October 22, 2004


India draws 'medical tourists'
Cheaper health care a powerful attraction
(John Lancaster, Oct. 21, 2004
, The Washington Post)

Three months ago, Howard Staab learned that he suffered from a life-threatening heart condition and would have to undergo surgery at a cost of up to $200,000 -- an impossible sum for the 53-year-old carpenter from Durham, N.C., who has no health insurance.

So he outsourced the job to India.

Taking his cue from cost-cutting U.S. businesses, Staab last month flew about 7,500 miles to the Indian capital, where doctors at the Escorts Heart Institute & Research Centre -- a sleek aluminum-colored building across the street from a bicycle-rickshaw stand -- replaced his balky heart valve with one harvested from a pig. Total bill: about $10,000, including roundtrip airfare and a planned side trip to the Taj Mahal.

"The Indian doctors, they did such a fine job here, and took care of us so well," said Staab, a gentle, pony-tailed bicycling enthusiast who was accompanied to India by his partner, Maggi Grace. "I would do it again."

Staab is one of a growing number of people known as "medical tourists" who are traveling to India in search of First World health care at Third World prices.

May as well, the doctor you see here will likely be Indian too.

Posted by Orrin Judd at October 22, 2004 8:21 PM

If so, that would not be good for us and it would not be good for India.

I cannot think of anybody it would be good for, which is why I am not an unvarnished admirer of the consequences of free markets.

Posted by: Harry Eagar at October 22, 2004 9:22 PM

Why wouldn't it be good for all concerned?

Posted by: oj at October 22, 2004 9:24 PM

The best eye surgeons in the world used to be in Russia (for all I know, they still may be).

Hadn't heard about medical tourists. Very interesting. I wonder if Europeans and Canadians are going to India, given the wait and the quality they face at home.

Posted by: jim hamlen at October 22, 2004 10:04 PM

Medical tourism is already a big business in Thailand. Cosmetic surgery is a particular speciality where a procedure done there will typically run about 25% or less of what it would here. Bangkok boasts some of the finest medical facilities in Asia with many resembling 5 star hotels more than they do hospitals. Many, if not most, of the physicians and surgeons received their degrees in the U.S. and are fluent in English. The main downside to having a procedure done there is if there are complications that result after you have gone home.

Bumrungrad Hospital

Posted by: MB at October 22, 2004 10:36 PM

This is very dangerous. In India, the only way you pass in medical school is to bribe the professor.

Thailand is a serious place so they have decent medical care. As for me, I'd try Taiwan.

Posted by: Bart at October 22, 2004 10:46 PM

Did he declare himself when askied by customs if he was bringing into the country "any fruit, vegetables or animal products"?

I just hope the "a gentle, pony-tailed bicycling enthusiast" isn't also someone who funds and supports such organizations as PETA, or at least recognizes the irony of his situation.

Posted by: Raoul Ortega at October 22, 2004 10:48 PM

In my limited experience with Canadian hospitals and public clinics in the past few years, a large percentage of the staff, both doctors and nurses, are third world immigrants. Same with pharmacies. I also have the general impression they are very good and very dedicated. More and more, from trained professionals to ordinary service clerks, I find myself subconsciously drawn to immigrants if I have a problem or am looking for any individual service.

Posted by: Peter B at October 23, 2004 4:37 AM


In my youth, I parachuted. My instructor insisted that I practice my landing techniques, assuring me that 99% of all parachuting fatalities occured on landing. Isn't this like "[t]he main downside to having a procedure done there [Thailand] is if there are complications that result after you have gone home."

Posted by: Fred Jacobsen (San Fran) at October 23, 2004 5:18 AM

Peter B,

Given the diffident to downright hostile behavior of most native Canadians in service occupations, that is quite understandable. My experience at the Skydome Hotel is instructive.

Posted by: Bart at October 23, 2004 8:18 AM


Keep telling yourself that and life will continue to be oh-so-simple.

The problem is not hostility or diffidence (well, some days it can seem that way in Quebec). Haven't you heard we lead the world in niceness? The problem is competence, pride and an ability to think beyond whatever is in some operational manual or on a computer screen.

Posted by: Peter B at October 23, 2004 8:45 AM


It's the same here with people who use midwives. Any complications and you'd better have real medical care available.

Posted by: oj at October 23, 2004 9:08 AM

Fred & OJ:

I'm not enthusiastically promoting the idea that just anyone fly halfway round the world for medical treatment. Rather I was simply commenting that this is not unique to India nor is it a novel concept. But I will say that I do consider it a legitimate option for those folks who are willing to accept the inherent risks. In my case it is a more acceptable proposition being that my wife is Thai and therefore my cost versus benefit calculus is different than most folks would be.

Posted by: MB at October 23, 2004 11:12 AM

Haven't you heard we lead the world in niceness?

I must say I've found Canadian politeness to be much overrated in my trips to Canada. To be sure, it's much politer than New York or many other coastal metropolises. But I certainly didn't find them nicer or more polite than people from my own native North Carolina.

Posted by: John Thacker at October 23, 2004 6:12 PM

It may be different today, but 20 years ago the Hotel de l'Institute in Montreal was mostly Canadians, and no one anywhere was more devoted to service.
Two years to become a waiter.

Orrin, among many reasons this is bad is that India cannot afford to educate physicians for export, because it is poor. And because the new medical techniques that we all want to see invented before we need them come from the US, not India, and are financed by the economic system of people using the already invented techniques. Knocking the props out from under that means stagnation in medical care both here and in India.

There's a clinic in Canada that does induinal hernia surgery, and it's the best in the world. Great. But everybody in the world who needs that sort of surgery cannot go there. And one rule of surgery is that practice makes perfect. To the extent that elite medical centers siphon off ordinary procedures (and induinal hernia is very ordinary), that lessens the quality of surgery you get at your local hospital when you need it.

There ain't no free lunch.

Posted by: Harry Eagar at October 24, 2004 3:27 PM
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