Medical travel to Asia is not a new phenomenon for those living in Europe and the United States. Asia already sees millions of medical tourist arrivals each year and the numbers are growing at double-digit rates. In the first of a new series of articles on medical travel, our guest writer and American citizen Dylan Waller shares his experience with the healthcare system in Asia.
When I first moved to Asia in 2012 after finishing university in the United States, I was shocked at how cheap private healthcare was in all of the countries that I visited.
This was an extreme blessing to me during times when I ran into unusual situations while travelling and ended up laughing at how cheap the medical bill was.
I remember many cases where I paid less than $10 to visit a doctor. I ended up paying less than $100 out of pocket in total while living in India for 6 months, which included several doctor visits and medicine.
After spending 6 years traveling and working in Asia no single hospital visit exceeded the average monthly premium that people currently pay for health insurance in the United States. This included a large number of visits for issues such as heat exhaustion (throwing up blood), food poisoning, and a hand injury from a motorcycle wreck. In fact, I only usually paid around $50 or less for most of these visits and I chose private hospitals over public hospitals for faster and higher quality service.
Experiencing all of this for 6-7 years made it very difficult for me to accept the extremely unreasonable prices of healthcare in the US, even after considering the differences in wages and quality of facilities. It helped me to quickly conclude that the US healthcare system was inefficient and ridden with skewed incentives. This is a topic that is heating up among Americans on the back of the upcoming election in 2020.
Asia is surely a cheaper destination for medical tourism, but it is also imperative to note that even developed markets in Europe offer cheaper options.
Healthcare is also substantially cheaper in other developed countries such as Singapore, Thailand, Canada and the United Kingdom to name a few. This is one reason why Americans are the best positioned to benefit from medical travel to Asia.
Average monthly insurance premiums in the US are absurd relative to the price of travel insurance plans.
In many cases, Americans can actually be much safer being abroad in the event of a medical emergency given that travel insurance plans are cheap and the treatment is also much cheaper in many countries. Average monthly healthcare premiums in the United States were between $231-790/month in 2018 for individuals based on their age.
Yet many expats living in Asia are able to purchase private insurance plans for less than $100/month because this includes treatment in hospitals outside of the United States. For the most part, insurance companies have failed to see the opportunity that medical tourism presents, and are focusing solely on treating people in the United States. This is a trend that could very well change in the future.
I have been living in the United States for the past year and have been self employed during this time. I always felt the safest when I was traveling and had proper coverage under a travel insurance plan ( roughly $37-70/month). I often prayed for my appendix to burst while traveling if this was ever going to happen and for it not to happen in the United States.
While living in the US, I opted for the cheapest insurance plans because the cost/value for more expensive plans was completely obtuse. I felt safer knowing that Thailand and India were just a plane ride away if I had an medical conditional that did not require immediate attention. In some cases, hospitals in these countries are viable options for people in the United States that are self employed or do not have a favorable health insurance plan, while treatment in Europe could also be an option for those Americans who are less cost-conscious or unable to travel long distances.
Around 9% of people in the United States do not have health insurance, while many have basic plans that would not fully cover serious medical issues. Companies are increasingly opting out of insuring their employers, and politicians such as Andrew Yang have noted that this burden should be removed from companies.
Every Asian medical travel destination has its unique strengths
My tetanus shot in India ended up costing less than $1.
This is my go to story when I want to shock people in the US with how cheap healthcare is in Asia.
Before joining the Peace Corps, we were all required to do medical check ups and to have certain vaccinations. Luckily, I was in India at the time and was able to complete all of this at a fraction of the cost that other people paid doing this in the United States. One of the greatest shockers I experienced was getting a tetanus shot in Madurai for less than $1, which would cost roughly $50-60 in the United States.
While I am not suggesting that anyone should travel all the way from the United States to India for immunization shots, this experience showed me how cost effective treatment in Asia can be, relative to the United States and, hence, why medical travel to Asia can end up saving Americans huge amounts of money.
