Earlier this year, I happened to see a social media video depicting Tijuana as a medical paradise for aging Americans, who were shown walking across the border on their way to the doctor. 

After watching, I had a few questions: Was this a solution to our health care woes in California? Or was it creating more problems for older adults? 

Because I’m a health columnist, I planned a trip to find out, accompanied by my trusted photographer, Maison Tran, and a former student, Oliver Garcia, who documented the trip on Instagram and TikTok. Our goal was to explore Tijuana’s medical care, talk to practitioners and their patients, and, yes, if time allowed, to consume a taco or two along the way. Here’s what we learned:

The confluence

The western hemisphere’s busiest land border crossing pulsates at a dizzying clip with buzzing freeways, a trolly station, pedestrians coming and going over walkways, and a seemingly endless fenced border stretching across the horizon. 

From here, you can’t miss the shiny blue tower: The 28-floor Newcity Medical Plaza in Tijuana stands like a beacon. It houses a hospital, operating rooms, medical offices, laboratories and imaging centers. The plaza includes a pharmacy, an optician and even a farm-to-table restaurant. There’s also an adjacent hotel and spa for patients, who are largely out-of-towners staying overnight to complete multiple procedures.

Newcity Medical Plaza is one of many health care facilities in the border town — which has become a medical tourism hub — but its flashy exterior and border proximity make it stand out.

Lower costs draw patients

Every year, an estimated 1 or more million patients venture from California to Mexico to obtain medical treatments and medicines, and a large contingent of these are aging people. 

Cost is the main reason to make the trip for 60 to 70 percent of patients, said Arturo Vargas Bustamante, a professor in the UCLA Fielding School of Public Health. 

“They cross the border mostly because cost is lower or they cannot access health care in the U.S. They have no insurance or are minimally insured,” he said. “They are saving their U.S. coverage for emergencies … They simply cannot afford high deductibles or high copays.”

About two-thirds of patients travelling from the US to Mexico are U.S.-born Latinos or Latino immigrants, according to Bustamante’s research. In the years to come, the share of older U.S.-based patients is expected to increase as the immigrant population ages and grows more diverse, he said.

The most popular treatments among older patients who cross the border are dental services, according to research and experts I interviewed, largely because so many lower-income workers and retirees don’t get dental care through their insurance or their basic Medicare package. 

After dentistry, the most in-demand treatments for older patients are plastic and bariatric surgeries, according to Dr. Fabian Walters, the president of the Baja Health Cluster, a Tijuana-based network connecting patients to 200 medical professionals, labs, hospitals and clinics. Walters said an average of 80 percent of the Baja Health’s patients are from the U.S.

Medical clinics such as those in the Baja Health network often make it easy for low-mobility elderly patients, chauffeuring them from the border to their offices, or providing a special “fast pass” that drivers can use to return to the U.S. in an expedited traffic lane. As for payment, insurance isn’t typically an option. 

“Most patients pay in cash,” Walters explained.

Besides cost, another benefit of medical tourism is the time that doctors take with patients to answer questions, Walters said. “In general, it’s a more personal relationship between doctor and patients,” he said.

The dental difference

A basic tooth cleaning, without X-rays, can cost as little as $60 in Tijuana, according to dental websites. But many aging adults are coming to Tijuana for pricier complex procedures, such as dental implants, which are often seen as far superior to conventional dentures. A full set of implants in the U.S might cost anywhere between $25,000 and $100,000.

In Tijuana’s Aviacion district, about four miles from the border, Dr. Sergio Herrera co-owns a dental practice called ProDent where he specializes in implants. According to his website, a single implant starts at $1,700 and includes a list of services such as X-rays. But the cost of a single implant in the U.S. runs on average $4,500.

Eighty percent of Herrera’s patients are over 50, and two thirds of those are from the U.S.

“Most are older patients that have already had dentures, or they’re missing teeth or their teeth are starting to crumble,” he said. “The biggest reason why patients come is price” — and not just the amount but the transparency.

“There are many times I’ll say, ‘This is the total,’ and they come back and say, ‘Are there any add-ons?’ ‘No, this is the final price.’”

