Keeping yourself healthy long
enough to abuse yourself again
|"It was inevitable Thailand
would develop a health tourism industry. The country already had
the vast tourist arrivals requiring medical care from time to time
after abusing on drink, drugs, and dregs. It was just a matter of
time before Thailand went after citizens in other countries to cure
their medical ailments before they could abuse themselves here on drink,
drugs, and dregs. "
There is a common misperception that Thailand is a Third World
basket case economy with commensurate medical care.
There is also the opposite misperception among, obviously, different
individuals that Thailand's hospitals are among the best in the world.
This depends upon which hospitals we're talking about. As
of 2010, the Ministry of Public Health listed slightly more than a
thousand public hospitals and 316 private hospitals. A small
percentage of those private hospitals enjoy a reputation as showpiece
hospitals, hospitals held up by Thailand to the rest of the world to
show that Thailand can perform a bypass or a sex change or a hair
transplant as good as the best of 'em, but at a fraction the cost.
Outside Bangkok and other key tourist areas where these showpiece
hospitals operate, the claim that Thailand's hospitals are some of the
best in the industry should be taken as seriously as Drew Barrymore's
pick. The Thai medical establishment is waiting for you and
today's global economy, nations try to stand out any way
they can. 6-7% of Thailand's economy is based on
tourism. Thailand has
been playing its huge tourist influx to its advantage by
encouraging arrivals to stop on by for a botox treatment or
a crown implant. The Tourism Authority of Thailand has
gotten in on the act with a
medical portal. You can look up the procedure you
desire and see who's performing it. The site
boasts that as of 2013, Thailand has 17
Joint Commission International (JCI) certified
hospitals. This is an American certification, and for
what it's worth, the standard by which consumers
worldwide can assess whether a non-American hospital meets
international standards. In reality, there are likely
a lot more non-JCI certified hospitals in Thailand that
would more than suffice for most consumers' needs.
You must know how the game is played by now.
Certifying bodies convince a business why it needs
certification and why they, as the certifying organization,
are worth paying .
The Bangkok Hospital Group (BGH) is the largest hospital
conglomerate in the country. The group contains the
Bangkok Hospital chain, located in Bangkok, Hua Hin,
Phuket, Pattaya, and beyond, as well as the well-known
Paolo Hospitals. As of 2013, the BGH had 29
hospitals in the country and a lustful desire to expand. The
group has holdings in Turkey, Singapore, China, and
Malaysia. BGH is well positioned to cash in on medical
Thailand's ultimate showpiece hospital is
Bumrungrad and not in the BGH group. Bumrungrad markets itself worldwide.
It's got referral offices in Australia, Bahrain,
Bangladesh, Cambodia, Ethiopia, Hong Kong, Indonesia,
Mongolia, Burma, Nepal, Oman, and Vietnam to date, with no
doubt, more on the way. All this marketing costs in
the way of commissions, which get passed on to you when Bumrungrad does your procedure.
I've gone to Bumrungrad twice. Once, for dental procedures; and the
second time, for an infection my wife was suffering from.
Bumrungrad isn't cheap, which is why there was a four year
spread between the first and second visits. We
made the second visit at the beginning of the calendar year
when our medical insurance deductible limits reset. We
have a $400 annual deductible -- the first $400 of medical
expenses each year, wherever we incur them, are not covered.
To reach our deductible limit faster, we went to Bumrungrad,
as Bumrungrad can charge two to three times the price of a
similar private Thai hospital.
This is not to say that the Bangkok Hospital Group, which
has a 20% stake in Bumrungrad, is such a bargain.
They're not. My wife has made visits to Samitivej,
Bangkok Hospital, and San Paolo. All were overpriced.
San Paolo's Hua Hin branch admitted her for overnight 'testing'.
The testing was a waste of time and money and unearthed
nothing about what my wife was suffering from. You can
almost imagine the senior managers telling staff to upsell
San Paolo services any way they can to improve the bottom
Today, our hospital of choice in Bangkok is
Bangkok Adventist Hospital, a private hospitals whose
costs fall somewhere between a public and showpiece private
hospital. On my wife's recent visit there, she saw two
different doctors for two different conditions, receiving
two different batches of medicines. The cost was 45%
of going to Bumrungrad for just one condition, and she found
the service and doctor's attention far more personal.
Nonetheless, for most foreigners in the Kingdom, the slick
medical marketing convinces them to look no further than
Bumrungrad or one of Bangkok Hospital's overpriced brands.
