This is valuable info for an ex-pat or American in need of competent medical care. A traveler, or US resident willing to take a junket to a 5-star hotel + quality hospital in an exotic land need not have American medical insurance at the low rates 3rd world countries charge for diagnosis, treatment & operations. (Someone pointed out to me that it is correctly termed medical rather than health insurance, because many overwrought american doctors are ill at promoting your health.)

As you say, it's all in finding the right doctor, anywhere. I insist on older docs and sports med physicians, or at least one who does sports. In a dearth, visit a sharp young clinic operation of a handful of friend docs who in synergy come up with the proper diagnosis and treatment. My luck with physicians in foreign countries has been excellent. They kick the price 20% for ex-pats or visitors, bringing it to maybe 5% of American rates.

As you say, foreign hospital doctors nearly always have private practices at home, and that's where I get instant professional help. No appointment, his wife is the secretary, and he's linked to top specialists for radiology, lab tests, surgery, etc. in town. You're in and out his doctor's door in 15 minutes, and feeling so much better for it that you're tempted to toss the prescription to be filled down the block instantly at about 25% USA costs. The doctors & pharmacists generally speak some English.

Foreign docs, while making less than American, often own businesses on the side. I got close to an Iquitos waitress to meet the physician-owner of a restaurant who gave me a tour of his clinic, some excellent off-the-cuff health pointers, and was willing to trade english lessons for future diagnoses.

On the other hand, here in lake Toba, Sumatra, the elderly lady who just made me a salad says that no one in Toba gets sick, and there are no dentists (she's never been), but for a village accident or emergency one is whisked in one of three cars to a nearby town where the doctor accepts homemade pies and chickens, just like the old-time American doctors.

Medical tourism is a welcome wave set off by shock American fees.However, it's all about competition (as your letter indicates re: the Bumrungrad Bangkok hospital ruins), and it's reckoned that USA prices will fall with less demand. or, they'll try to control it somehow, like recently 'requiring' american passports to re-enter from Mexico, where thousands of borderline americans travel for medical, dental, px. The truth at the border -tested by friends and I dozens of times & most recently 6 mo. ago- is when a smart-alec immigration officer demands your passport or else, the legal repartee is that he may not prevent you from entering your own country. Then his face reddens, and he waves a sheet in your face that asks that you next time to bring a passport.


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