Herrera earned a Doctor of Dental Surgery degree at the Autonomous University of Baja, California in Mexico. He completed a residency in implant dentistry in Boston and later, San Diego. He uses FDA-approved dental materials and generally tries to align his services with U.S. guidelines. 

His approach, which seems to combine training, methods and philosophy from two different cultures, is a good match for many of his patients who are comfortable in two cultures. A pair of cousins from Chula Vista, both over 50, who were in Herrera’s waiting room on the day I visited, exemplified the bicultural orientation. 

The two women grew up in both Mexico and the U.S. and speak English and Spanish interchangeably. One of the women said she receives all her dental treatment in Tijuana, because Medicare doesn’t cover her dental care. Her cousin, a retired nurse, said she feels comfortable in Herrera’s office, a brightly lit space with big windows, interior glass walls and plush white dental chairs that look a bit like chaise lounges when extended.

Care that caters to patients

Other advantages of medical tourism include speedy access to procedures. Ken Gunderson, 71, a retiree who lives in a mobile home community in Vista, said he and his wife have crossed the border to obtain imaging and cortisone shots within days, compared to the delays of insurance approvals and wait times for office visits in the U.S. He called the medical staff he’s encountered in Tijuana, “incredibly professional.”

Patients also report satisfaction in finding the exact treatments they want in addition to saving money.

Danielle Sokol, 55, a chiropractor from Huntington Beach who doesn’t have dental insurance, said her cost to do a series of procedures in Tijuana, including extractions, was about a quarter of the amount she was quoted locally. Further, she was able to find a biologic dentist in Tijuana, that is, one who takes a more wholistic approach, connecting teeth to whole-body health.

As for bedside manner in Tijuana, “They treated me like a princess. I’m serious,” she said. 

For Sonia Nuesse, 62, and her 71-year-old husband from Chino Hills, Tijuana doctors and pharmacies have allowed them to find allergy and other prescription medicines that provide better relief than their U.S. doctors can provide.

Is this a solution?

What I find myself asking is whether medical tourism is really a health care solution for U.S. patients. It would be hard to argue with the vast majority of patients I interviewed that it is not. But there are reasons why getting medical treatments in another country can be problematic. For one, you may need after-care beyond a day or two out from surgery, if healing doesn’t take place normally, and, once home, you won’t have access to your doctor who knows your case. Further, less regulation of medical professionals in Mexico can mean a less predictable level of care.

Procedures can and do go wrong, as in the U.S. A few years ago, a 73-year-old Laguna Woods woman I spoke to took her ailing husband to a dentist in Los Algodones, Mexico. She said he botched the job, leaving her husband with crumbling temporary veneers that he failed to fix on second visit. She had to get him all-new veneers in the U.S. at the cost of $60,000.

Meanwhile, the lure of a Tijuana practice has enriched the city but has drawn medical professionals away from rural Mexican regions, leaving residents bereft. Mexico has addressed this problem by employing Cuban physicians in these areas, UCLA’s Bustamante said.

Another question raised by Tijuana’s free-market medicine environment is whether it offers a long-term model for U.S. health care reform. If patients in the U.S. paid doctors directly, would those doctors compete for patients’ business by substantially lowering their rates? Would we see sales on biopsies? Two for one PET scans?

I have a hard time envisioning this outcome.

When I was a cancer patient, it took all my strength to endure a flurry of tests, procedures, imaging, surgery and medicines during an emotionally fraught time. I can’t even imagine trying to call various practitioners to compare quotes on the cost of MRIs, ultrasounds, mastectomy, reconstruction, lymph node dissection or medicines. Instead, my doctors followed protocols dictated by the latest research at the time. My care was covered, except for a few copayments. 

And that’s the way it should be for everyone.

I’m glad aging people can afford to get their teeth fixed and many of their unmet health needs addressed in Tijuana, and I was highly impressed with the medical professionals I interviewed there. But here on this side of the border, we need a longer-term solution, one that doesn’t force us to leave the country to get the care we deserve.

Amy DePaul is a California Health Report columnist who writes about aging and health equity.