Cross Border Dental Care Part One

Phoenix, AZ – The first time Mike Negle walked across the US-Mexico border, to Los Algodones - near Yuma, Arizona - he was immediately surrounded by salesmen who swore to him that they had the best price, the best deal, the best offer. They reminded Negle of hawkers who sold tomatoes or knock-off designer sunglasses. But these men weren't selling tomatoes or sunglasses. They were selling root canals.

There's a guy standing right at the gate by the border. He says, I got good dentistry, come with me, then they'll give you an estimate, and then when you walk out of that door, someone else will grab you up and take you to another dentist down the road, and knock twenty bucks off.

Mike Negle wasn't used to doing business like this. Like most Americans, he'd always chosen his dentists not because of cost, but because of coverage -- as in, did his insurance plan cover the provider or not?

Negle drives 18-wheelers for a company in Minnesota that provides some insurance. It wasn't enough to help with all Mike needed for his many toothaches. So Negle looked for other options. Know where to find a good dentist in Mexico? he asked someone he met on the road. Yes, she said. Go to Los Algodones.

I've had four root canals, four crowns... teeth cleaning, deep cleaning. I had the laser whitening done. And they're going to replace my partial with two implants and bridge the rest of the teeth together. That's it.

This was going to cost Mike $20,000 in the US. In Mexico, it cost him $3,800.

The reasons for this incredible difference in price are many -- it's cheaper to live in Mexico, Mexican dentists don't have to buy malpractice insurance, they don't have as much student debt, they don't have as many regulations. The market sets the bottom line. Which means that in Los Algodones, it's a constant race to the bottom to lower and lower prices. One economist we spoke with -- Michael Ellis, from New Mexico State University -- calls this an example of a medical maquila, not unlike the factories along the border that produce goods for the US market.

The medical maquila model is one that has been talked about for the last decade and just beginning to take hold, but I think the pressure will build dramatically as the boomers retire.

In Los Algodones, the pressure has spawned a cycle like that in any competitive marketplace, where there constantly arrive new dentists with cheaper rates who use tactics the more expensive dentists don't like and try to stop. The dentist many say started this cycle is Dr. Bernardo Magana, who moved to Los Algodones in 1969.

74, 75 they started to arrive. They started to arrive, and it started to fill up

He's saying that in 1974, 1975 other dentists started to arrive in Los Algodones. They moved into the buildings that used to be cantinas or brothels. By the mid-80s, there were maybe 20 dentists in Los Algodones. Now, there are close to 400. All kinds of people want in on the boom, including happy patients like Mike Negle. He's nowon commission with his dentist, for persuading his trucking company in Minnesota to send their 140 drivers down to Mexico for dental work. It might be Negle's next business venture, exact business name still to be decided.

Like Happy Smiles Vacation, or something like that.

The dentists are doing so well that their success might also be their own downfall. New, cheaper dentists move into town all the time, undercutting more established dentists like Dr. Magana, who in turn undercuts American dentists. Meanwhile, American dentists aren't letting their patients go so quietly. In the truly competitive spirit that defines the dental marketplace here, they've fired back with what they say is an educational campaign called Trouble in Paradise.

In Phoenix, I'm Devin Browne.