OPTIONS ~ by Robin Sparks
been two years since you’ve had a physical exam. You need to have your
vision checked and your teeth cleaned. But you are one of 44,000,000 U.S.
citizens without health insurance.
Who ya gonna
travel agency for an airplane ticket to Thailand - or a handful of other
developing countries with top-rate medical care at rock-bottom prices.
It was news
to me when I heard about Bangkok’s world-class hospitals. Wasn’t
Thailand a third world country? I was preparing to return home after
living in Asia for eight months when I learned that my U.S. health care
policy had expired.
The word among expats in southeast Asia was that in Bangkok, I could get
state-of-the-art health care for as little as $10 per doctor visit.
I learned that
over the past seven years, the number of private hospital beds in Bangkok
had doubled to over 16,000. Twenty years ago the major Asian health care
destinations were Singapore and Hong Kong. But in the past 20 years, Thailand
has moved ahead with a vastly improved medical infrastructure. And the
devaluation of the baht, which makes medical care a bargain for foreigners.
From over 24
hospitals, I chose Bumrungrad because of its focus on international patients.
On a computer in Bali, I logged into the hospital’s website at www.bumrungrad.com.
There I set up appointments with various specialists as well as a dentist.
Two days later, I pulled up in a taxi in front of Southeast Asia’s Number
1 certified hospital, Bumrungrad, in Bangkok, Thailand.
The entrance to Bumrungrad
Hospital in Bangkok.
In the circular
drive fronting the 12-story hospital, the largest private hospital in all
of Southeast Asia, uniformed doormen and a concierge loaded and unloaded
passengers. A soft-spoken Thai woman dressed in a suit and high heels
greeted me at the door and directed me to the International floor. As I
was being swept up the wide escalator, I took in the 5-star hotel-like
lobby with its teak columns, plush seating , computer kiosks, and
a Starbucks Cafe. The second floor atrium was ringed with French, Japanese,
and Indian restaurants -and a McDonald’s.
Starbucks coffee shop in
the lobby of the Hospital.
International lobby felt like a convention of the United Nations.
Egyptians in white turbans filled the waiting room alongside Indians in
saris, Muslims in kabalas, South Africans in colorful caftans, and Westerners
in shorts and tennis shoes.
I saw two familiar
faces - Peter, an American who lives in Bali and Kathryn who lives
in Katmandu. I also met an family of four who told me they were from Florida
but were living in India while Dad worked as an agriculture
consultant for a National Government Organization. They were in Bangkok
to get their visa's renewed and so had added a trip to the hospital.
The day before the children had seen a dentist, dad had had a physical
exam, and Mom was seen by an OB-GYN and had an ultrasound. Their
total bill was $125.
Out of 850,000
patients treated at Bumrungrad last year, 300,000 were foreigners from
more than 100 countries - a number expected to increase 10% in 2004. Most
physicians at Bumrungrad are either American or U.K.-trained and all speak
some English. Translators are provided for over 22 languages. The average
cost for an operation is 50-80% below the cost in Europe or the U.S. And
at Bumrungrad there is no wait. As if all of this were not enough, add
Thailand’s renowned hospitality and you have a prescription for a luxurious
healing environment that won’t break the bank.
the hospital by a sky walk, BH Residence is a convenient housing
option for recovering patients and their families . But in the hospital,
private rooms have marble countertops, plush couches, cable-TV,
internet connections, and refrigerators full of sodas and soy milk - with
price tags as low as $80 per night. I was ready to move in. At what other
hospital could I send a postcard home saying "Wish you were here?"
the city’s finest restaurants prepare meals to order for patients and their
guests. The Mandara Spa offers bedridden patients body work to help with
healing . Mothers in labor are given a choice of delivery styles, complete
with nurses who massage them throughout labor.
pediatric wing, dubbed “Kid’s Village” looks more like Disneyland’s Main
Street than a scary hospital ward. The curved ceilings have been painted
with clouds, and the hallways leading into pediatricians' offices are a
splash of bright contrasting colors. The Village is completely self-contained
with its own Treatment Rooms, Children’s Pharmacy and Cashier for one-stop
service. A host of kid-sized and parent friendly features include
“The Kids Zone" a play area with jungle gym , a miniature movie theater,
and child-scaled computer modules. The Center is home to almost 50
highly qualified pediatricians representing all pediatric specialties from
general pediatrics to specialists in pediatric cardiology, pulmonary, nephrology
(kidneys), allergy, endocrinology (growth & diabetes), genetics, neonatology,
psychiatry, neurology, oncology (cancer), gastroenterology and rheumatology.
There are 29 beds in the pediatrics inpatient wing, a pediatric intensive
care and a complete newborn nursery including a Level III regional neonatology
center treating premature and sick babies from throughout Thailand and
the ASEAN region.
known world wide as THE place to go for sex reassignment surgery.
It makes sense then, that if Thailand’s plastic surgeons can convincingly
turn a man into a woman and vice versa, erasing a few wrinkles would
be a cinch. So after my appointment with the dermatologist, I slipped
into The Plastic Surgery Center across the hall to pick up some brochures
for future reference. I noted that the most expensive procedure, a complete
facelift including eyes, neck, brow, nose, lips (and what ever else is
left) including pre and post doctor visits and hospital stay , is
to the Wellness Center.
