So, a couple of months ago, I was in Malaysia. I was there with the business of medicine program run by the Kelley School of Business to learn about medical tourism. We also went to Singapore, but I'll tell you about that in a future episode. On the last day, we did more tourist-y things. We went to the Batu Caves, which is a Tamil shrine for Lord Murugan, who is the Hindu god of war. There's a huge statue of him, and you have to climb 272 colorful steps to get there. It was totally cool and totally worth it. And, on the way down, a monkey stole my eyeglasses. That's the topic of this week's Healthcare Triage.

[Intro]

I'm not kidding, a monkey stole my eyeglasses. Here's how it happened: I was walking down the stairs holding a small bag with two small souvenir statues of Lord Murugan for my kids. And all of the sudden I felt something tugging at it, and I thought someone was trying to steal the statues. I turn around, and it's a monkey! It's gripping the bag with two hands, pulling as hard as it can, and next thing you know, the monkey and I are totally yelling at each other and pulling the bag. And, it explodes, and the two statues go flying in the air. Then, I leap for one of the statues, and the monkey gets the other statues. And, I'm turning and screaming and yelling at the monkey, and I realize, oh my god, it took my glasses out of my hand.

I was wearing my prescription sunglasses and holding my regular glasses in my hand, and, all of the sudden, all I'm left with is my prescription sunglasses. I was going to be that guy at dinner wearing his sunglasses at night. I was going to have to wear them on the 24-hour airplane ride home the next day, and it didn't have the bifocals that I need to read. Or was I?

The previous day at a mall, not even the fancy mall near us in Malaysia, I'd seen an eyeglasses store that promised to make a new pair of glasses for you in 10 minutes. 10 minutes! Couldn't hurt to try, could it? We went there, and, if I'm being honest, I was skeptical.

I walk in the store, and some nice man immediately came up to me. I told him I needed new glasses. I had the prescription of my sunglasses, and I gave it to him. He took them back to some fancy machine, and, the next thing you know, he's got my prescription. Then, he asked me, would you like an eye exam just to fine-tune it. I ask him how much that would cost, and he laughed. It would be free! He quickly checked my prescription, told me I could get some new glasses; I had to pick out some frames. I said, show me the cheap frames. He took me to the front. Everything's on sale. I pick out one. He says, hey, I just got to tell you, your prescription's pretty bad, so you can't have the cheapest lenses. You got to get sort of fancy lenses, otherwise they're going to be like this thick. And, I said that's fine. How much is it going to be? He says, 399 ringgits. 399 ringgits is less than 100 dollars. They even threw in a case for my sunglasses for free, which was nicer than any other case I've owned. This is the case!

The irony! On a trip to learn about medical tourism, I became a medical tourist. I'm not alone.

Why do people become medical tourists? Maybe they want to obtain services they can't get at home. Maybe they want to save money. Maybe they want better quality care.

Malaysia's medical tourism focus, run by the Ministry of Finance, which says something, focuses on infertility and cardiology. For a variety of reasons, many of the surrounding countries, like China and Singapore, don't offer all the fertility services some patients want. So, people travel. People from those countries and others, like Australia, may travel for cardiology care that's better and faster than what they can get at home.

I toured hospitals there. They are fancy. I mean, fancy! They have all kinds of translations services and connections to talk to the doctors back at home. They're set up to do this, and their technology is top-notch.

So, why does medical tourism get a bad rap? Well, the medical community here in the United States isn't really keen on it. I mean, it's not hard to see why. Even the CDC has a bunch of warnings up noting communication barriers, counterfeit medications, infection risks, and more. They're not entirely wrong. Traveling to a subpar system to save money may be a risk, but many countries have systems that are far from subpar.

When I brought this up to some of the Malaysians, they asked me if I knew anyone who ever traveled in the United States for care. Of course I had. That was medical tourism, they pointed out. Just recently, in our episode on cancer caregivers, I talked about how my friend, Jim, went from Indianapolis to New York for a second opinion on his care. That's medical tourism. People do that all the time in the United States. Jim had to transfer medical records, which was a huge pain in the butt. He had to get the doctors in one place to talk the other, which is difficult. He had to arrange for travel and for a hotel, and more. It's the same problems.

People do this all the time in the United States, but when we're crossing state boundaries, even traveling thousands of miles, we think that's great. But, if you cross a border into Canada or Mexico, that's horrible.

People still do it. Studies have show that many Canadians travel for medical care to the United States and other areas. Somewhere between 100,000 and 200,000 people fly to the United States every years for health care. We don't have a problem with that. We even brag about it. But, even more, somewhere between 150,000 and 320,000 Americans fly out of the United States every year for health care. Most go to South America, Central America, and the Caribbean, but that's because those are close. If Malaysia were closer, we'd go there. Almost a million people in California, alone, drive to Mexico each year for care. About half of whom are Mexican immigrants.

And, yes, you have to pay for medical tourism out-of-pocket. Insurance isn't usually going to cover it. But, with deductibles rising the way the are today, that price barrier seems less and less important to a lot of people.

And, is care here really that much faster and cheaper? When I got home, I made an appointment with my eye doctor. The first available appointment was a week out; my wife, of course, called back and got that moved up to two days later, but most people lack an Amy Carroll in their life. After the appointment, which insurance did cover, my glasses, which I'm wearing, cost $750. Insurance reduced my payment to $186. It took more than two weeks to get them. Are they really that much better than my Malaysian glasses? I'm really not sure. They definitely came with a worse case.

[Outro]

If you like this video, you might also like this other video on the difficulties of caregivers and caring for their friends and family with cancer.

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