Thai hospital welcomes foreign patients
By Sami Sillanpää
There are no treatment queues in this hospital when a client - as patients here are called - walks into the 22-storey Bumrungrad private hospital, treatment is available right away. The hospital has more than 1,000 doctors representing all fields of medicine.
Patients are housed in private rooms, and each one is equipped with its own refrigerator, flat screen TV, computer, and wireless Internet connection.
Food can be ordered through room service from the menus of the hospital’s six international restaurants: Japanese sushi, hummus from the Middle East, or sizzling delights in the American style.
A convalescing patient can spend time in the hospital’s swimming pool, in its bookstores or fashion boutiques, in an espresso café, or listening to jazz.
There are water fountains in the halls, soft sofas, modern art, and wall-sized windows with a view of the high-rise buildings of the centre of Bangkok.
All of this luxury is so cheap that it is worth coming here form the other side of the world. And people do just that. Last year, Bumrungrad treated more than 430,000 foreign patients from 190 different countries, including a few hundred Finns.
This is called health tourism. It has become a massive business which brings millions of people abroad for medical services.
Bumrungrad is the largest and most famous hospital of its type. The Thai personnel and more than 100 interpreters serve patients in dozens of languages. Checking in has been made easy. The hospital and its partners organise plane tickets, visas, and hotels, and pick up the customers from the airport in a limousine.
“A great place”, says Californian Kristin Alise, as she sits in a wheelchair on the roof terrace of the hospital. “Better than any hospital I have ever seen in America.
People in industrialised countries are living longer, and are becoming more obese.
At the same time, especially in many European countries, public health care is in a sorry state. There are shortages of personnel, hospital beds, and medical equipment. The sick have to wait for hours to get treatment for their minor ailments, and sometimes for years for surgery.
“Many people in the West are simply tired. Waiting lists at home are so long that they prefer to come here for treatment”, says
Ralf Krewer, head of marketing at Bangkok Hospital, which is one of the largest hospital companies in Asia.
At the beginning of the decade, only a few foreigners would visit the group’s main hospital in a day. Now the hospital treats 600 foreigners a day. The wards have signs in Japanese and Arabic. Muslims and Christians have their own prayer rooms. “For the Buddhists, monks come to visit.”
The surge in health tourism began after the terror attacks against the united States in 2001. Travel to Western countries became difficult for Arabs, and the rich from the oil producing countries started going to hospitals in Asia.
Estimates are that as many as a fifth of citizens of the United Arab Emirates go to Thailand for hospital treatment.
Spurring the globalisation of health care have been cheaper air fares and the increasingly middle class nature of long-haul travel. Thailand has long been a holiday destination favoured by Westerners. Tourists from Europe and North America come to Thailand to dive or to play golf, while getting new knees, whiter teeth, or better eyesight.
Depending on the procedures involved, the cost of medical treatment in Thailand can be as low as one fifth of the price charged by private clinics in the West. Heart bypass surgery ends up cheaper than at home, even if the prices of flights and hotels are included.
This is not to say that a patient cannot manage to spend thousands of euros even at Bangkok Hospital. The hospital is listed on the stock exchange.
Thailand as a whole has become one of the centres of global health care in recent years. Last year its hospitals treated 1.2 million foreign patients. Also competing for customers on the health tourism market are India, Malaysia, and Singapore. Outside Asia, countries such as Mexico, Brazil, and South Africa are important in the business.
When the rich get sick, the poor take care of them.
“Sawadeekha!” say the Thai nurses, while bowing down. The entrance to the Bangkok Hospital outlet in the resort of Pattaya gleams with marble.
“Here they treat you like royalty”, says Pirkko Jansson, 66, a Finn from Kotka.
Jansson and her husband spend their winters in Thailand on the advice of her pulmonary specialist. If she needs treatment while in Pattaya, she goes to Bangkok Hospital.
“In Finland it is hard to see a specialist. Here, it is possible to come at any time of the day, and there are no queues. You can see a doctor in ten minutes.”
People from many other European countries also spend their winters in Pattaya. About 40 per cent of the customers of the hospital are foreigners. Languages that can be heard in the hallways include Russian, German, and Chinese. Supervising the interpreters, who speak more than 20 different languages, is a Finn - Leena Kettong.
“I just hired a Finnish interpreter who starts in December”, Kettong says.
The Thai doctors at the hospital speak English. “Even if a customer speaks English, medical terminology can be difficult. That is why we seek to offer service in the patient’s own language.”
Finns have used the hospital for dental treatment and eye surgery, for instance. Some have had magnetic scans. The results are put on a disc to take home, and all of this is for a fraction of the price that would be paid in Finland.
Also popular are the full medical examinations offered by the hospital.
“Examinations can be very expensive in Finland, and they aren’t even easy to get. Doctors do not easily order them, because they want to save resources.”
Here they are available without a reservation. “One hundred euros, please.”
During the winter season up to 650 Finnish patients visit the Pattaya hospital, and considerably more Swedes and Norwegians.
Figures from a few large Thai hospitals suggest that each year at least a few thousand Finns go to Thai hospitals each year for treatment. The numbers include Finns who live in Thailand, and tourists who unexpectedly require treatment. Hundreds of Finns travel to Thailand each year to get treatment.
