# International Medical Insurance



## miaclockman

My wife has just retired and I'm on Social Security Disability from several major health problems. In order to maximize our retirement $$$ we are considering moving to San Miguel de Allende.

My main concern is being able to obtain International Health insurance to cover the costs that I have with a multitude of specialists, required yearly tests, and prescription drugs. My fear is that the companies will exclude my current medical diseases and I won't be able to obtain medication insurance. Some of the pain meds are Class II in the USA (highly controlled), so I can't just go over the border once a month and then bring them into Mexico. I have a feeling that eyebrows would be raised.

Has anyone had experience with obtaining Int'l medical insurance AND having pre-existing conditions and/or disorders? Granted, I know that medical care in that particular city is excellent and much cheaper than in the USA, but I'm afraid that without insurance, we would be eaten alive by costs for tests and medications. Our major medical insurance which can be purchased from our employer can be retained until age 65, but it only covers emergencies when traveling as a tourist in a foreign country.

So, am I out of luck as far as considering a permanent move to Mexico? My doctors tell me that Insurance plans in other countries are much more forgiving because they don't have the regulations and restrictions that companies in the USA have.

Any advice or links would be greatly appreciated.

Thanks,

Miaclockman


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## El Toro Furioso

miaclockman said:


> ....So, am I out of luck as far as considering a permanent move to Mexico? My doctors tell me that Insurance plans in other countries are much more forgiving because they don't have the regulations and restrictions that companies in the USA have.
> 
> Any advice or links would be greatly appreciated.
> 
> Thanks,
> 
> Miaclockman


I hope that someone else can come up with better news than I have, but here goes:
Any and all preexisting conditions will be excluded. Further, the fact of the preexisting conditions will most likely exclude *you* completely as well. I have benign hypertension completely under control with one pill a day, but a big insurer affiliated with a US insurance company excluded me because of it. So I could only get IMSS, or Mexican SS insurance. 

What might make sense to do is to find out, preferably in person, how much your medical care and medications would cost you in SMA. (BTW, you could live a lot cheaper in a lot of other places in Mexico, including some places lakeside.) You would need to consult a local doctor and, if needed, the most appropriate hospital institution for your condition(s). The hospital costs may include the services of any specialists you need to consult. You would need to ensure that there would be no problems getting an MD in Mexico to write your Rx's, since the drugs you are taking require this here. See if one of the doctor(s) would translate your meds into the generic (where available) Mexican equivalent drug in Spanish. Then you would need to take a list of your medications to at least four pharmacies that carry them all to get quotes. You will probably find that the prices vary from one pharmacy to another significantly, sometimes by a huge amount, so the multiple quotes are a necessity. Then you would be in a position to make some decisions. Mexico might just turn out to be affordable for you without private insurance which, if you could get it, would cost at least $3,000 USD/year if not a lot more.
Finally, you might consider doing the same exercise, remotely or in person, in another area of Mexico such as the Lake Chapala area near superb medical facilities in Guadalajara. Good luck! ¡Qué le vaya bien!


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## miaclockman

El Toro:
thank you for the quick reply. If I may ask, what do you think is the quality of IMSS insurance compared to the average HMO in the USA? I understand that the cost of living is considerably lower in Mexico, and SMA looks to be a lovely city with 15th century charm.

What would kill me financially WOULD be the cost of drugs. I have been in pain managment since 2001 from 4 failed back surgeries. My vertebrae are now fused without any relief from the pain. Without considerable doses of pain medications in the doses that are given to cancer patients, I would not be able to function. I know that the 2 meds that I am prescribed here in the USA would cost me $3,000/month without insurance. So I don't know if IMSS covers prescription medications. To further complicate matters, most medications could be fillled in the states for a 90-day supply which I could even cheaply fly to Texas or California for that. However, the pain meds are so restricted because of the paranoia in this country. The patient can only get a 30-day supply, the script must be written in ink, filled within 5 days of the date on the script, and NO refills.

I have no idea if you can answer any of these questions, but maybe some other reader may be in a similar situation.

Thanks again, and I will perform a search for IMSS on the web to see if I can get some more answers.

