking lower costs or treatments inaccessible at home, despite the risks -- including that of going to a country known for drug-related violence.

Americans make the trip for everything from dental work to cosmetic surgery to treatment for cancer.

The industry in Mexico has grown steadily in the past two decades, with a lull during the Covid-19 pandemic, and was valued at a little over $5 billion in 2018, according to the state-owned National Exterior Commerce Bank.

Mexico is now one of the top medical tourism destinations in the world, though the country has had to contend with a negative image associated with entrenched organized crime and cartel-related violence.

But risks associated with medical tourism are more often linked to substandard care if one is not careful in selecting a provider than "political or social violence," said Josef Woodman, CEO of international health care consulting company Patients Beyond Borders, told AFP. "That is so rare in our community."

The US Centers for Disease Control and Prevention (CDC) also warns of potentially poor quality of care as a medical tourism risk, along with infection and difficulty communicating with staff.

Tamaulipas state, where the four Americans crossed into the crime-plagued city of Matamoros, is one of the Mexican states most affected by crime. The US State Department advises citizens to avoid the region entirely, citing kidnapping as one danger.

But it is not a state particularly popular for medical tourism, said Woodman, as it lacks the medical infrastructure other areas have cultivated.

And far from being discouraged by the grisly news, Woodman said his organization's inbox has been "deluged over the past 36 hours" by requests from individuals interested in travelling for procedures.

Just a few days ago, Colorado retiree Amber O'Hara recommended to a friend the dental clinic in Mexico where she has traveled multiple times for treatment.

"The cost is why I go," O'Hara said, noting, however, that the care was also top notch.

"I felt very comfortable and confident in all aspects of treatment and will definitely go again when needed," she told AFP.

Her dentist is in the town of Los Algodones, nicknamed "Molar City" for its wide array of dental offices catering to foreigners.

It is snug against the Arizona border, on the other side of the country from Matamoros, which O'Hara said she would avoid, as "there have been more than one bad situation there."

'Prohibitive' cost

She is one of 1.2 million Americans that Patients Without Borders estimates travel to Mexico for healthcare annually.

Dental treatment is one of the most commonly sought procedures, according to the CDC, along with "surgery, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment."

Woodman said surgeries to control weight not covered by a patient's insurance are common goals among Americans traveling to Mexico.

Getting "unavailable or unapproved" procedures is a top reason for going abroad, according to the CDC, which also highlights lower costs -- averaging at 40-60 percent cheaper for Americans in Mexico, according to Woodman -- as a major driver.

A 2020 study that surveyed more than 400 people crossing the US–Mexico border found 92 percent cited cost as a key factor in choosing medical tourism.

"In the US, we have the most expensive healthcare system on the planet," said Elizabeth Ziemba, president of training and consulting group Medical Tourism Training.

"The possibility of having to spend a great deal of money to access health care in the US is prohibitive for some people so they look at other cost effective alternatives."

But, she added, when looking abroad it's crucial to research thoroughly the healthcare provider, as well as the destination, as substandard care often comes with an enticing price tag.

"I encourage people to really do their homework."

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One million people do it every year. But after the tummy tuck murders, how safe is it to seek healthcare in Mexico?

The killing of two us citizens on their way to a mexican clinic is a stark warning for the nearly one million americans who cross the border for medical care each year, io dodds reports, article bookmarked.

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"Ma, I’ll be okay." That was what 33-year-old Latavia "Tay" Washington McGee told her mother on Wednesday 1 March before setting off on the roughly 1,500 mile journey to Mexico to visit a medical clinic.

Two days later, Washington McGee and the three friends accompanying her were ambushed and kidnapped in the border town of Matamoros by gunmen believed to be part of a Mexican criminal cartel.

The trip ended in tragedy, with one Mexican bystander and two of the Americans killed while Washington McGee and the other survivor were returned safely to the US. Mexican police have arrested at least one suspect who allegedly surveilled the victims before the attack.

It is a stark warning to the early one million Americans who are estimated to visit Mexico for medical care every year, often in border towns where violence between rival cartels is particularly dire.

"There has been increased violence in the last several months," Ken Bombace, a former US military intelligence officer who now provides bodyguards for travellers, tells The Independent .