“We have noticed that Finns ave become increasingly interested in recent times. We are currently looking for an employee who speaks Finnish”, says Martin Olsen, a Dane, who heads Destination Beauty, a health care broker in Bangkok.
The company serves as an agent, especially for Nordic customers seeking treatment at Thai hospitals. It markets its services in ten languages on its website, helping to find the right hospital.. It handles the paperwork with the doctors, and organises the travel. Of its approximately 1,500 customers this year, only 30 have been from Finland.
There are other similar companies in Sweden, Norway, and Denmark.
Traditional travel agencies are concerned with liability issues if something goes wrong in the hospital. Usually health tourists have private medical insurance, but they will not cover everything. Legal disputes in Thai courts are difficult.
Olsen’s agency currently focuses on plastic surgery. In the Nordic Countries it is hard to get public health care to pay for cosmetic surgery. For treatment that the patient has to pay for anyway, Thailand is significantly cheaper.
What do the customers want? “Ninety nine per cent want larger breasts.”
Prices of breast augmentation in Thailand usually start at about EUR 1,700. In addition, cosmetic surgery has long been popular, and generally approved.
“In Thailand it is possible to get a much more skilled surgeon. There are doctors here who have performed 7,000 breast augmentations. In Denmark the best have performed maybe 200", Olsen says.
During the Vietnam War the US military hired Thai doctors to treat American soldiers. Later a large number of Thai doctors moved to North America and elsewhere for better pay. The health tourism boom has turned the migration patterns back to Thailand. However, the change ha not been exclusively good.
Only doctors and nurses who have a degree completed in Thailand are allowed to work in Thai hospitals. Critics say that Thai doctors are concentrating so much on foreigners, that there is hardly enough personnel to treat the country’s own people.
The numbers suggest that the situation is not alarming. Most of the patients in hospitals catering for foreigners are Thai - the wealthy urban elite.
However, there are concerns that doctors might be hard to persuade to stay at rural clinics. Furthermore, many doctors specialise in fields that are of little use for public health - such as penis extensions.
One of the most famous cosmetic surgery hospitals is Yanhee, which is owned by a wealthy Thai businessman. It could be the only hospital in the world that organises its own beauty pageant. Each year a Miss Yanhee is chosen.
The new 15-storey hospital building has just been completed, but the number of patients is growing so fast that another 10-storey extension is already being built.
Yanhee performs all known surgeries to make people thinner, more graceful, bugger, taller, or flatter. Faces are lifted, fat tissue sucked out, and missing hair is replaced with new growth.
“Beauty is experiencing a worldwide boom. We are riding on it”, says Ismael Naypa, the head physician of the international ward.
However, there is no accounting for taste - or beauty. The doctor’s idea of what looks good might not please the customer.
When disputes arise, the hospital uses a panel of experts to determine if cosmetic surgery has been performed in the proper manner. If the panel agrees with a complaining customer, the customer gets either new surgery free of charge, or a refund. However, the panel can also find in favour of the hospital.
Yanhee and many large cosmetic surgery centres in Bangkok enjoy a good reputation abroad. However, there are many less reputable entrepreneurs in the field. Some smaller plastic surgery clinics have been caught using incompetent surgeons.
Large Thai hospitals, such as Bumrungrad and Bangkok Hospital have enhanced their credibility by acquiring international quality certificates.
In recent years cosmetic surgery and dental care have been the mainstream treatments. Professionals in the field nevertheless believe that the big market in the future is in general practitioner services for people from rich countries.
Cardiovascular diseases, cancer treatment, orthopaedic surgery, dementia - there is a big market in treating the diseases linked with the high standard of living in the West.
“Obesity is a problem in the west. For us it is a big market”, Naypa says.
The health tourism business already has its own magazines, Internet services, and travel guides. There are no precise figures, but various estimates put the money involved in health tourism in the tens of billions of euros. Eight per cent of Americans have sought medical treatment abroad. The number of foreigners treated in Thailand is expected to grow this year, even though tourism has decreased, owing to the recession.
Already 50 countries have named health tourism as a growth industry.
Are we seeing the dawn of a new age? Can cross-border health care really compensate for the ailing national health care systems?
“It is possible to get treatment here that is faster, cheaper, and often of better quality”, says Kenneth Mays, the American head of marketing at the Bumrungrad hospital.
“However, there are many reasons why people want treatment closer to home. It will not change. Global hospitals can nevertheless offer options.”
A big question is, how state social security systems will react to medical treatment in other countries. In Europe, France is a forerunner: its public health care system will pay for some medical costs incurred in certain Thai hospitals. Norway also has a system, which will reimburse medical expenses incurred abroad under certain circumstances.
Could this be the salvation for the struggling Nordic welfare state model? If patients were sent from a surgery queue to other countries, it would save resources of public health care and taxpayers’ money.
Mays gives a diplomatic laugh.
“That would be complicated politically.”
Helsingin Sanomat / First published in print 25.10.2009
SAMI SILLANPÄÄ / Helsingin Sanomat
sami.sillanpaa@hs.fi
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| 27.10.2009 - THIS WEEK |
 Thai hospital welcomes foreign patients |
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