Miaclockman


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## RVGRINGO

El Toro is correct on all points; San Miguel de Allende is a very expensive place to live, in comparison to other options, farther from an international airport and at higher altitude, etc. Yes, you are likely to be totally excluded from insurance coverage by your preexisting conditions; even by IMSS. You may find a pain management physician (not all can do that) to treat you at your own expense, as well as an orthopedist, but will have to pay for your own medications as well. It would appear that your only recourse might be the choice between paying your own way in Mexico or staying in the USA for Medicare and VA benefits, if you are eligible. In any case, I believe that you would have to return to the USA periodically to maintain your Social Security Disability via medical updates from a US physician; isn't that so?


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## El Toro Furioso

I think RV answered your questions. When you speak of "the paranoid in this country," I take it that you are talking about the US. There is a lot of caution in Mexico as well, with some MDs reluctant to prescribe them. I know nothing of costs, but I would be happy to ask if you send me the names of a few of your meds. On a personal note, I had neurosurgical anterior fusion of C5/C6 and removal of a bone spur after two years on a similar pharmaceutical regimen. So I know a little of what you speak.
On a lighter side, San Miguel de Allende did have a lot of 15th century charm. Then the Spaniards arrived in the 16th century! ¡Qué le vaya bien!


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## BryansRose

I moved down here, in large part because of health care costs in the US. I'm on several medications, and I've found this: the brand names seem to be about the same as I paid in the US, while the generics are about 10% of what I paid in the US. I'm also finding that at least one of the generics doesn't work for me. 

I just signed up for the IMSS health insurance, and the questionairre I had to fill out was much less than I expected. Do you drink? how much? Do you smoke? And a small list of about 20 chronic things to check off. I could find one thing that applied to me. So that will be excluded, I think for 2 years. Clinic visits will be free to me. I do think there is an exam when you first show up at the clinic, so other things may be excluded, I don't know. The cost for my age range is $160 USD per year. 

I have seen a private doctor already, and his charge was abour $45 for about 45 minutes of his time. House calls are about $60. Lab tests were an estimated 25% of the cost in the US. Although it's been a few years since I could afford any tests in the US so maybe it's even better than that. 

Hope this helps. Have you thought about making a trip down here first, and checking out drug prices?

And I would second the above opinions that San Miguel is expensive to live. You want to find a reasonably-sized city, though, or move close to one, so that you are assured of good health care.


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## El Toro Furioso

BryansRose said:


> I moved down here, in large part because of health care costs in the US. I'm on several medications, and...I'm also finding that at least one of the generics doesn't work for me.


Are you buying from Similares? Their drugs are not true generics, they are "similar" to but not the same formulation as the proprietary drug. Also, I'm guessing that you have tried several different generics of the drug that didn't work for you. You can also try asking if a particular pharmacy has a Canadian version of the generic. This will automatically include US-made and other "foreign" generics in the pharmacist's mind, but eases the way a little. I had to double the dose of the only med I take until I asked for a "Canadian" version. It works great and is made in Ireland. $45 pesos a month.


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## BryansRose

Thanks for the suggestions!

No, I'm not buying from Similares, but I didn't know about what you said, so I will bear that in mind. 

Just today I bought the brand name instead of generic to see if I start feeling better again. If I do, I'll shop around for different generics, and Canadian versions, too. 

Yes, the price is worth it. I went from 65 pesos to 1000 pesos for the brand name. Ugh.


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## El Toro Furioso

Yuck! (but it has to be at least 10 characters) so Yuckity yuck!


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## maesonna

There are 3 more possible avenues of research that could be worth exploring. You can research all these on the internet. 

