“This doesn’t look like a hospital,” says Ruben Toral, showing me around. “It feels more like a hotel or an upscale mall.” After studying the gleaming lobby of Bumrungrad International for a minute or two, I’m inclined to agree. Americans in shorts recline across from Arab couples in flowing white dishdashas and black abayas, the latter accessorized with designer handbags and sunglasses. We’re in Bangkok in August, when even the asphalt is overripe and malodorous, but the only scent inside is a faint whiff of espresso from the Starbucks in the corner.

Toral is responsible for luring that cosmopolitan clientele here, thousands of miles from home, for a knee replacement or a triple bypass or even just a checkup. Before he arrived in 2001 as Bumrungrad’s marketing director, “we were a Thai hospital serving a Thai community,” he says. “Now we’re an international hospital that just happens to be in Thailand.”

Toral himself just happens to be a dead ringer for George Clooney, and he tells his story in similarly seductive tones. He’s still amazed, seven years later, that folks who have never set foot on a plane, let alone owned a passport, will log a 24-hour flight — in coach! — to put themselves in the care of a hospital whose name they can’t even pronounce. Overseas patients have more than doubled on his watch, to 430,000 in 2006, generating the majority of the privately owned hospital’s revenue. “It’s the high-school-cafeteria person,” Toral says. “The independent businessman, the doctor, the lawyer. They tell me, ‘We did the math. We can’t afford to pay $1,200 for insurance every month.’ ”

The phrase “medical tourism” was once used to describe early retirees jetting in to Bangkok or Bangalore to have a little work done before recuperating on the beach. That image doesn’t jibe with the numbers today. As many as half a million Americans streamed abroad last year in search of affordable alternatives for hip replacements or prostate surgery. And they went not for the postsurgical tanning but for the savings: up to 90% off the going rates in the United States. They went because 47 million Americans lack insurance and can’t pay for surgery to fix a bad back or clogged arteries. Or because they have insurance but can’t begin to pay the soaring deductibles a major surgery entails. They’re fleeing a system that is by far the most expensive in the world and growing more so by the hour, with diminishing returns in quality of care.

“Your options are paying $50,000 to $60,000 in the States or coming here and paying $8,000,” says Toral, an American raised in North Carolina. “That’s the difference between putting it on your credit card or going into bankruptcy.”

Bangkok Phuket Hospital, on the island of Phuket, can perform a Heart Bypass surgery for approximately US$12,000. The price for the same procedure in the US begins at US$66,000 and can easily rise to US$150,000 and in the UK the procedure can actually cost upwards of US$200,000.

Gastric Bypass surgery is tremendously popular in the United States and is gaining popularity in the United Kingdom. As Americans are dealing with the issue of obesity, this procedure is gaining widespread appeal. You can expect to pay anywhere from US$33,000 to US$58,000 to have this operation in the US with the UK being in the same price range. In Thailand, you can expect to pay approximately US$13,000 for the same surgery.

Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas. This is a very popular procedure in the US as well as the UK. Liposuction is on offer in Thailand for approximately US$1,600 whereas the price in the US begins at US$2,500 and can go as high as US$10,000 which is comparable to the cost in the UK.

Abdominoplasty (Tummy Tuck) is an operation that removes excess skin and fat from the middle and lower abdomen and tightens the muscles of the abdominal wall. This procedure in the US can cost as much as US$8,000, while in the UK you can expect to pay from US$6,000 to US$10,000. Thailand offers this procedure at US$3,500.

If you are considering diagnostic imaging such as a CT scan or an MRI scan, the price for this procedure can be very expensive. For example, a private MRI scan can cost upwards of US$1,500 in the UK whereas in the United States the scan can cost upwards of US$1,600. An MRI scan costs around US$700 in Thailand.

Medical tourists have also shown an interest in elective dental procedures such as dental implants, dental veneers and laser whitening. You can have a tooth extracted in Thailand for US$30 while you can pay US$400 in the US and US$300-$400 in the UK.