• Mexico kidnapping – live: Fifth friend reveals she had lucky escape from Matamoros drug cartel attack
• Mexico kidnappings: What we know about the abduction of four US citizens in Matamoros
• Suspect arrested in death of Mexico ‘tummy tuck’ tourists as US vows ‘justice will be done’
• Photos show rescue of two American tourists from drug cartel stash house as dead friends identified

"The unstable situation with migration and fentanyl transport at the border has created a very dangerous environment... I would avoid travel to Mexico right now if it can in any way be avoided – especially in the north."

The kidnappings come after a string of other incidents in which foreign travellers were killed or tangled up in conflict between rival gangs , as well as a far greater number of murders and "disappearances" targeting Mexican civilians.

Experts say that specific areas of Mexico remain broadly safe for tourists , with popular travel spots such as Yucatán state, Mexico City, and the city of Monterey posing little danger while states with a heavy cartel presence such as Sinaloa and Jalisco are best avoided.

The US State Department currently warns Americans not to travel to Matamoros and its surrounding state of Tamaulipas due to "crime and kidnapping ", with all but one other border state classified as "reconsider travel".

But that may not be so easy for travellers visiting a specific medical clinic, especially if their reason for doing so in the first place is because they can't afford healthcare in the US.

"It's economics," University of Texas immigration professor Néstor Rodriguez told BBC News. "Medicines and services are cheaper in Mexico, especially dental procedures. You can get your teeth cleaned or an implant for a fraction of the cost of what you get in the US."

So how safe is Mexico today for tourists, including so-called medical tourists?

A formerly calm border city consumed by cartel civil wars

Shortly after crossing the border on Friday 3 March, Washington McGee called her mother Barbara Burgess to say she and her friends were 15 minutes away from her clinic.

Burgess, 54, told ABC News that her daughter had travelled from their home in Myrtle Beach, South Carolina to get a tummy tuck in Mexico , her second such trip. She was joined by her cousin Shaeed Woodard and friends Zindell Brown and Eric Williams.

What happened next is unclear, but a family friend told CNN that the group had got lost and contacted their clinic asking for directions. Not long afterwards, a gunman opened fire on their vehicle, and they were subsequently removed and loaded into a truck by armed men in body armour.

US investigators reportedly believe that gangsters mistook Washington McGee and her friends, who are Black, for Haitian drug smugglers.

Such incidents are all too common in Tamaulipas, where the US State Department says criminal gangs often stop cars and buses to capture the passengers and demand ransom payments.

"Heavily armed members of criminal groups often patrol areas of the state and operate with impunity particularly along the border region from Reynosa to Nuevo Laredo," says the State Department. "In these areas, local law enforcement has limited capacity to respond to incidents of crime."

According to José Andrés Sumano Rodríguez, a Mexican professor specialising in border violence at the College of the Northern Border, these latest attackers are thought to be members of a criminal group known as the Scorpions, linked to the powerful but now splintered Gulf Cartel.

Once upon a time, Matamoros was relatively peaceful due to its domination by the Gulf Cartel, which allegedly infiltrated the Tamaulipas state government at a high level. Texan students would often visit the city for spring break blowouts, according to the Associated Press.

But the death of drug lord Samuel Flores Borrego in 2011 set off a power struggle between rival factions that continues to this day. More than 6,000 people have disappeared in the state of Tamaulipas, and mass graves have reportedly been found near a local beach called the Playa Bagdad.

Hence, the Scorpions regularly clash with two other Gulf splinter gangs, the Northeast Cartel and Los Metros, Andrés Sumano says. The main criminal industries are drug trafficking, human trafficking, and extortion.

"In Tamaulipas, you have an important fragmentation in organised crime groups... with a new government that seems like it's still a little bit confused and doesn't know exactly how to respond to this type of situation," he tells The Independent .

"Usually, more criminal competition with low state capacity will [lead to] higher violence and high crime, and this is what has happened in Tamaulipas."

Worse, Andrés Sumano says the election of a new state governor last year, which dislodged the existing protection agreements and other relationships between criminal gangs and local officials. The previous governor is in a long-running constitutional dispute with federal authorities over allegations of corruption .

Meanwhile, Bombace says that the arrest of Sinaloa Cartel capo Ovidio "The Mouse" Guzman Lopez , the son of notorious drug lord Joaquin "El Chapo" Guzman, has set off violent reprisals throughout the state of Sinaloa, with gunmen even opening fire on a passenger airliner at Culiacán International Airport .

