Oct 26

Chapter 3 Page 5 | The Media Imprimatur

The media in the United States did not really discover medical tourism until 2004-05, and it was found in the Far East rather than in central and South America. It was Bumrungrad Hospital in Thailand and the Apollo Hospital Group in India and Penang Adventist Hospital in Malaysia that made 60 Minutes and the front pages of the Wall Street Journal and The New York Times, not the plucky surgeons and dentists of Costa Rica, Mexico, and Brazil — even though far more U.S. citizens were heading South for inexpensive medical and dental care and surgery than were heading to the Far East. There are a few good reasons for that, which I offer not as an apology for the media but as explanation:

1. The story wasn’t about cosmetic surgery, which, despite its popularity and the professionalism of its practitioners, doesn’t get the same treatment in the news as does “real” medicine. Cosmetic surgery news is fluffier, more frivolous, than open-heart surgery news. The international hospitals of the Far East, wisely, didn’t play up cosmetic surgery — though they do a lot of it. They played up cardiothoracic surgery, and their state-of-the-art technology and facilities, and thus were taken more seriously. For the first time, much was made of the fact that there is an estimated 42 million people in the United States who lack adequate medical insurance who could go out of the country to get treatment they could not otherwise afford.

2. The story was delivered in part as a business story with big dollar signs, the kind that gets attention from the media. India put a $2 billion sticker on medical tourism. As previously noted, Bumrungrad sees more than 350,000 patients a year.

3. The story was generated by big multipurpose hospitals, and supported by the tourism and economic development officials of their respective countries. This is the way countries in the Far East go after markets, and there is nothing in Central or South America to compare as yet.

As we move through the first decade of the 21st century, medical tourism is still both newly discovered and in transition. The tip of the iceberg remains elective medical care, mostly cosmetic surgery and dentistry; beneath the surface is the larger consumer health-care market of North America and Europe.

And the media is paying attention. In February 2006 a West Virginia state legislator introduced the first bill in the country providing for the outsourcing of medical care to foreign countries. In Chicago, Blue Cross/Blue Shield investigated and then approved payment for an insured child’s heart surgery in India. And when President Bush visited India for the first time in March 2006, the two countries released a statement pledging American support for Indian efforts to support medical tourism, saying there is “enormous potential for collaboration” in health tourism.

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Sep 25

Chapter 1 Page 2

Fast forward to April 2005, a year later. My phone rings in Connecticut, a little too early. “Did you see 60 Minutes last night?” the voice asks. I hadn’t, actually; instead, I had been sitting in a gymnasium in West Haven listening to my son play clarinet with his high school concert band. But I had known what 60 Minutes was doing. Weeks before, Ruben Toral, who is responsible for public relations at Bumrungrad Hospital in Thailand, had told me that CBS had been filming there.

Later, I watch a tape of the show and am frankly astonished that it portrays medical care in Thailand and India as being of the highest quality, and at a fraction of the cost of the same care in the United States. The lid is off, I think. It is not a new story to me, of course; but that 60 Minutes had done it raised the credibility level. If there was something awful about medical tourism, anything especially dangerous about going overseas for health care, surely they would have found it?

Millions of people saw the show. Hundreds of thousands of people — at least the ones who have already been overseas for health care — felt vindicated, a little less crazy. The next morning, I read, on a prominent mailing list on the Internet, this comment:

“This could turn out to be one of the most important stories 60 Minutes has ever produced. First, because it addresses one of the most critical issues in America: rising health-care cost (combined with the uninsured), and second, because the show’s audience are the prime consumers of these services: the aging baby-boomers. While I can see that it might take a few years for flying to Asia for major surgery to catch on, I predict that insurance companies will eventually find a way to use these options to force U.S. health-care providers to lower their prices. (Of course, then the battles in Congress will start …)”

Whatever sense I had of being privy to a secret vanished.

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Sep 16

I added Curtis J. Schroeder’s Afterword for Beauty from Afar today, along with fussing with links on the table of contents page and updating the “About” page to reflect the fact that I am available for work and that I am open to the partnership and advertising possibilities inherent in this site.

Curt, as far as I know, is still group CEO at Bumrungrad International in Bangkok, Thailand; and I am still grateful for his kind words, written in 2006.

Yes, putting up the Afterword now is out of order. I thought about putting it up last. But I decided that anything that was really about the book and gives people the reasons why they might want to read it, ought to go up before I started posting actual chapters.

Besides, I love the Afterword and it makes me feel good to read it again.

So … next, I’ll put the jacket copy up, somehow; and then the Introduction … and then, I’ll probably start letting people know about the site and, little by little, post the 12 chapters. I’ll make pretty ebooks, in various formats, once I have pulled all the text out of the Quark file and massaged it sufficiently.

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Sep 16

(January 2006)

A Bangladeshi, a Brit, an Arab and a New Yorker were sitting in a doctor’s waiting room …

What could be a preamble for an off-color joke is in reality the tangible face of the medical-tourism phenomenon. What brings together such a rich melange of people to a medical facility thousands of miles from the comfort of their homes? In fact, their motivation is as diverse as their cultures, languages, and geography.

The Bangladeshi seeks an alternative to the less-developed medical system in his own country. He comes for quality.

The British woman undergoing radiation therapy for her breast cancer is side-stepping the long queue in England?s socialized health-care scheme. She comes for access.

The affluent Emirati from the United Arab Emirates is seeing four doctors in one morning with a personal interpreter/valet in tow and a steaming cup of Starbuck’s coffee in his hand. He comes for service.

Then there is the New Yorker. What on Earth is he doing here? What has possessed this 55-ear-old upper-middle-class stockbroker from one of the most cosmopolitan cities in the world to leave behind arguably the most sophisticated medical system on the planet to have surgery in Asia? He is one of 40 million uninsured Americans who is self-employed, not rich, not poor, old enough to need his prostate removed but not old enough to qualify for Medicare. And he does not want to pay the high price for private medical insurance. He comes for price.

But the Americans can not be sold on price alone. Our friend from New York is a case in point. Of course, the price was 80 percent less than that of the U.S. quotes he got. But being a day-trader, he knows his research. He knows what he wants — a cutting-edge minimally invasive laser procedure for prostate removal by a surgeon who has done the most of that procedure in the world, in a hospital that is of international standard that could take him right away. His search brought him to Asia.

He came for quality?; and access?; and service; ?and price.

As an American who has lived in Asia for over a decade, I can safely say that we Americans are a demanding bunch. And it is truly a leap of faith to trust your health to a doctor that you have never met at a hospital you have never seen in a country you have to find first on a map.

This is the value then of Jeff Schult’s excellent guide to the world of medical tourism. Jeff has scoured the hot-spots of medical tourism, talked to the patients, Googled the Internet to within an inch of its life, and taken the plunge himself into overseas health care. The result is a balanced, unbiased, and thoughtful guide for the informed consumer. Beauty from Afar is an entertaining and practical handbook that includes important considerations that any prospective medical tourist would? and should? consider before making the “leap”.

I thought I knew a lot about the subject, having lived it for 10 years. Jeff has opened a whole new world of possibilities, and he has made me a student again. I am convinced more than ever that medical tourism is not a fad. It is not about “cheap” health care. It is about smart, well informed people looking for quality service at a reasonable price in a world where distances and lines drawn on a map are not the barriers they once were.

Decisions about your health are important. Read this book. Do your own research. Make smart, informed decisions. Maybe you can narrow the leap of faith to be more of a hop.

Healthy Travels!

Curtis J. Schroeder
Group Chief Executive Officer
Bumrungrad International
Bangkok, Thailand

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