Hip Replacement surgery can cost over US$40,000 in both the US and UK. In Thailand, you can have this surgery for just US$13,000. Knee Replacement surgery will also cost over US$40,000 in both the UK and the US, whereas Thailand is offering the same surgery for about US$10,000.

Hair Transplants are another popular procedure with medical tourists. The procedure can be performed in Thailand starting at US$2,000 (less than 1,000 grafts). While this procedure is very common in the US for both men and women, it has remained an extremely costly procedure with beginning costs of $US5,000 (less than 1,000 grafts). The UK has a starting price of approximately US$6,000 (less than 1,000 grafts).

Many people will consider medical tourism in Thailand for elective and medical procedures due largely to the fact that the price is only a fraction of what similar treatments would cost in Western countries. However, not every condition is suitable for treatment abroad so make sure that your condition allows you the flexibility of long distance travel.

Coronary Artery Bypass Grafting (CABG) is the reason for 55.7% of hospital stays.

Next on the list is angioplasty, accounting for 48.7% of hospital stays.

And what do you save when you get treated in Bangkok, Thailand? If you come for bypass surgery, you will save over 75%, even after taking airfares and local stay into consideration.

Case Study: An 87 year old US citizen who needed a mitral valve replacement turned to Bangkok, Thailand as no hospital would touch him being a high risk patient. He underwent a triple by-pass surgery years ago that cost him $40,000 in contrast the mitral valve surgery, a more complex and expensive surgery cost only $8,000 here in Bangkok, Thailand. (The patient’s damaged mitral valve was replaced with a bio-prosthetic valve whose life is said to be 15 years.)
(Source: The Bangkok Post Newspaper publication; Feb. ‘05)

How much can you save by your world-class treatment in Bangkok, Thailand?

Here’s a brief comparison of the cost of few of the Dental treatment procedures between USA and Bangkok, Thailand.

The difference in price depends upon the medical procedure you choose. In reviewing the cost of many procedures in the US, versus the same ones performed in Bangkok, Thailand. Costs are typically 50-75% lower in Bangkok, Thailand. The greatest cost savings is typically found in orthopedic / cardiac procedures (75-90% lower fees outside of the United States). If you have received quotes in the US for $10,000, you can expect the same procedure to cost between $2,500 and $5,000. This significant cost reduction enables you purchase a round trip air ticket, recuperative holidays post – treatment in a lazy beach location in Bangkok, Thailand and return home saving money.

Elective out-patient procedures like check-ups, dental care, LASIK are becoming increasingly popular and there is a growing interest on the part of the tourism industry to include these services as part of their travel packages. Higher intensity medical services, like spinal and cardiac surgery, pose a bigger challenge because these medical services are not as easily packaged and require significantly more knowledge about medicine.

Who are the players?

Bumrungrad Hospital located in central Bangkok is a dominant player in the medical tourism field in  Thailand, attracting over 360,000 international patients annually from over 150 countries worldwide. But Bumrungrad is not alone. There are quite a few other hospitals in Thailand and also regionally that are aggressively marketing their hospitals to capture a slice of this fast growing market. Both Bumrungrad Hospital and the India-based Apollo Hospital were recently featured on the CBS award winning news programme “60 Minutes” as medical tourism destinations for a growing number of Americans.

What is the future?

Reliable figures on the size and growth of medical tourism are hard to come by, as government and immigration statistics do not yet categorize inbound travellers coming for medical care. That said, the Tourism Authority of Thailand is actively promoting medical tourism as medical tourists on average spend more and stay longer than leisure travellers.

Ruben Toral, Group Marketing Director for Bumrungrad Hospital, sums it up this way. “In five years time, the idea of hopping on a plane and travelling overseas to get a hip replacement or a heart operation will be commonplace. People around the world are looking for the same things in healthcare – high quality, immediate access and affordable prices – and if they cannot find that combination at home, then they will seek alternatives abroad.” This niche market has tremendous protential for Thailand’s healthcare providers and also represents an opportunity for airlines, hoteliers and tour operators.