A previous attempt at arresting Guzman Lopez failed in 2019 when when government troops were besieged and forced to flee by a massive cartel force. One of the officers involved was reportedly murdered the following month .

• Drug lord, trafficker, killer of wedding singers: How the ‘New Mouse’ followed in the bloody footsteps of his father El Chapo

How safe are other parts of Mexico?

Ask Mexico's president Andrés Manuel López Obrador and he would tell you that Mexico is very much open for business. In 2021, responding to a series of attacks on foreign travellers, he formed a new "Tourist Security Battalion" comprising 1,445 officers from the National Guard military police force he created two years earlier.

In a televised phone call with Tamaulipas's new governor on Tuesday, Lopez Obrador said this latest tragedy will be seized by the American media to portray Mexico as a dangerous country, in stark contrast with their "silence when Mexicans are killed in the US".

During a press conference, he added: "We continue to work every day towards peace, and are very sorry that this has happened in our country."

Experts consulted by The Independent say that the danger to tourists differs sharply between Mexico's 32 states and federal jurisdictions.

"It's not everywhere. It's in very specific areas," Alejandro Hope, a security analyst and former member of Mexico's National Intelligence Centre, told The Independent last August after a recent week of violence along the US border.

"It's really highly unlikely that any tourist will face something like this, but still, the risk is there and will be there for a while."

Brad Bonnell, a forensic consultant and former head of global security for the Intercontinental Hotels Group, which owns the Intercontinental and Crown Plaza chains, likewise said last year that "lot of the fear is unreasonable fear, and a lot of the risks can be mitigated through intelligence".

Even Dan Howell, a travel agent in Cincinnati, Ohio who was forced to take shelter during a 2021 trip to Cancún when gunfire broke out between rival drug dealers, said he does not plan to stop visiting Mexico and that bookings for the so-called "Mayan Riviera" had not slowed down.

Bombace, who provides travel protection services through his company Global Threat Solutions, was more pessimistic, saying last year: "Until recently, my advice has been that I definitely wouldn’t cancel my trip to Mexico because of reports of violence.

"However, it seems that the violence between cartels has been increasingly spilling into the areas most often visited by tourists... and tourists have even fallen victim to feuding gang members in areas that were often thought to be off limits to the cartels, such as hotels, resorts and restaurants."

What about visiting medical clinics in border states?

The situation is murkier for those visiting one of the many Mexican medical clinics that specialise in catering to foreigners, which are often located near the US border.

The Mexican Council for the Medical Tourism Industry estimates that almost one million Americans visit Mexico for healthcare every year. Prior to the pandemic, the health travel advocacy group Patients Beyond Borders gave a similar estimate of about 800,000 to one million American citizens per year, roughly 75 per cent of whom sought dental or cosmetic care.

There are also many undocumented Mexican immigrants who temporarily travel back home for medical procedures, the group added.

The reason is simple: cost savings of between 40 to 60 per cent, according to PBB. A knee replacement that costs $31,200 on average in the US can be reduced to an average $12,300 in Mexico, while a facelift drops from $10,350 to $5,300 and a nose job from $6,300 to $3,950.

Some Americans have crossed the border in search of insulin – an essential drug for people with type 1 diabetes that is sometimes unaffordable in the US even with health insurance . One such traveller told Kaiser Health News in 2019 that they had paid $600 in the border city of Tijuana for a supply that would have been $3,700 in Los Angeles.

In Tamaulipas, the roads leading south from the state's two main border crossings are lined with dentistry offices and hotels. For some border towns, foreign healthcare is a major industry.

“The Matamoros incident was an extreme rarity, one that I expected to see a long time ago,” PBB’s chief executive Josef Woodman tells The Independent. “I am so sorry for the survivors and their families – so much for anyone to have to endure.

“While there's nothing I can think of to prevent a freak [event] like this from happening to a medical traveler, there's plenty that patients can do to help ensure a rewarding outcome on an affordable procedure.”

The group’s most recent guidebook recommends that health travellers check goverment advisers before travelling and trust only “established travel service providers”, ideally those that shuttle their patients directly to clinics from an airport or hotel.