Center and the Plastic Surgery Center are just two of over 30 “Centers”
in the hospital. There is also The Wellness Center that focuses on preventative
health care. Low lights, meditative music, and rich wood walls give the
clinic a serene ambience. In the Wellness Center vitamins and mineral
compounds are prepared individually for patients depending on their needs.
director of the International Center, Rubin Toral, told me that in 2002,
a year when most hospitals world-wide had growth rates of just 3%,
Bumrungrad’s revenue grew by 22%.
US ,” Toral said, “where doctors often have their own practices, all our
services are offered under one roof - the family practitioner, the
surgeon, a physical therapy center, the lab, the pharmacy... During the
1997 economic crisis, we invested in a state of the art computer
software system which digitizes everything from patient registrations,
clinical systems, operating room scheduling, billing, purchasing, inventory
management, and gives doctors instantaneous access to medical records,
including digital x-ray’s. Thailand’s labor costs are
low, as is overhead, and there is virtually no litigation. The result
is world class health care at rock bottom prices.”
of the International Center, Rubin Toral.
Day In the Life Of A Patient At Bumrungrad Hospital
my arrival on the International floor, I approached the desk, where
they printed up a patient card with my name along with a list of my prearranged
appointments (remember, I had set them up online two days earlier). There
were no forms to fill out. A woman was assigned to be my guide for
the day. I had signed up for Bumrungrad’s “comprehensive exam”. She took
me first to the waiting room where I would see a general practitioner.
Thai kick boxing was on the overhead TV. A nurse in a uniform and triangular
cap rolled a cart my way and asked, "Would you like some fruit juice or
As the afternoon
progressed, she guided me from appointment to appointment. Each doctor
had on his or her desk a computer which he referred to and to which
he added his own notes. My x-rays and ultrasound were there along with
all doctors’ notes for each doctor to access with the click of a keyboard.
By the end
of the afternoon, I'd seen eight specialists including a dentist, and had
had every inch of my body from my toenails to my scalp scanned, poked,
and tested. My final appointment was with the general practitioner
I began the day with. He opened a 10 page bound medical report with
my name on the front, just under a photo of the hospital, and we proceeded
to go through the report line by line, word by word until he was satisfied
that I understood everything from the significance of my blood count to
my HDL levels to my liver function.
was the pharmacy. I handed the pharmacist my I.D. card, and he handed
me my meds in a small chic shopping bag with the Bumrungrad logo on its
My last stop
was the cashier.
be $470,” she said.
With my personal
medical report tucked under my arm, and my shopping bag of meds in
the other, I took the escalator to Au Bon Pain for a croissant and a cappuccino
and thought to myself that I’d never had so much fun in a hospital.
I have focused
on Bumrungrad’s International services in this article because of the nature
of this magazine. The hospital also offers outstanding outreach programs
to locals including heart replacement valves for local children.
Hospital, multilingual, interactive website www.bumrungrad.com.
I asked Jim
Kirby, a part-time resident of Brazil and a writer for this magazine, to
talk about health care in Brazil.
He said, "The
health care value in Brazil can far surpass that available in the USA for
everyone, especially for the local rich and those who have dollars.
a fraction of what they do in the U.S., especially considering you can
buy them without a prescription. For a very small fee ($5), you can get
a piece of glass taken out of your foot or an even drug injection right
in the pharmacy. Eyeglasses cost probably 1/5th what they do in the U.S.
A dentist will clean your teeth for $15, fill a tooth for $30. And the
dentist does it herself, not a dental technician.
the Argentines, Brazilians are the world leaders in cosmetic surgery,
from around the world. A nose job in Sao Paulo will cost you about $900.
The big news
lately is that the Brazilians lead the world in combating AIDS. They dishonor
HIV-drug patents and produce and distribute generics themselves at very
There are several
tiers of general care available, from free community clinics spread around
the neighborhoods, to crowded, but cheap public hospitals, to world-class
private hospitals. The three southern states of Paraná, Santa Catarina
and Rio Grande do Sul maintain the highest standards.”
To read James
P.Kirby’s story about Brazil in this magazine, go to:
For more information
about health care in Brazil, type “hospitals in Brazil” or something similar
into a search engine. There is loads about medical services in Brazil available
online - unfortunately most of it is in Portuguese. If you find information
in English, please let me know!
In the March
28, 2002 issue of the BBC online, a headline reads “Britons Head for South
African hospitals”. The article reports that hundreds of British patients
are flying to Cape Town, South Africa to avoid National Health Service
waiting lists in the UK. The treatment they are seeking ranges from major
heart surgery and cancer operations, to cosmetic surgery and they have
found that the low cost is worth skipping the wait.
In the September,
2003 issue of Elle Magazine, Nancy Hass reported on a travel tour company
called “Surgeon & Safari”. Trips to big game reserves are combined
with a trip to the doctor - in this case a plastic surgeon in Johannesburg.
Because the Rand has been greatly devalued since apartheid, a multi procedural
cosmetic surgery/safari trip costs about the same as an eye lift on Park
Avenue. Manhattan surgeon Alan Matarasso says that South African doctors
are among the world’s best. The Elle article concludes, “The combination
of large game preserves and affordable surgery has made South Africa the
newest winner in the overseas cosmetic surgery sweepstakes, a game that
for years has been played in places like Thailand, Mexico, and Brazil.”
“It used to
be that someone from France or the United States would never leave their
country for health care in another country,” Rubin Toral of Bangkok’s Bumrungrad
Hospital said. “The ease of travel today allows people to access health
care wherever they wish. “
And I would
add, if you are a foreigner living in a “medical vacation” country, all
To see Robin's
article on Bali Click
Here or her article on Nepal Click