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FM AMCONSUL MONTERREY
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RUEHME/AMEMBASSY MEXICO PRIORITY 3196
INFO RUEHXC/ALL US CONSULATES IN MEXICO COLLECTIVE
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RUEHGP/AMEMBASSY SINGAPORE PRIORITY 0004
RUEHBK/AMEMBASSY BANGKOK PRIORITY 0014
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHMC/AMCONSUL MONTERREY 7657

UNCLAS SECTION 01 OF 03 MONTERREY 000801 
 
SIPDIS 
 
SIPDIS 
 
DEPARTMENT OF STATE, PLEASE PASS TO USTR 
 
E.O. 12958: N/A 
TAGS: PGOV EINV ECON SOCI TBIO MX
SUBJECT: NUEVO LEON AT THE HEART OF MEXICO'S MEDICAL TOURISM 
INDUSTRY 
 
MONTERREY 00000801  001.2 OF 003 
 
 
¶1.  SUMMARY.  Nuevo Leon is actively working to become the 
medical tourism destination-of-choice in Mexico for Mexican and 
American citizens seeking quality, affordable health care.  The 
Nuevo Leon State Government has formed a Specialized Medical 
Services Cluster of ten public and private hospitals to promote 
their services, particularly to un- or under-insured Americans 
who require costly medical procedures in the U.S.  With a 
growing number of U.S. and Northern Mexican "tourists" traveling 
to Monterrey for treatment, Nuevo Leon seems poised to realize 
its goal, particularly with the construction of two new 
state-of-the-art hospitals.  In an effort to improve its 
competitiveness with other popular medical tourism destinations 
such as India, Thailand, and Singapore, the Cluster hospitals 
are currently seeking Joint Commission International 
Accreditation, and have plans to develop all-inclusive airline, 
hotel, and surgery packages.  While Nuevo Leon has the potential 
for success in this growing international market, patients 
should beware because Mexico lacks a robust medical malpractice 
regime and public information about physicians' professional 
histories is not readily available.  This may pose a roadblock 
in convincing would-be U.S. patients to seek medical treatment 
in Nuevo Leon.  END SUMMARY. 
 
-------------------------- 
BRING US YOUR POOR, YOUR UNINSURED 
-------------------------- 
 
¶2.  While Monterrey is already known as Mexico's industrial 
capital, the Nuevo Leon government wants it to be known as the 
medical capital, too.  The Government of Nuevo Leon has 
developed a comprehensive plan to become the 
destination-of-choice for Mexicans and Americans seeking 
high-quality, affordable health care.  According to press 
reports, Nuevo Leon's medical services cost 25-33% of comparable 
services in the United States.  Under the direction of the Nuevo 
Leon Secretariat of Economic Development (SEDEC), a group of ten 
private and public hospitals have joined together to form a 
"Specialized Medical Services Cluster."  In essence, the Cluster 
integrates and promotes services on behalf of all of its member 
hospitals.  According to Dr. Jesus Zacarias Villarreal, the 
former Secretary of Health for Nuevo Leon and current Chair of 
the Cluster's Advisory Committee, Nuevo Leon is the only state 
in Mexico that is actively working to develop itself as a 
medical tourism destination. 
 
¶3.  Econoff met with Zulamith Berlanga, the Director of SEDEC's 
Office to Promote Monterrey as a City of Health, to discuss the 
Cluster's promotion plan.  She said that their outreach efforts 
will focus on people who seek elective surgeries (namely 
cosmetic and plastic surgery) and those un- or under-insured 
people seeking less costly alternatives for non-emergency, 
non-elective surgery, such as organ transplants, oncology 
services, and orthopedic surgery.  A large-scale advertising 
campaign that will direct potential tourists to SEDEC's 
"Monterrey City of Health" website will begin in October 2007, 
with preliminary ads being placed in American Airlines "American 
Way" in-flight magazine.  SEDEC also plans to reach out directly 
to Hispanic groups and tourists boards in Texas, and later to 
tourist boards in other states. 
 
¶4.  Though SEDEC has not yet begun advertising in the United 
States or other parts of Northern Mexico, anecdotal evidence 
from local hospital administrators suggests that a growing 
number of persons travel to Monterrey for medical treatment. 
Previously, most of the "tourists" hailed from other parts of 
Nuevo Leon and the states of Tamaulipas and Coahuila, but over 
the last three years, more people from Texas and other Mexican 
states, including Yucatan, Veracruz, Tabasco, and even Oaxaca, 
have traveled to take advantage of Monterrey's quality 
hospitals.  When Econoff asked for statistics on the numbers of 
patients seeking treatment at the Cluster's ten hospitals, 
SEDEC's Berlanga said that the hospitals maintain their own 
statistics and that SEDEC does not have access to them.  She did 
add that SEDEC plans to compile its own statistics in order to 
measure the success of its promotion and outreach efforts.  One 
of the Cluster member hospitals, Monterrey Tec's San Jose 
Hospital, reported to Econoff directly that over 7500 of its 
patients in 2006 came from outside of Nuevo Leon. 
 