What are the drivers behind medical tourism?

Before there even was a term ‘medical tourism’, it was common practice among the well-heeled in developing countries to travel to the USA, Switzerland and Germany for medical care. However, over the past five years this trend has been turned upside down and now countries such as Thailand, are attracting patients from the USA, Canada and the UK.

This new niche market has evolved as healthcare systems worldwide are struggling to meet the medical needs of their populations. In the United States, the price of healthcare is beyond the means of many and there are an estimated 40 million uninsured people. While in Britain, Canada and Holland, socialised healthcare guarantees affordability, demand for medical services far outstrips supply and waiting lists for surgical procedures or specialty medicine can be as long as two-to-three years.

Today, governments, insurers and employers are carefully looking at medical outsourcing as a way to improve access and lower healthcare costs for their citizens, policyholders and employees.

Bangkok, Thailand’s healthcare services are about half the cost of similar services in Singapore, one-third the cost of Hong Kong and one-tenth the cost in the United States.

With world class surgeons, highly esteemed research professors, and the latest technology, Thailand’s medical services add a new dimension to its long tradition of hospitality to foreign visitors.

The Thai medical profession is probably one of the most advanced in the region. Successive governments have invested in ensuring the education and training Thai doctors receive is parallel to that offered elsewhere in the region. Many doctors undertake specialist training abroad, particularly the United States and Europe and are at least equally as well qualified as physicians in the west – often more so. Many large private hospitals are also staffed with translators to assist foreigners in communicating with medical professionals.

The Thai Government has made major investments in equipment and infrastructure, and Thai hospitals are recognized for their high management standards. Health management groups ensure that service standards are comparable in regional hospitals as well. All this expertise and proficiency makes Thailand’s hospitals a secure option for those seeking medical treatment.

Foreigners have access to a range of medical services, such as general diagnosis and treatment, physical check-ups, and dental and eye care. A variety of cosmetic surgery options are also available, as is cosmetic dentistry (laser teeth whitening, etc.) and laser sight correction (LASIK, etc.).

Pricing Guidelines

By Western standards, Thai hospitals offer very competitive prices for health care services. Costs for medical services in Bangkok, Thailand can be 50–80 percent less than similar procedures in North America . Please refer to the table below for the pricing guidelines of medical services in Bangkok, Thailand:

Thailand offers everything from cardiac surgery to organ transplants at a price much lower than the US or Europe. Thai medicine also features a higher, more personalized level of nursing care than westerners are accustomed to receiving in hospitals at home. One patient who received a coronary artery bypass surgery at Bumrungrad International hospital in Bangkok said the operation cost him US$12,000 (8,200 euros), as opposed to the $100,000 (68,000 euros) he estimated the operation would have cost him at home.

Hospitals in Thailand are a popular destination for other Asians. Another hospital that caters to medical tourists, Bangkok Hospital, has a Japanese wing and Phyathai Hospitals Group has interpreters for over 22 languages, besides the English-speaking medical staff. When Nepal Prime Minister Girija Prasad Koirala needed medical care in 2006, he went to Bangkok.

Today many Thai physicians hold US or UK professional certification. Several Thai hospitals have relationships with educational facilities in the US and UK (for example, Sheffield Hallam University has links with Bangkok}. One Thai hospital, Bumrungrad International, states that many of its doctors and staff are trained in the UK, Europe and the US. Bumrungrad International was accredited most recently in 2005 by an American group in order to ensure an international standard of medical services.

The US consular information sheet gives the Thai health care system high marks for quality, particularly facilities in Bangkok, although the World Health Organization ranks the Thai healthcare system at number 47, which is below the USA’s ranking at 37 and the United Kingdom’s ranking at 18. The UK’s Foreign and Commonwealth Office web site states “There are excellent international hospitals in Bangkok but they can be expensive”.