- how much would your medications, or generic versions of them, or alternative medications for your conditions cost in Mexico?
- private Mexican health insurance instead of international insurance
- cheaper places to live in Mexico than San Miguel Allende


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## marcuswraight

BryansRose,
Hi - I wondered if you could contact me? I'm interested in your move to Mexico. I work for a public radio program and we are looking at the health care issue now. My email address is mark.durant at ymail dot com
Thanks
Marcus


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## Davidc

*Mexico Medical*



miaclockman said:


> My wife has just retired and I'm on Social Security Disability from several major health problems. In order to maximize our retirement $$$ we are considering moving to San Miguel de Allende.
> 
> My main concern is being able to obtain International Health insurance to cover the costs that I have with a multitude of specialists, required yearly tests, and prescription drugs. My fear is that the companies will exclude my current medical diseases and I won't be able to obtain medication insurance. Some of the pain meds are Class II in the USA (highly controlled), so I can't just go over the border once a month and then bring them into Mexico. I have a feeling that eyebrows would be raised.
> 
> Has anyone had experience with obtaining Int'l medical insurance AND having pre-existing conditions and/or disorders? Granted, I know that medical care in that particular city is excellent and much cheaper than in the USA, but I'm afraid that without insurance, we would be eaten alive by costs for tests and medications. Our major medical insurance which can be purchased from our employer can be retained until age 65, but it only covers emergencies when traveling as a tourist in a foreign country.
> 
> So, am I out of luck as far as considering a permanent move to Mexico? My doctors tell me that Insurance plans in other countries are much more forgiving because they don't have the regulations and restrictions that companies in the USA have.
> 
> Any advice or links would be greatly appreciated.
> 
> Thanks,
> 
> Miaclockman


Please Note: If you become a resident of Mexico you and your wife can be covered by Mexican Social Security, IMSS, Instituto Mexicano del Seguro Social and your cost per year could be as low as $3,400.00 pesos per year (about $260.00 dollars per year each). They provide you with all medication, examination, and whatever else is needed to keep you healthy. This is one of the major perks of living in Mexico, one of many. Check it out and be protected.


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## DNP

Davidc said:


> Please Note: If you become a resident of Mexico you and your wife can be covered by Mexican Social Security, IMSS, Instituto Mexicano del Seguro Social and your cost per year could be as low as $3,400.00 pesos per year (about $260.00 dollars per year each). They provide you with all medication, examination, and whatever else is needed to keep you healthy. This is one of the major perks of living in Mexico, one of many. Check it out and be protected.


IMSS will provide for all your prescription drugs, but only if they have them in stock!--too often not the case. If you're provided for well at home, you probably won't be here, unless you go out of pocket private.

Sent from my iPod touch using ExpatForum


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## Isla Verde

Davidc said:


> Please Note: If you become a resident of Mexico you and your wife can be covered by Mexican Social Security, IMSS, Instituto Mexicano del Seguro Social and your cost per year could be as low as $3,400.00 pesos per year (about $260.00 dollars per year each). They provide you with all medication, examination, and whatever else is needed to keep you healthy. This is one of the major perks of living in Mexico, one of many. Check it out and be protected.


This may not be true any longer, at least not in places that have a high proportion of expats who are enrolled with IMSS. I've been following a thread on another expat website that has been discussing this matter. Apparently, in certain areas, services to expats are now being limited to care for acute illnesses and emergencies, not for routine checkups and medicine and not for things like long-term cancer therapies.


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## pappabee

First of all, IMSS will not insure and new members who have pre-existing illnesses such as heart problems or diabetes. That has changed since 2010.
You must now take a physical and pass it in order to be insured. I am 68 and have controlled diabetes. I will not pass. Nor will I be able to purchase most other insurance due to my illness and age.

I spoke to the IMSS representative at Lake Chapala Society in May of 2011 and was told that there was no way anyone with a pre-existing illness would be able to pass.


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## AlanMexicali

*Imms*



Isla Verde said:


> This may not be true any longer, at least not in places that have a high proportion of expats who are enrolled with IMSS. I've been following a thread on another expat website that has been discussing this matter. Apparently, in certain areas, services to expats are now being limited to care for acute illnesses and emergencies, not for routine checkups and medicine and not for things like long-term cancer therapies.


"Seguro Popular the national health service or some other organization and are you saying it will cover people without any other health care plan for pre-existing disorders like High Blood Pressure, diabeties, arthritic hip & knee etc?"

Yes it is the bottom of the rung of the three systems of socialized heath care in Mexico funded and administed by the Federal Govt. The IMSS [Instituto Mexicano Seguro Social] is the largest and tax paying citizens y dependents for no charge or immigrants with Fm3 or FM2 status are invited to join for about $300.00 US year. Pre existing chronic conditions will not be treated or you may not be enrolled, depending on several things.

