[Dental suction tool]
Every year, U.S. visitors make
1.2 million trips across the Mexican border
to this tiny border town so they can receive affordable health care.
- More than 300 hundred clinics are in a place around seven square miles.
In Hawaii, [laughs] it would've been easy up to $45,000.
- Do you have dental insurance in the U.S.?
- It is, but it's worthless.
- What began with one dentist and one clinic more than 50 years ago
grew into a series of interconnected industries -
all either serving or surviving off of medical tourism.
- But what does it mean when even middle class residents
of one of the world's wealthiest nations
are forced to cross the border to receive health care?
- I just try to live my life with my mouth closed and not smile.
- And how impactful is the influx on Mexicans who live here?
I’m in postal code 21970
in Los Algodones, Mexico, aka Molar City.
It’s a place about 10 miles from Yuma, Arizona,
and its economy is synonymous with dental tourism.
As soon as you enter the town you have your choice
of optometrists, pharmacists, cosmetic practitioners
and dentists - the town's primary financial driver.
Many U.S. visitors here cross the border on foot.
Traveling from the U.S. is easy, if you can afford to get here.
But the option is entirely out of reach for the poorest U.S. residents.
- It’s where Charles Kuehn, a 60-year-old California resident,
is inspecting the extensive dental work
Dr. Paola Duque has done on him -
after years of pain and failing oral health.
I had, in January, effectively 28 teeth removed.
I had 10 implants installed
along with whatever grafting the doctor felt was appropriate.
- How much did you pay here for all the work?
$19,000 plus or minus.
- How much would it have cost you in San Jose?
$55,000 plus or minus.
This desert town is an oasis of medical care for U.S. residents priced out at home,
a home with the world's most expensive health care system.
- Do you think you'll ever do any of your dental care in the U.S. ever again?
- No, I don't think so.
I mean, I'm a veteran. I pay for veteran’s insurance.
But it, you know, dental crown and after with insurance, it's like 800 bucks.
Here after insurance. My out of pocket here, $210.
- Mexico is one of the top 10 countries for medical tourism.
[Beep]
- Dental care is extremely important
because going without it can lead to things like heart disease.
Dr. Paola says this work is fundamental health care.
- I think when I lost my front teeth about two-and-a-half, three years ago,
and you're down to just sharp edges right there in the front.
And it's a big, it's a big loss.
It's a big loss.
And, I just try to live my life with my mouth closed and not smile.
- How do you live your life with your mouth closed?
You find moments when you're more alone to open.
Just keep it slightly closed when you're visiting the people.
You don't talk to people as much.
♪ Amazing Grace
how sweet ...
[Sniffles]
the sound ♪
I’m sorry.
Dr. Paola’s patient is singing this song on her 35th birthday
and one year after she co-founded her practice,
Smile Makers Group, with another dentist.
- Dr. Paola has been a dentist for 14 years
and came to Mexico when the political climate
forced her to leave her native Venezuela.
She drives an hour to get to work six days a week,
and the vast majority of her patients are older people.
How much do you worry about competition?
- Los Algodones’ dentists may not feel the need to compete with one another,
but they are competing with their northern neighbors.
Some of the most expensive dental procedures you can get in the U.S.
are more than 60% less in Mexico.
There are a combination of reasons
the prices are cheaper in Mexico.
Mexican dentists make less money
than their U.S. counterparts.
The government subsidizes their education,
so they graduate with less debt.
And Mexican dentists aren't required
to have malpractice insurance
like they are in the U.S.
Every single U.S. visitor I met said price was the number one reason
they came to Mexico.
Dental issues are some of the most frequent conditions
for which doctors treat medical tourists.
Between 65%-70% of all U.S.
outbound medical travel is for dentistry.
Being Kānaka Maoli, native Hawaiian,
it's different because we are so isolated out there in Hawaii
that our resources are limited.
Everything gets shipped out to us.
So the price, the cost is inflated, extremely inflated.
- Stephanie Manera has spent 40 of her 52 years
without adequate dental care.
She says where she’s lived in Hawaii,
dentists didn’t even have the most modern equipment.
For the most part of my adult life,
I've only been able to eat on this side.
So for this side,
if it was to go out, like if there was some kind of issue
where I lost a tooth on this side, then it's a done deal.
I won't be able to eat. So that's why I'm here.
- Stephanie, like almost all the U.S. visitors I met,
does have dental insurance back home.
It's just not enough to cover the work she needs.
An estimated 74 million people in the U.S.
don't have dental insurance, which is separate from health insurance.
Even Medicaid, the U.S.’ health care program for low-income people,
doesn’t guarantee dental coverage for people older than 21.
Instead, states determine the type of dental care they provide, if any.
And less than half of the 50 states
offer comprehensive dental care.
I would have to pay out of pocket
and that's something that we would never be able to afford.
How long did you all have to save?
For about a good 15 years.
Putting aside, putting aside, putting aside…
- … to be able to get the dental care you need?
And over those 15 years,
did you feel your oral health failing you, even as you were saving?
Yes, and I felt anxious that,
like maybe I would just give in,
cave in and just go do what I can over there.
- Stephanie spent a week getting implants,
her gap closed, root canals and crowns.
And the reason she’s able to get inexpensive dental work in this Mexican town -
and that Dr. Paola is able to practice here - goes back to one man.
- Dr. Bernardo Magaña is the godfather of the dental industry in Los Algodones.
But the nearly 83-year-old doesn’t care about that
and he doesn’t want you to either.
- Dr. Magaña, who came here in 1968,
is such a force in this town
that he owns a lot of the land and buildings where the clinics reside.
- Dr. Magaña’s impact on the dental workforce in Los Algodones is palpable.
- Nina Delgado Murrieta is a Los Algodones native
who’s seen her small town evolve into
an international health care destination.
- Los Algodones may be the self-described dental capital of the world,
but it cannot be the solution for the millions in the U.S.
who are only one procedure away from financial disaster.
- The dental care here isn’t only out of reach for working class
and impoverished people in the U.S.
Ironically, this flood of dollars means dentistry is too costly
for the around 5,000 residents who live in Los Algodones,
which is why locals receive different rates.
- In Los Algodones, most tourists visit between November and April.
Locals call them “snowbirds.”
I’m here in June, the low season.
Here, Mexicans, like this 70-year-old vegetable merchant,
rely upon medical tourism dollars to earn a living.
- Not even a border wall can sever the interdependence these people have.
The vast majority of Mexican residents who live here and shape the industry
don’t get wealthy doing so.
Many are working class people,
some migrating from 30 hours away to earn a living.
In this town, dentistry is literally life
and it’s solely because the U.S. failed to sustain life for its own people.
What could the U.S. learn from Los Algodones?