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.”
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.”
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.
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.