Operation Vacation

Larry Shaw undergoes tests at Bumrungrad hospital in Bangkok. Shaw faced a $47,000 bill for heart surgery in the States; at Bumrungrad, the price was $6,400.
Larry Shaw undergoes tests at Bumrungrad hospital in Bangkok. Shaw faced a $47,000 bill for heart surgery in the States; at Bumrungrad, the price was $6,400. (By Will Baxter -- WPN)
By Cindy Loose
Washington Post Staff Writer
Sunday, September 9, 2007

On learning he needed heart surgery last spring, Larry Shaw's first question was: How much?

The surgeon's fee, between $1,500 and $2,000, was within Shaw's means as a self-insured businessman. But the angioplasty, including placement of a thin tube in a clogged artery, would require a one-night hospital stay. He called the closest major medical center to his Dallas home. Estimated charge: $47,000, not including anesthesia.

Shaw's next calls were to Thailand and India.

The price at Bangkok's private Bumrungrad International Hospital: $6,400, including a two-night stay, surgeon's fees, anesthesiologist and drugs. The Apollo hospital in New Delhi: $4,600.

A few weeks later, in late June, Shaw and his wife, Kathy, are more than 9,000 miles from home, walking the marble floors of a Bangkok hospital lobby that looks like the entrance to a newly renovated Hilton. Shaw, by economic necessity, is joining an ever-growing trend: medical travel, sometimes referred to as medical tourism.

The reputation of outstanding U.S. hospitals has long drawn wealthy patients from around the world. But today, traffic also heads in the opposite direction. It's a trend that quietly has been expanding well beyond facelifts, tummy tucks and dental crowns to embrace all sorts of non-emergency treatments.

Most American patients are seeking significantly lower prices. But some go abroad for treatments not yet available or not yet widely practiced in the United States. Others head overseas for the personalized service emphasized by high-end private hospitals working to appeal to an international clientele.

"There is a fierce, pitched battle for medical tourists, who are the highest-value tourists in terms of how long they stay and money spent," says Ruben Toral, marketing director of Bumrungrad Hospital. "Governments in Southeast Asia and now in Dubai view it as an important extension of regular tourism."

Medical travelers logged an estimated 19 million trips and spent $20 billion in 2005; the numbers are expected to more than double by 2010, according to Tourism Research and Marketing, a London consulting firm. Thailand last year served 1.4 million medical tourists, including 65,000 Americans, some of whom were already living abroad. Singapore and India also have a strong network of hospitals drawing foreign tourists, as does Malaysia.

Other parts of Asia rushing to develop medical tourism: South Korea, Taiwan and the Philippines. Brazil, Costa Rica and Mexico also attract Americans seeking cosmetic surgery or dentistry, but "the infrastructure isn't in place for extensive, invasive procedures," says Josef Woodman, author of a how-to guide called "Patients Beyond Borders: Everybody's Guide to Affordable, World-Class Medical Tourism."

A medical tourist, as opposed to a medical traveler, will use some of his or her savings on medical care to enjoy a holiday abroad. Take Dana Updyke, 62, of Los Angeles, who was recently on a ferry between Phuket and the Phi Phi Islands. She had come to Thailand several weeks earlier for a hip resurfacing, a less-invasive alternative to a hip replacement that is not yet widely practiced in the United States. After recuperating in a five-star hotel on the beach, a stone's throw from a satellite hospital Bumrungrad operates in Phuket, she was ready to move from one Thai tourist destination to an even more exotic one.

Some international hospitals broker deals with resorts. The Apollo Chennai in India, for example, staffs the ritzy Taj Fisherman's Cove on the Bay of Bengal with an intern and nurses prepared to do routine follow-up care.

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