It surely doesn't hurt that these gorillas have locked up
agreements with the international insurers. If we were to
visit Bumrungrad or BNH, we would have to front no cash.
The hospital bills the insurer directly, after which we have
to reimburse the insurer anything insurance doesn't cover.
With the smaller guys, like Bangkok Adventist or
Bangkok Christian or a myriad of other hospitals located throughout
the country, we have to pay up front and then lodge a claim
with the insurer for reimbursement. Foreigners seem to
accept spending more if they don't pay up front.
A Real Checkup On
Medical Care In Thailand
Doctors In Thailand
all the hype about medical tourism promoted hospitals in
Thailand for a moment and examine the health care
landscape of Thailand in general. As of 2012, the life
expectancy of the total Thai population at birth was 73.83
years; in the United States, 78.24.
expectancy is boosted by its much lower infant mortality
rate. According to the CIA World Factbook for
2010, the U.S. infant mortality rate was 6, on par with
Poland, Slovakia, New Caledonia, Croatia, and Qatar;
Thailand's, 15.9. Keep in mind that the
United States spends a shocking 15.2% of its gross domestic
product on health care, the highest in the world, and
Thailand just 4.3%. Higher health care expenditure doesn't
necessary lead to better outcomes. Check out
Uganda. The life expectancy is 54.1 years and infant mortality
is 64.2, yet Uganda spends 7.4% of its GDP on health.
To make a gross
generalization based on the data, standard Thai medical
care, the type the average Thai receives, can't be all that
shi--y if Thais, with minimal medical expenditures, are
staying alive just 6% shorter. You might want to look in the direction of a
showpiece private hospital when birthing your own child in
the Kingdom or having a complicated procedure like a penis
transplant. Other than that, normal Thai hospitals
will probably do the trick for substantially lower cost.
The finer hospitals make note of their
doctors' credentials. Bumrungrad has more than 1,200
full-time physicians and consultants on staff. The
hospital doesn't keep it a secret that 200 are U.S. board certified and a large unspecified
percentage carry board certification from the UK, Australia,
Germany, or Japan. The much less expensive Mission
Hospital still sports docs who've done fellowships,
post-graduate education, or possible medical degrees abroad.
Such credential tooting is done to put potential patients'
minds at ease. A Thai doctor is somehow considered
competent if he's been exposed in some small part to the
medical education system of a more advanced nation.
There might be something to this when the chosen procedure
is complex and requires specialized training. But if
all that's being contemplated is a nose job or a hair
transplant, a Thai doctor holding a local degree from Chulalongkorn or Mahidol
should not set off any alarm bells.
You could say you pay more to a private well known hospital to have staff speak to you
and treat you in your own language in a setting that more closely resembles
hospitals back in your own country, but without having to wait in a long queue
or pay in spades.
Cut out the glamor and glitz you're paying for at the showpieces, and you can
save a dear bit of cash.
Trends, procedures, techniques, and machines from more
advanced nations find their way here eventually. This
same care is attentively administered to patients at lower cost
than they'd pay back in the nations from whence everything
came. There is some lag. An
innovative new procedure in the West won't be practiced in
Thailand until the procedure becomes mainstream and falls in price. Thailand, like many another Asian
nation, copies at lower cost what doctors in other nations
have originated. Witness LASIK eye surgery. The
first implementation of LASIK in the United States was in the
early 1990's. A few years after that, South
Koreans were performing it. Another half decade later,
Thailand got it.
With some some slight differences, medical tourism works much
like any product sold in international trade. Products
once manufactured in Europe and America are now manufactured in
lower cost countries to save money. And as
once specialized medical procedures become mundane, lower cost
countries and more average doctors start practicing them.
Medical tourism, like international trade, doesn't move in just
one direction. For extremely complicated life and death
procedures (i.e. high tech products), it is not uncommon to see
wealthier privileged citizens of poorer countries seek treatment
(i.e. import such products) from more expensive countries.
When King Hussein of Jordan was suffering from lymphatic cancer
in 1998, he didn't head to Bumrungrad. He went for treatment at
the Mayo Clinic in Minnesota, USA.
As Thailand is more a low cost practitioner of techniques
innovated elsewhere, expect competency over sheer
brilliance. Thai doctors are not excellent diagnosticians.
Your ailment must be obvious for them to catch it.
