Pharmacies in Ciudad Juárez that cater to El Pasoans and other U.S. customers who cross the border to save on prescription drugs have run out of Plaquenil, the brand name for hydroxychoroquine. Pharmacists say many of those buying the drug want it as a possible treatment for COVID-19. (Angela Kocherga/El Paso Matters)
By Joaquin Moreno

Recent events regarding the COVID-19 pandemic have shed light on major issues regarding disease and how it disproportionately affects specific demographics of the American population. Health inequity and the lack of access to care, especially for low-income populations, is a major problem that has silently persisted in the United States for a long time.

Across the border, Mexico has dealt with similar systematic differences even after its effort to implement universal health coverage at the turn of the century. The interdependent economical relation between the U.S. and Mexico has provided many opportunities for the social development of both countries mainly through trade and investment. Nonetheless, an obvious bi-national failure to address the lack of access to care for the most vulnerable populations in either country has yet to be solved.

Joaquin Moreno

Cross-border populations who migrate between Mexico and the United States often are unable to receive proper medical care back home and in their final destination due to their socio-economic status. The possibility of being denied a basic human right in two different countries is an issue that urgently requires more attention and new health policies to be considered.

My family and I migrated across the border, from Ciudad Juárez to El Paso, in 2008 due to the violence from ongoing drug wars and seeking better education opportunities for my siblings and me.

This experience taught me a valuable lesson about how detrimental a negative socio-political environment can be to the status quo of a country. Institutional corruption and government instability often dictate the outcome of how different sectors of government operate, including health care.

The Mexican health-care sector had a promising change in 2003 after the implementation of universal health coverage by tentatively ensuring medical care for all its citizens. However, research indicated that almost half of the Mexican population in 2012 did not have access to effective health-care services.

This major flaw in the Mexican health-care system still persists today and most of it can be attributed to the lack of appropriate and transparent regulatory mechanisms that have yet to be imposed by its government. Unfortunately, this disproportionately affects those of low socioeconomic status.

On the other hand, a first world country that currently spends close to 18 percent of its GDP on health care faces similar issues, some of which have become more apparent during the COVID-19 pandemic.

In the United States, data from the Centers for Disease Control and Prevention has highlighted how the coronavirus has disproportionately affected members of racial and ethnic minority groups who are at increased risk of getting COVID-19 or experiencing severe illness.Nonetheless, this should not come as a surprise since studies have consistently shown that racial and ethnic disparities in health and health care still remain a persistent challenge in the United States. Disparities not only result in inequities but also limit continued improvement in the quality of care and population health, resulting in unnecessary health care costs.

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The communities along the southern border of the United States share socio-cultural norms and values with Mexico but also rely on a collective economy that directly affects the health and wellbeing of its residents. This interconnectedness at the border regions contrasts the separation of efforts between the Mexican and U.S. health-care delivery systems.

In 2011, a publication on globalization and health between the United States and Mexico determined that differences in a health-care organization and its financing disrupt professional collaborations between the two countries, and is a major setback for the integration of systems.

The distinct societal values greatly influence how medicine is practiced in both countries. “In Mexico, as in many other countries, health care is based on solidarity; that is, on the principle of a national health system. In the United States, the organization of health care responds to a principle of individualism and laissez-faire that has created a fragmented health system,” Dr. Nuria Homedes of El Paso said.

The neighboring countries constantly work together to benefit from trade and investment initiatives, as well as cultural ties that connect both of the countries. However, we still fail to see initiatives be put to action which could benefit cross-border populations and their health care needs.

Mexico’s proximity to the United States has brought many opportunities in the past century for individuals seeking better life opportunities, especially those of lower socioeconomic status. This poses an interesting question: If individuals coming to the United States intend to seek a better lifestyle, why is access to health care not being included?

One study showed that Mexican-origin migrant adults, who are neither citizens nor legal permanent residents, often are the people least likely to have insurance coverage in this country. The lack of health coverage for Mexican migrants supports the idea that some individuals might not be able to receive care in either country.

Data suggests that immigrants often work in riskier jobs and in more dangerous occupations, which seems an obvious reason for providing them coverage. Additional studies have shown that providing health insurance for immigrants could lower the health premiums for all Americans.

Solutions to these problems have been suggested and health policies have been laid out for political figures to take action. Binational initiatives such as Salud Migrante and Medicare in Mexico have been proposed as solutions that could significantly benefit populations on both sides of the border. These initiatives would help overcome U.S. health-care reform limitations for uninsured Mexican immigrants and facilitate access to health care for U.S. retirees living in Mexico.

Even though significant legal, regulatory, and political challenges may exist, it would create the possibility of improving health insurance coverage for important segments of underserved binational populations.

The current global outbreak of the novel coronavirus has prompted government officials to realize the importance of establishing a strong health-care sector, both for the United States and Mexico. Nevertheless, this pandemic has also taught the public about the disproportionate effect that disease has on low-income populations.

Even though both countries have long benefitted from cross-border populations which greatly contribute to their respective economies, the health-care needs of those who are most vulnerable have been ignored for too long.

Individuals migrate to the United States seeking a better life which should not only consist of a good education or better job opportunities. A better life should also include access to a basic human right – health care.

Joaquin Moreno is an undergraduate student at the University of Texas at Austin pursuing a double major in biology and sociology. Being native to the border region has influenced his interest in studying binational health relations between the U.S. and Mexico.

Cover photo: Pharmacies in Ciudad Juárez are a key source of health care for residents on both sides of the border. (Angela Kocherga/El Paso Matters)