The second is ISSSTE [Instituto de Secretaria de Seguro Social de Trabajadores del Estatado] which is the State and Federal employees and their dependents or spouses personal separate Hospital, Emergency rooms, Ambulance service and clinic system.

The third is Seguro Popular which is for everyone else and has the largest coverage in Mexico and called Secretaria De Salud.

Anyone can go to get medical care there. All you have to do is go to the largest clinic and ask to see a Trabajador Social [Social Worker] They will ask about your financial situation and if you have no extra money you can be enrolled and no one is charged for services or Medicine if they stock it. You will need an FMM, FM3 or FM2 and a local address. If you are too sick to go through all that you can go to a Secretaria De Salud clinic to wait and see a Dr. and pay $65.00 pesos for a consultation, stitches set a broken arm Etc. and they will give you the medicine if they have it and a prescription if they don't.

Seguro Popular:
More than a 1,400 diseases that covers the Popular Health Services are related with specialties such as orthopedics, traumatology, rheumatology, rehabilitation, stomatology, gynecology and obstetrics, pediatrics, dermatology, mental health, addictions and emergency services. In addition to actions of prevention and health promotion, as well as care for communicable diseases, chronic-degenerative and general surgery.

Many times we have heard situations of people diagnosed with a serious illness, or diabetes, hypertension, problems with the heart and even cancer, without medical services of social security or sufficient economic resources to pay for your care in private hospitals; in these cases the alternative is the Popular Health Services.

Seguro Popular website: Continued

"In an interview with SUMEDICO Gabriel Cuts Gallo, deputy director of the Popular Health Insurance, said that any person even if you record a state of advanced disease can join this service for medical care, where there are no limits for registration. "From birth until the third age there is not a limitation, nor in the pre-existence of diseases, if a person is sick with cancer can apply for membership and will be granted".

"We know that people with higher income insurance major medical expenses and other advantages in private hospitals, as a fourth to a single patient; the permission to be with the several families; and even services such as television and that is why the Popular Health Insurance is not their first choice, it is understandable; but if it should be clarified that we have a very high technical quality of medical services, similar to that of any private institution", stressed the official.

In this context, he said that the care provided through this system is in first-class clinics, but also in specialty hospitals as well as on the network of the National Institutes of Health, which have international recognition for its high level of quality."

"He clarified that the Popular Health Insurance covers 100 percent of the attentions in the health service centers and 90 percent in general hospitals and the national institutes of health, this represents the attention of 1,400 diseases."

"He emphasized that this system of medical care covers, to date, the diseases with a greater impact by the gravity of the population, such as the various cancers in children; the breast and cervical in women and the testes in men, as well as cardiovascular disease. Another service that must be highlighted is the supply of antiretroviral drugs for people with the Human Immunodeficiency Virus (HIV/Aids)."


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## Davidc

*IMSS Denying Service!*



Davidc said:


> Please Note: If you become a resident of Mexico you and your wife can be covered by Mexican Social Security, IMSS, Instituto Mexicano del Seguro Social and your cost per year could be as low as $3,400.00 pesos per year (about $260.00 dollars per year each). They provide you with all medication, examination, and whatever else is needed to keep you healthy. This is one of the major perks of living in Mexico, one of many. Check it out and be protected.


Warning! IMSS is tightening its belt (in some areas) and denying service with strict enforcement of the Reglamentos. There is a lot of speculation, gossip, facts, who knows, going around and nobody seems to know who, where, why, when the ax will fall or even if because of all the complaints. Try googling IMSS Denying Service for lots of opinions.
And when will we know what they are really going to do? It appears every area is going to treat it differently until the word comes down from above, whatever that means? So, the warning is, wait and see, but prepare a plan B or even C, just in case.


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## TundraGreen

Davidc said:


> Warning! IMSS is tightening its belt (in some areas) and denying service with strict enforcement of the Reglamentos. There is a lot of speculation, gossip, facts, who knows, going around and nobody seems to know who, where, why, when the ax will fall or even if because of all the complaints. Try googling IMSS Denying Service for lots of opinions.
> And when will we know what they are really going to do? It appears every area is going to treat it differently until the word comes down from above, whatever that means? So, the warning is, wait and see, but prepare a plan B or even C, just in case.