¶5.  During a separate meeting, Dr. Villarreal qualified 
Berlanga's statement by adding that, while there are not exact 
statistics about the number of medical tourists that have come 
to Monterrey since the Cluster was conceived in March 2005, the 
number of private hospital beds in Monterrey has doubled in the 
 
MONTERREY 00000801  002.2 OF 003 
 
 
last three years.  Further, due to a significant increase in 
demand for non-elective and plastic surgery, two new hospitals 
have recently been constructed in Monterrey - one in the 
northern part of the city and one in the southern suburbs - to 
meet the need for more hospital beds. 
 
-------------------------- 
MEETING INTERNATIONAL STANDARDS 
-------------------------- 
 
¶6.  In order to increase its competitiveness, the Cluster wants 
to have all ten of its member hospitals accredited within the 
next five years by Joint Commission International (JCI), the 
U.S. based non-profit organization that accredits hospitals 
around the world.  The purpose, according to Dr. Villarreal, is 
to help demonstrate the quality of patient care available in 
Nuevo Leon. (Note.  Currently, there are no hospitals in Mexico 
accredited by the JCI, but all of SEDEC's Cluster hospitals are 
accredited by the Mexico National Institute of Public Health. 
End Note.)  Hospital accreditation would help Nuevo Leon compete 
with other popular medical tourism destinations around the world 
that boast JCI-accredited hospitals, such as the National Heart 
Center in Singapore and the Apollo Hospital Group in India.  Dr. 
Villarreal readily admits that without accreditation, Mexico, 
and Nuevo Leon in particular, will not be able to compete in the 
long-term as a destination-of-choice for Americans who want 
guarantees that the level of hospital service is up to U.S. 
standards. 
 
¶7.  In addition to the JCI accreditation, the state government 
plans to make Nuevo Leon a more attractive medical tourism 
destination by working with travel agencies and hotels to 
develop the type of all-inclusive medical tourism packages 
promoted by hospitals in Singapore, Thailand, and India.  To 
this end, some hospitals have already begun forming partnerships 
with established medical tourism facilitators.  For example, the 
Christus Muguerza Hospital system in Monterrey has partnered 
with Global Choice Healthcare, a New Mexico based company that 
handles the range of logistics services required by medical 
travelers.  Further, the Cluster plans to invite other medical 
practitioners to join them, most notably dentists and oral 
surgeons, who would also benefit from the type of 
state-sponsored international promotion that will be enjoyed by 
the current Cluster members.  Finally, the Cluster is already 
exploring the possibility of developing service provider 
agreements with U.S. insurance companies so that, once the 
hospitals are accredited, patients from the U.S. will not have 
to pay up-front for non-elective procedures and, instead, can 
present their insurance cards as a financial guarantee. 
 
¶8.  Comment.  It seems likely that at least some of the 
Cluster's hospitals will receive their JCI accreditation, since 
most of the Cluster hospitals have Board Certified physicians, 
as well as state-of-the-art laboratory and diagnostic equipment. 
 Additionally, at least one of the Cluster hospitals, Christus 
Muguerza, has a direct affiliation with a U.S. hospital group 
that is already certified by the U.S. Joint Commission.  This 
affiliation should also help when SEDEC endeavors to establish 
service-provider agreements with U.S. health insurance 
companies.  End Comment. 
 
-------------------------- 
BUYER BEWARE: PATIENTS LACK LEGAL RECOURSE 
-------------------------- 
 
¶9.  While SEDEC's plans to turn Nuevo Leon into Mexico's medical 
tourism capital have real potential for success, patients may 
not be aware that they have little recourse for malpractice 
litigation and limited access to public information about 
physicians' professional histories.  This could serve as a 
potential roadblock in the State's efforts to attract "tourists" 
from the U.S.  First, Mexico has a limited system to handle 
cases of medical malpractice or malfeasance.  Each state has a 
Medical Arbitration Commission, and the patient's complaint is 
decided by an arbiter who issues a final, legally-binding 
resolution.  The problem with this type of case is that the 
arbiter relies on General Practitioners with little or no 
specialized experience to render a professional opinion on the 
case.  These appeals are rare, with only four cases filed in 
Nuevo Leon in 2006.  A civil or criminal medical malpractice 
lawsuit is even more uncommon, and rarely finds in favor of the 
patient.  In fact, there was only one medical malpractice suit 
filed in civil court in 2006 for all of Mexico.  Cluster 
officials acknowledged to Econoff that they believe that some 
 
MONTERREY 00000801  003.2 OF 003 
 
 
potential tourists will decline seeking treatment in Nuevo Leon 
if they know that there is no real precedent for medical 
malpractice claims 
 
¶10.  Moreover, there is little to no public access to 
physicians' professional or medical malpractice history in most 
Mexican states.  Dr. Villarreal told Econoff that, while any 
patient can ask a physician directly for his or her educational 
history and professional accreditations, this type of 
information is not made readily available to the general public, 
which is why Mexicans often rely on word-of-mouth to choose 
physicians and hospitals.  This lack of transparency may also 
frustrate some potential U.S. patients who expect the same level 
of public information that is available in the United States. 
"Regardless," said SEDEC's Berlanga, "patients from throughout 
Mexico and the United States will still seek treatment in Nuevo 
Leon because of the exceptional quality of care and low cost 
that we offer, even when they clearly understand the limits of 
the Mexican medical system." 
WILLIAMSON