When I was suffering from an infection in my thumb and went
to San Paolo, any person with eyes could've figured out my
problem. When my wife went to the same hospital with
an unknown ailment and a few symptoms, the doctors just
wasted our money and time by admitting her.
It's antibiotic land in the Kingdom. It seems
that no matter what affliction you enter the hospital or
clinic with, the doctor will prescribe you a dosage of
antibiotics. Even a yeast infection, which itself can
be caused by antibiotics usage, will be treated with antibiotics.
Fever, cold, excess gas, the flu -- have some antibiotics
with a side order of more antibiotics.
It reminds me of the joke I used to make as a teenager about
dermatology being the best kept secret into the medical
profession. When a patient arrives with a skin
problem, a dermatologist prescribes medicines or refers him
to another specialist. The dermatologist never really
has to do any real
diagnosis himself. Every Thai doctor is like that
would do yourself a great favor self diagnosing yourself
whenever possible. Go onto the internet and at least
narrow down what you might have. If you can visit a
pharmacy and obtain the medicines yourself without visiting a
doctor, all the better. Should you need to see a doctor,
at least mention what you have discovered yourself.
If you could be suffering from malady A or malady B, but a
certain test C is required to determine which, tell the doctor.
Narrow down their options for them or you run the risk of
them wasting your time and money. This is probably not such bad
advice if you're going to see a doctor in your own country, too.
warnings aren't germane if
you're coming over to Thailand for a specific procedure.
You would know in advance you were coming for a tummy tuck, hip
replacement, or face lift. In those instances, I would
demand photographs or testimonials to genuinely assess whether
this doctor is worth the money saved.
Medical Costs In Thailand
-- Are They Really That Cheap?
For routine procedures,
Thai medical costs are undoubtedly reasonable. A typical teeth cleaning at a dental
clinic could run USD 25-35. A filling, USD 25. A
quick consult with a doctor for something minor could incur a
USD 15 charge.
Looking at the cost comparison chart at the top of the
page, it appears that Thailand is a bargain for knee
replacements, angioplasties, and hysterectomies compared to the
United States. India could be 10-30% cheaper per
procedure, but India doesn't have the iced cold brews, the
shapely Thai vixens, and the picturesque beaches. For most
visitors from abroad, Thailand will be the more pleasant tourist
experience as they're having their breast removed. In
India, if that breast were to remain, local Indian men would
squeeze it childishly like a desperate teen at the prom.
But look more closely at that chart in the last
column, to Singapore. Compared to Thailand, a heart
bypass is 70% more expensive. Less risky
procedures either cost the same or are 30% more expensive.
And yet Singapore's consumer prices are twice Thailand's,
rent is five times Thailand's, restaurant prices
two-and-a-half times Thailand's. I've been to
Singapore. On a cost of living comparison, the United
States is cheaper than Singapore.
a First World country with First World medical care. It's
a free trading country. Its medical costs likely
reflect the true cost to perform such procedures if bureaucracy,
insurance companies, and kickbacks aren't factored in.
Singapore is considered honest. It ranked as the fifth
least corrupt country in the Corruption Perceptions Index for
2012. (Thailand ranked 88, India 94] If
Singapore is the benchmark for fair pricing for medical
procedures, Thailand and India are actually quite expensive
given their much lower costs of living.
Publishing the American costs is deceiving. First of all,
America's health care system is in shambles and in need of a total
revamp. The Washington Post
published an article documenting how out-of-line American
medical prices are for a number of different procedures. A routine office visit to a physician
in France that would cost $30 there costs $68-176 in the United
States. A $264 angiogram in France could cost as much as $2,430
in the U.S. By those measures, any country, not just
Thailand, appears cheaper. And second, Americans don't
pay out of pocket those ludicrous prices. An American in
need of a bypass doesn't really pay $130,000. His insurance
covers most of it. If he's uninsured, as 45m Americans
are, none of the $130,000 would be covered, but he also wouldn't
have $10,000-11,000 just sitting around either to spend on a
procedure in Thailand or India.
American and European
medical insurance isn't likely to cover luxury procedures,
non-life and death procedures that aren't essentials. Things
like eye reshaping, skin whitening, and sex changes. It is
these procedures that would be best shown on a comparison chart.
I met an American from the San Francisco area who was boasting
in Phuket of his hair transplant, for which he paid $10,000 at
Bumrungrad. At those prices, he could've had surgery done
in the United States.
Do your research and do it well before you fly over to
Thailand to have your face redesigned. In the
end, you might find it's cheaper to stay at home.