I see comments here about IMSS denying coverage, but I don't see any evidence of it when I go the clinic. Fortunately, I have not had to use it much but the few times I have been there the care has been great. Once I had to wait about an hour and a half in the emergency room. They had a sign stating there policy on triage. Basically, if you were bleeding they take you immediately with longer delays for lesser emergencies. By going in first thing in the morning, I have been able to see a doctor or dentist for teeth cleaning almost immediately. I do read about their financial problems but they haven't affected me. In fact the first year I enrolled I ended up having to pay twice. It took about 6 months but they eventually refunded the overpayment. However, my experience may differ from places where there are a lot of foreigners. I have never seen any other non-Mexican in any of the IMSS offices or clinics I have been too. There aren't many foreigners in my neck of the woods (Guadalajara Centro).


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## pappabee

TundraGreen said:


> I see comments here about IMSS denying coverage, but I don't see any evidence of it when I go the clinic. Fortunately, I have not had to use it much but the few times I have been there the care has been great. Once I had to wait about an hour and a half in the emergency room. They had a sign stating there policy on triage. Basically, if you were bleeding they take you immediately with longer delays for lesser emergencies. By going in first thing in the morning, I have been able to see a doctor or dentist for teeth cleaning almost immediately. I do read about their financial problems but they haven't affected me. In fact the first year I enrolled I ended up having to pay twice. It took about 6 months but they eventually refunded the overpayment. However, my experience may differ from places where there are a lot of foreigners. I have never seen any other non-Mexican in any of the IMSS offices or clinics I have been too. There aren't many foreigners in my neck of the woods (Guadalajara Centro).


Please read the attached article. IMSS denying expats chronic disease care | Guadalajara Reporter


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## TundraGreen

pappabee said:


> Please read the attached article. IMSS denying expats chronic disease care | Guadalajara Reporter


Thanks for the link. It is an interesting article. The situation near Lake Chapala seems very different than the experience I am having with IMSS in the city center. If anything, I feel like I get special treatment because of the novelty of seeing a foreigner. I had to fill out a questionnaire about my health history, but there was no medical exam required.


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## AlanMexicali

*Imms*



TundraGreen said:


> Thanks for the link. It is an interesting article. The situation near Lake Chapala seems very different than the experience I am having with IMSS in the city center. If anything, I feel like I get special treatment because of the novelty of seeing a foreigner. I had to fill out a questionnaire about my health history, but there was no medical exam required.


How many years ago was that?


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## pappabee

AlanMexicali said:


> How many years ago was that?


Must have been more than three.


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## AlanMexicali

*Socialized medicine*



pappabee said:


> Must have been more than three.


One of my sister in law's husband is a lawyer who works for the state judicial prosecution section for medical fraud. He claims there has been a thrust forward in clamping down since Calderon's administration discourages corruption and waste in almost all sectors and going forward improving Mexico's overall infrastructure. Just notice all the federal TV ads. addressing corruption and abuse and advertising the improvements nationwide.

The IMMS is a large part of the federal govt.'s budget. It does not seem unlikely it has been under scrutiny for years and policies are in place to repair it.


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## TundraGreen

pappabee said:


> Must have been more than three.


I first enrolled in June of 2010. I only filled out a questionnaire at that time. Then, I neglected to pay the annual dues until September of 2011. They told me I had been dropped and I would have to enroll as a new subscriber again. So I again answered the same medical questions, and re-enrolled. The first year my final form was stamped "Se Applican Restricciones". When they gave me the final form the second year, it was stamped "No Applican Restricciones" so they gave me credit for the first year even though I had let it drop.


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## AlanMexicali

*Socialized thinking*



TundraGreen said:


> I first enrolled in June of 2010. I only filled out a questionnaire at that time. Then, I neglected to pay the annual dues until September of 2011. They told me I had been dropped and I would have to enroll as a new subscriber again. So I again answered the same medical questions, and re-enrolled. The first year my final form was stamped "Se Applican Restricciones". When they gave me the final form the second year, it was stamped "No Applican Restricciones" so they gave me credit for the first year even though I had let it drop.


