As the U.S. population ages, demand for home health aides and other low-wage service workers who can provide for the elderly is increasing, and this rising demand is often cited by advocates of higher immigration levels. The trouble, of course, is that low-wage workers will one day age themselves, and their low incomes mean that they will need safety-net benefits and wage subsidies to lead decent and dignified lives on U.S. soil. Medicare-in-Mexico offers an alternative.
For years, U.S. retirees have been settling in Jalisco, Guanajuato, Baja Sur, and the Mexican Caribbean in large numbers, and they’ve been doing so despite the fact that Medicare does not cover health services outside of the United States, even if extending coverage would yield substantial savings for U.S. taxpayers. By covering health services for Medicare-eligible Americans in Mexico, the U.S. could generate employment opportunities for low-skill workers in Mexico, including Central American migrants. It might also meaningfully reduce Medicare expenditures, since the cost of offering benefits would be considerably lower in Mexico than in the U.S., as Marla Haims and Andrew Dick suggested in a 2010 report for the Rand Corporation.
Needless to say, such a proposal would surely be met with ferocious resistance from U.S. medical providers who fear the prospect of foreign competition, and their political allies would surely denounce it as part of a larger plot to export aging Americans en masse. But U.S. retirees are growing more diverse, and a large and growing number of them have origins in Mexico. Many of them would welcome the opportunity to reconnect with their ancestral homeland, provided that they wouldn’t have to surrender the promise of high-quality medical care in their twilight years in the process.