The twin cities of El Paso and Ciudad Juarez are unique in many ways. They originated as a single community before being divided by an international border. After the division they grew separately but the culture that has evolved is a blend of the two. Residents of the area feel equally at home on either side of the border and access health care services based on several decision making factors but crossing the border is not a consideration. The factors include economics, cultural preference and quality of care.

The border is also not a barrier for trade in other goods and services. Pickup truck and trailer loads of products are seen crossing the border in both directions. This blending of trade creates economic effects on both side of the border. Even though the community believes that “there is no border here”, the analysis of international trade must consider the effects on each community separately.

The international trade of health care in El Paso-Juarez is encouraged by governments and providers. Governments do nothing to stop the flow of prescription drugs and providers market their services to the population of the other country.