Andrés Sumano says criminals in Mexico rarely target tourists deliberately because the risks far outweigh the benefits. "Usually, when [gangsters] see someone that isn't recognisable, or from other areas, or something strange, they stop the car and ask questions, trying to find out who they are and what they're doing there. It's not the natural thing to go and attack," he says.

"If by some accident they happen to kidnap an American citizen, the most probable thing is that they will take him to banks, have him take money out of his account, and let him free. They know the implications of doing more than that."

Even so, some US travellers now change their vehicle's licence plate to a Mexican one after they enter the country so as to avoid the kind of attention that Washington McGee and her friends inadvertently attracted.

"If you cross the border, you know to go directly to your destination," Néstor Rodriguez, the immigration professor, told BBC News . "I stopped going."

The State Department says those who do travel in unsafe areas should keep their family or friends back home informed at all times; share their GPS location and photos of any taxi licence plates if they travel alone; use toll roads where possible; avoid driving at night; be cautious in bars, nightclubs, and casinos; and display no signs of wealth such as expensive watches or jewelry.

Another option would be to choose a clinic in a major city in one of Mexico's safer states and to fly there rather than drive, if you can afford to do so.

Brad Bonnell also advises US citizens to register with the State Department's Smart Traveller Enrollment Programme (STEP), which sends out regular bulletins about safety risks in the area you're visiting and helps US embassies and consulates track and search for citizens who run into trouble.

"There is an unbelievable amount of information available to you about the risks, whether it's from disease, crime, threat of civil disturbances," he told The Independent last year. "You can have your own personal intelligence-led security strategy...

"It's incumbent upon us take some responsibility not to put ourselves in harm's way. Or if we have to go someplace where know there might be an element of risk, to take reasonable precautions to mitigate those risks."

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Why Millions of Americans Are Taking Deadly Risks for Medical Tourism

The recent kidnapping of four Americans in Mexico are really part of a larger, damning indictment of the U.S. health care system.

Tony Ho Tran

Photo Illustration by Thomas Levinson/The Daily Beast

Last weekend, four Americans were ambushed and shot at by gunmen after they drove a minivan across the border into Northeastern Mexico. Two of the Americans were killed during the shootings, while the other two were kidnapped for days until law enforcement were able to locate and rescue the victims from a house in the rural area of Tamaulipas.

Later reports suggested the group were victims of mistaken identity —and were erroneously targeted by the gunmen who mistook them for other people.

However, the Americans were also victims of the dark side of medical tourism—the practice of traveling abroad in order to receive medical treatments that they might not otherwise be able to obtain in the U.S. due to financial or regulatory constraints.

“Border cities tend to be inherently dangerous places, but that is where many medical centers that attract Americans happen to be located,” Adam Wellstead, a professor of public policy and social sciences at Michigan Tech University, told The Daily Beast. “[Many] people flock to Mexico for medical care.”

It’s important to stress at the outset that the four who were attacked were undoubtedly victims. Two of them had their lives taken while the lives of the other two have been changed forever by this tragedy. However, the situation underscores some of the inherent dangers that come with the practice of medical tourism and traveling into foreign countries in order to receive medical care.

Patients Beyond Borders, a medical travel advocacy group based in North Carolina, estimates that roughly 800,000 to 1 million Americans travel abroad each year in order to receive some form of treatment. While medical tourists will travel to far-flung countries like Singapore, India, Thailand, and Malaysia to receive care, they’re more than likely to stick to places closer to home like Mexico, Costa Rica, or even Cuba. That makes Mexican border cities like Matamoros (where the four Americans traveled to) or nearby Reynosa fertile ground for medical centers to service them.

But that’s where the risks begin—at least for the four Americans who traveled to Tamaulipas. The U.S. State Department has issued a “Do Not Travel” advisory on the state of Tamaulipas “due to crime and kidnapping” by organized criminal groups—the exact place where the four Americans traveled to for the tummy tuck procedure.

Wellstead emphasized that the situation sounds like “an isolated incident” that may not necessarily reflect the risks that most Americans might face when traveling for medical procedures. But the U.S. Center for Disease Control and Prevention also warns that, like any other medical procedure, medical tourism also comes with risks such as complications from surgeries, and contracting pathogens such as hepatitis B and HIV.