That sounds good. They took your word on it. The restrictions are normal I know. 

Another thing I noticed being in hospitals, clinics, govt. buildings is that the people cleaning the floors and grounds do not use efficient tools. The tiny cheap plastic buckets and cheap disposable mops they wring out by hand and have to take many trips to the sink and using cardboard to fan and stay there to keep people away. I asked my wife why they don't have professional yellow mop buckets and large industrial mops and 3 foot wide brooms instead of little cheap brooms etc. She said that is the policy. Being fairly confused I asked "What?". She explained that the people who clean inside and out are collecting fair wages, in a union, getting benefits for their family. They have a policy to keep as many people who deserve a decent break employed as possible. The more the better for the society and the better chance future generations will have better opportunities through a higher education because the children they have will not necessarily have to stop school to work for the survival of the family, especially if it is a large family.


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## TundraGreen

AlanMexicali said:


> That sounds good. They took your word on it. The restrictions are normal I know.
> 
> Another thing I noticed being in hospitals, clinics, govt. buildings is that the people cleaning the floors and grounds do not use efficient tools. The tiny cheap plastic buckets and cheap disposable mops they wring out by hand and have to take many trips to the sink and using cardboard to fan and stay there to keep people away. I asked my wife why they don't have professional yellow mop buckets and large industrial mops and 3 foot wide brooms instead of little cheap brooms etc. She said that is the policy. Being fairly confused I asked "What?". She explained that the people who clean inside and out are collecting fair wages, in a union, getting benefits for their family. They have a policy to keep as many people who deserve a decent break employed as possible. The more the better for the society and the better chance future generations will have better opportunities through a higher education because the children they have will not necessarily have to stop school to work for the survival of the family, especially if it is a large family.


I think there is more to it than that. I have one of the industrial style yellow buckets with a wringer on it. But the nice lady that I pay to clean the house every week never uses it. She just wrings out the mop by hand. I think that is the way she has always done it and doesn't think about changing. In a similar vein I had some workmen putting in new ceilings in a few rooms. They were using buckets to carry all of the water to mix the plaster and to wet down the ceiling before replastering it. They would just take handfuls of water from the bucket and throw it at the ceiling. Without saying anything, I put a hose next to the faucet they were using to fill the buckets. Then they started using the hose to mix the cement and to wet down the ceiling instead of carrying the water buckets. But bringing a hose with them was not something that they had been doing. I conclude from these two examples that there is a tendency to just do things the way they have always been done, without the impulse to always look for better ways to do things. But maybe I am extrapolating too much from too small a sample.


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## AlanMexicali

*Experimenting*



TundraGreen said:


> I think there is more to it than that. I have one of the industrial style yellow buckets with a wringer on it. But the nice lady that I pay to clean the house every week never uses it. She just wrings out the mop by hand. I think that is the way she has always done it and doesn't think about changing. In a similar vein I had some workmen putting in new ceilings in a few rooms. They were using buckets to carry all of the water to mix the plaster and to wet down the ceiling before replastering it. They would just take handfuls of water from the bucket and throw it at the ceiling. Without saying anything, I put a hose next to the faucet they were using to fill the buckets. Then they started using the hose to mix the cement and to wet down the ceiling instead of carrying the water buckets. But bringing a hose with them was not something that they had been doing. I conclude from these two examples that there is a tendency to just do things the way they have always been done, without the impulse to always look for better ways to do things. But maybe I am extrapolating too much from too small a sample.


I know what you mean from years past. Once in awhile in Mexicali I have been in tiendas buying things, especially since I have had to remodel 2 houses there a few times each and have heard younger employees who had worked in the many Japanese consumer electronic factories tell the other employees that way is a waste of time. We do it this way. Mexicali has so many things different than San Luis Potosi since people have been upgrading their approach. It is amazing how some ingrained practices are never questioned.

My wife is a top federal bureaucrat in our state for Mexico's socialized medical system. I get some good insight from her at times. Luckily she is not a political appointee.


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