Retired police officer Bob Ritz has health insurance that covers his medical and dental care in the United States.

But every few months he drives from his home in Tombstone, Arizona, to this small town in northern Mexico to avoid the healthcare costs that aren't paid by insurance.

I pay $400 a month for my health insurance, and it's still cheaper to come to Mexico, says Ritz, 60, as he stood outside a sun-bleached pharmacy in Naco, a few hours drive southeast of Phoenix.

President Barack Obama is locked in a bitter fight to overhaul U.S. healthcare, as he seeks to increase the number of Americans getting coverage and drive down costs of around $2.5 trillion a year.

Republican critics charge that Obama and his Democratic allies in Congress are seeking a government takeover of healthcare that will drive up the budget deficit.

With Washington bickering over how to reform the system and contain its spiraling costs, many Americans like Ritz simply head to Mexico to get care they can afford.

The total number making the trip is unclear. But a recent study by the UCLA Center for Health Policy Research estimated that nearly 1 million people from California alone seek medical, dental or prescription services in Mexico each year.

Some making the trek have little or no medical coverage. Others like Ritz are on fixed incomes and want to avoid so-called co-pays and deductibles charged by U.S. insurers on top of policies that routinely cost from a few hundred dollars to a few thousand each month.

The very wealthy can afford whatever they want, the very poor get it through aid, but the working and the middle-class have to struggle to pay insurance, said Ritz, who worked as a police officer in Chicago for 28 years.

I'm very lucky to live near enough to Mexico to get good healthcare at a reasonable price, he added.

BROKEN BONES AND BRONCHITIS

Healthcare reform is the flagship domestic policy drive of Obama's first year in office.

He wants coverage for around 46 million uninsured Americans and to rein in rising medical costs, and regulate insurers that already provide care to millions more.

Republican opponents say Obama's plan amounts to socialism by stealth and argue that its trillion-dollar price tag will hurt the economy as the United States remains mired in the worst recession in decades.

While the bitter row continues to rage at town hall meetings across the United States, signs of the U.S. system's failings are visible in Mexican border cities, where cut-price pharmacies, dental clinics and doctors' surgeries vie for business from Americans who can't afford treatment at home.

In Tijuana, where medical tourism from neighboring San Diego is big business, clinics offer operations ranging from cut-rate cosmetic procedures to hysterectomies and bariatric surgery to curb obesity.

I waste up to four hours coming to an appointment, but it's worth it as we'll save thousands of dollars, said Beatriz Iturriaga, a 26-year-old mother of two from Eastlake, south of San Diego, who paid $6,500 for bariatric surgery at a Tijuana clinic that would cost up to $40,000 stateside.

At the other end of the cost spectrum in Naco, Mexican physician Sixto de la Pena Cortes charges the 15 or so Americans that trek to his clinic-cum-pharmacy each week $20 for a check-up -- the cost of an average co-pay in the United States.

Most common (ailments) are bronchitis, pneumonia and stomach problems, said de la Pena Cortes, 62, who said he has also set broken bones and arranged for an appendix to be removed at a hospital in nearby Agua Prieta at a cost of around $2,000.

Healthcare California Arizona Barack obama