Due to the gross mispricing of insurance plans in the United States, many people in the US do not have health insurance or have very basic plans.
In a recent video interview, Alexandria Ocasio Cortez even noted that she did not even have health insurance until she became a politician.
Plans are too expensive for a large percentage of the population that is burdened with student debt and companies are increasingly opting out of paying for health insurance.
The fine for not having health insurance in the United States actually exceeds the cost of some travel insurance plans on an annual basis and some expats abroad could likely pay around the same amount for a high quality international insurance plan.
People in the United States that pay less than $100/month for insurance are unlikely to receive high quality coverage.
The benefits of medical travel to Asia are manifold.
I was able to visit doctors at lower costs and any medication that I received was often a fraction of the cost compared to that of medicine received from hospitals in the United States.
I estimate that my total medical expenses during 2012-2017 were less than $1,000 and I never bothered filing any claims with my insurance when I was covered under Obamacare as this would be too tedious ( the Peace Corps ended up rejected my request to receive reimbursement for the $1 tetanus shot and other medical expenses anyway).
When it comes to treatment of cancer or chronic conditions that require continued medication, the large generics drugs industries of countries like India and Thailand make medical travel to Asia a great way to save on large medication bills.
The lower cost of living in Asia can also be on your side in the event that you have to take time off of work due to a medical issue.
I know several older expats living in Southeast Asia that have had to take time off of work for up to a year because of serious medical conditions, which was often made possible due to the lower cost of living coupled with lower medical expenses.
In my case, this was an option that I considered when I began to have serious health issues in 2018 though I ended up deciding to return to the United States to be with family.
Nevertheless, having this option as a backup plan was very liberating. I would have been able to use 1 month’s salary to live comfortably in rural Thailand for around 4 months if I would have chosen this route.
Medical travel to Asia is a viable option for people in the United States that encounter a medical emergency and are unable to have their insurance cover it.
According to a report by RVO, the average cost for a heart bypass surgery in India and Sri Lanka was between $5,000-7,000 compared to the cost of over $100,000 in the United States. Moreover, an average in day hospital visit in the United States costs around $4,293/day according to the LA Times, which is 6-10x higher than what it would cost in Argentina or Spain and even higher relative to what you would pay in many Asian countries.
A large percentage of the population in the United States do not even have enough savings to cover this type of emergency medical expense (circa 60% of the population could not cover even a $1,000 medical emergency). Americans that face a serious medical emergency like this should consider medical travel to Asia or even Europe if their medical conditions are not covered by their insurance plan.
One of the last and most important factors to note is that I did not feel any objection to the quality of any of the services I received.
As mentioned before, I always chose private hospitals and my medical expenses for these visits were certainly substantially higher compared to that of public hospitals.
I only ran into moderate language barriers when I visited private hospitals in smaller cities in rural Thailand, while the level of English spoken in other hospitals in Sri Lanka, India and Bangkok was extremely proficient.
Furthermore, there is still massive cost savings potential for other more complicated types of surgeries that I luckily did not encounter during these years, many of which could leave a person in the US without insurance deep in medical debt.
Thailand is one of the top choices in Asia based on quality and cost and is the prominent location used for serious types of medical emergencies that occur to Peace Corps volunteers.
My conclusion: Medical travel to Asia should be a serious option for those Americans who are being crushed under the weight of their huge medical bills.
If you are either uninsured or have an insurance plan with massive deductibles, the option of medical travel to Asia should be on your radar.
While quality of healthcare can be patchy across developing Asian countries, picking a JCI-accredited hospital in countries like Thailand or India is generally a safe bet.
If you prefer going to a country with greater consistency of healthcare quality, South Korea and Taiwan are excellent options given their high levels of medical technology adoption and more stringent regulatory standards; treatment costs in even these relatively developed Asian economies will still be far cheaper than what you would pay in the US.