The growing demand for medical services from Americans traveling abroad to places like Mexico also strains the “supply-side capacities” of these destination countries, Wellstead said. He added that not knowing the health policy environment of these countries might also result in additional “medical risks and safety concerns.”

Despite this, there has been little in the way of regulatory efforts when it comes to the practice. Wellstead co-authored a paper published in the journal Global Health in 2020 that looked at the policy environment when it comes to medical tourism. He argues that “policymakers have largely “failed to articulate a clear and comprehensive policy vision” when it comes to medical tourism regulation.

So medical tourism isn’t going to go away any time soon—especially as more and more Americans continue to reject the U.S. health care system due to its cripplingly expensive and generally exploitative nature . Overseas medical care offers “substantially lower costs with patients usually receiving the same quality of care as in the U.S.,” Wellstead said.

This makes places like Mexico or Thailand especially appealing to people who lack insurance but need dental or surgical work done. And even having insurance will not guarantee coverage for elective work like cosmetic surgery. A tummy tuck can cost upwards of $8,000 in the U.S. However, it can cost nearly half of that in a place like Tijauana or Bangkok. Abroad, low- to middle-income earners in the U.S. suddenly have access to procedures they are otherwise barred from.

It’s not just surgeries either. Americans are also willing to cross the border in order to purchase life-saving medicines like antibiotics and insulin at a fraction of what they would cost out-of-pocket in the U.S.—perhaps the most damning indictment of American health care and a more empathetic reason people engage with medical tourism.It’s more than just folks looking for cheap medicine or tummy tucks.

While policies could be enacted to discourage more Americans from practicing medical tourism, the easiest solution would perhaps be lower cost or even free health care. Instead, many feel their last resort is to dig out their passport, hop into a plane or car, and travel to a foreign country to find care at the risk of their own livelihoods.

That may seem like a wild approach, but for many Americans, these options are the difference between life or death.

Got a tip? Send it to The Daily Beast  here .

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Medical tourism drew kidnapped Americans to Mexico, along with millions of others

Group of americans kidnapped in matamoros had traveled for a “tummy tuck” procedure.

Garrett Brnger , Reporter

Ken Huizar , Photojournalist

San Antonio – The group of Americans kidnapped in Matamoros, a Mexican city across the border from Brownsville, were just a small part of the steady stream of U.S. travelers who cross the southern border for medical tourism every year.

The group had traveled from South Carolina because one of them wanted to get a tummy tuck procedure, a relative told the Associated Press . However, they got caught in a shootout and were abducted.

Two of them were found alive Tuesday and were brought to a U.S. hospital. The federal government is working to bring the bodies of the other two back to the United States.

READ MORE: 2 kidnapped Americans found dead in Mexico, 2 others alive

David Vequist, the director and founder of the Center for Medical Tourism Research at the University of the Incarnate Word, says millions of travelers from the U.S. side of the border visit Mexico every year in search of health care and prescription drugs.

The prices are cheaper, and he says the limited data available indicates there’s not much statistical difference in the quality of care.

“When people go into Mexico, they’re essentially saying that they believe that there’s a certain quality level at a certain price point that they believe is giving them value,” Vequist said.

READ MORE: Families shaken awaiting word on Americans taken in Mexico

In 2023 alone, he expects U.S. travelers to spend more than $264 million on health care in Mexico.

Vequist says recent CMTR research, which has not yet undergone the review process, shows tummy tucks are the most common procedure for women seeking cosmetic surgery abroad. A close second is the so-called “ mommy makeover ,” which is typically a combination of procedures.

However, Vequist says people traveling to Mexico for health care are most often going for dental care.

Although Vequist says there’s not enough data to say exactly where medical tourists are going in Mexico, he said people in the Rio Grande Valley tend to seek care across the border more frequently than the rest of the country.

The Mexican state of Tamaulipas, which stretches from Nuevo Laredo to the Gulf of Mexico and includes Matamoros, is considered one of the most dangerous in the country . The U.S. State Department has advised Americans against traveling there and has given it the same warning level as Ukraine, Afghanistan, and North Korea.

READ MORE: US warns against travel for much of Mexico, due to crime and kidnapping

Copyright 2023 by KSAT - All rights reserved.

About the Authors

Garrett brnger.

Garrett Brnger is a reporter with KSAT 12.

Before starting at KSAT in August 2011, Ken was a news photographer at KENS. Before that he was a news photographer at KVDA TV in San Antonio. Ken graduated from San Antonio College with an associate's degree in Radio, TV and Film. Ken has won a Sun Coast Emmy and four Lone Star Emmys. Ken has been in the TV industry since 1994.

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https://www.barrons.com/news/medical-tourism-in-spotlight-after-mexico-kidnapping-ec9e7143

• FROM AFP NEWS

Medical Tourism In Spotlight After Mexico Kidnapping

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Visitors from the United States walk past a dental office in downtown Los Algodones, near the US-Mexico border in 2017

As reports swirl around the recent kidnapping in Mexico of four Americans, two of whom were killed, one detail has drawn particular attention -- they had crossed the border for a medical procedure.

The revelation threw a spotlight on the steady stream of so-called medical tourism from the United States to its southern neighbor, as Americans cross the border seeking lower costs or treatments inaccessible at home, despite the risks -- including that of going to a country known for drug-related violence.

Americans make the trip for everything from dental work to cosmetic surgery to treatment for cancer.

The industry in Mexico has grown steadily in the past two decades, with a lull during the Covid-19 pandemic, and was valued at a little over $5 billion in 2018, according to the state-owned National Exterior Commerce Bank.

Mexico is now one of the top medical tourism destinations in the world, though the country has had to contend with a negative image associated with entrenched organized crime and cartel-related violence.

But risks associated with medical tourism are more often linked to substandard care if one is not careful in selecting a provider than "political or social violence," said Josef Woodman, CEO of international health care consulting company Patients Beyond Borders, told AFP. "That is so rare in our community."

The US Centers for Disease Control and Prevention (CDC) also warns of potentially poor quality of care as a medical tourism risk, along with infection and difficulty communicating with staff.

Tamaulipas state, where the four Americans crossed into the crime-plagued city of Matamoros, is one of the Mexican states most affected by crime. The US State Department advises citizens to avoid the region entirely, citing kidnapping as one danger.

Medical tourism from the United States into Mexico is a mult-billion dollar a year industry, according to Mexico's state-owned National Exterior Commerce Bank 

But it is not a state particularly popular for medical tourism, said Woodman, as it lacks the medical infrastructure other areas have cultivated.

And far from being discouraged by the grisly news, Woodman said his organization's inbox has been "deluged over the past 36 hours" by requests from individuals interested in travelling for procedures.

Just a few days ago, Colorado retiree Amber O'Hara recommended to a friend the dental clinic in Mexico where she has traveled multiple times for treatment.

"The cost is why I go," O'Hara said, noting, however, that the care was also top notch.

"I felt very comfortable and confident in all aspects of treatment and will definitely go again when needed," she told AFP.

Her dentist is in the town of Los Algodones, nicknamed "Molar City" for its wide array of dental offices catering to foreigners.

It is snug against the Arizona border, on the other side of the country from Matamoros, which O'Hara said she would avoid, as "there have been more than one bad situation there."

She is one of 1.2 million Americans that Patients Without Borders estimates travel to Mexico for healthcare annually.

Dental treatment is one of the most commonly sought procedures, according to the CDC, along with "surgery, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment."

In this photo taken on February 15, 2017 visitors from the United States sit near a souvenir stand and dental clinic in downtown Los Algodones, near the US/Mexico border, northwestern Mexico

Woodman said surgeries to control weight not covered by a patient's insurance are common goals among Americans traveling to Mexico.

Getting "unavailable or unapproved" procedures is a top reason for going abroad, according to the CDC, which also highlights lower costs -- averaging at 40-60 percent cheaper for Americans in Mexico, according to Woodman -- as a major driver.

A 2020 study that surveyed more than 400 people crossing the US–Mexico border found 92 percent cited cost as a key factor in choosing medical tourism.

"In the US, we have the most expensive healthcare system on the planet," said Elizabeth Ziemba, president of training and consulting group Medical Tourism Training.

"The possibility of having to spend a great deal of money to access health care in the US is prohibitive for some people so they look at other cost effective alternatives."

But, she added, when looking abroad it's crucial to research thoroughly the healthcare provider, as well as the destination, as substandard care often comes with an enticing price tag.

"I encourage people to really do their homework."

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