"Vacation, Adventure And Surgery?", CBS News, September 4, 2005,
Link:
http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998.shtml

Thailand is an exotic vacation spot known for its Buddhas, its beaches,
its brothels, and the bustle of Bangkok.

But for people needing medical care, it's known increasingly for
Bumrungrad Hospital, a luxurious place that claims to have more foreign
patients than any other hospital in the world. It's like a United
Nations of patients here, and they're cared for by more than 500
doctors, most with international training.

The hospital has state-of-the-art technology, and here's the
clincher: the price. Treatment here costs about one-eighth what it does
in the United States. It's the No. 1 international hospital in the
world.

"It's sort of Ground Zero. I haven't heard anybody yet who's told
us that they take more than 350,000 international patients a year,"
says Curt Schroeder, CEO of Bumrungrad.

One patient is Byron Bonnewell, who lives 12,000 miles away in
Shreveport, La., where he owns and runs a campground for RVs. A
year-and-a-half ago, he had a heart attack, and his doctor told him he
really needed bypass surgery.

"They told me I was gonna die," says Bonnewell, who didn't have
insurance.

He estimates he would have had to pay over $100,000 out of his own
pocket for the operation he needed, a complicated quintuple bypass. And
he says he actually decided not to do it: "I guess I figured I'd rather
die with a little bit of money in my pocket than live poor."

But Bonnewell says his health was deteriorating quickly, when he read
about Bumrungrad Hospital: "I was in my doctor's office one day having
some tests done, and there was a copy of Business Week magazine there.
And there was an article in Business Week magazine about Bumrungrad
Hospital. And I came home and went on the Internet and made an
appointment, and away I went to Thailand."

He made that appointment after he learned that the bypass would cost
him about $12,000. He chose his cardiologist, Dr. Chad Wanishawad,
after reading on the hospital's Web site that he used to practice at
the National Institutes of Health in Maryland.

"Every doctor that I saw there has practiced in the United States,"
says Bonnewell.

But three days after walking into the hospital, he was on the operating
table. Two weeks later, he was home.

How does he feel? "Wonderful. I wish I'd found them sooner," says
Bonnewell. "Because I went through a year - I was in bad shape. I
couldn't walk across the room."

How was the nursing? How was the treatment?

"I found it so strange in Thailand, because they were all registered
nurses. Being in a hospital in the United States, we see all kinds of
orderlies, all kinds of aides, maybe one RN on duty on the whole floor
of the hospital," says Bonnewell. "In Thailand, I bet I had eight RNs
just on my section of the floor alone. First-class care."

That's what the hospital prides itself on: its first-class medical
care, which it can offer so cheaply because everything is cheaper here,
particularly labor and malpractice insurance. You can get just about
any kind of treatment, from chemotherapy to plastic surgery.

Kim Atwater from Bend, Ore., was on vacation in Thailand when she
decided to combine sightseeing with a bit of an eyelift.

Was she nervous about having an operation done in Thailand?

"Yes, yes, I was somewhat hesitant about having any type of operation
in a foreign country, and it turned out to be, I mean, it was beyond my
expectations," says Atwater.

And it was not beyond her budget: $1,500, and that included a private
room.

How would she describe the difference between this place and an
American hospital? "It's much nicer than any that I've ever stayed in
the United States," says Atwater.

The rooms look more like hotel rooms than hospital rooms, and that's
no accident. The idea was to make the whole hospital look like a hotel
and a five-star hotel at that. There are boutiques and restaurants to
suit every taste and nationality

"Part of the concept was to create an environment when people came in
they didn't feel like they're in a hospital," says Schroeder.
"Because nobody really wants to go to a hospital."

Bonnewell says he's going back this fall for another checkup. He'll
have to take a 22-hour flight, but there's even an upside to that.

"We do have a very unique relationship with Thai Airways," says
Schroeder. "So you can buy a ticket. You can use frequent flier mileage
to get your checkup."

Whatever it takes to get your business.

"And this is not the only hospital trying to outsource healthcare, is
it?" asks Simon.

"My goodness, no. I, we certainly have not gone unnoticed," says
Schroeder. "There are hospitals throughout Asia. There are hospitals
throughout Asia, throughout India."

India wants to become the world leader in medical tourism, and it might
just make it. Alongside the familiar images of the country (teeming,
dusty streets, and poverty) you can add gleaming new, private
hospitals.

The hospital boom in India was fueled by India's growing middle-class
who demanded access to quality health care. Now, the country known for
exporting doctors is trying hard to import patients.

The most important player is the Apollo Group, the largest hospital
group in India, and the third largest in the world.

Why is it so important to get foreign patients here?

"It makes sense to establish India as sort of a world destination for
health care," says Anjali Kapoor Bissell, director of Apollo's
International Patient Office.

But why should foreigners come here? Well, it's even cheaper than
Thailand for most procedures, with prices about 10 percent what they
would be in the United States.

Anne Bell works at the British High Commission in New Delhi. She just
had a baby and says she's glad she was here, and not in England:
"There's been no pressure to go home after the delivery. We've been
welcomed to stay as long as we want. They're looking after the baby.
They're looking after me, giving me enough time to get settled and
get confident enough to go back home. Often in the UK, you might be out
of the hospital within five hours if you've had a normal delivery."

And in the UK, she wouldn't have had a private room and a private
bath. Not to mention massages, and yoga, too. And the doctors? Indian
doctors are known worldwide, they speak English, and they're often
the very same doctors you may have had in Europe or America, where many
of them practiced before returning to India.

"Do you find that many Indian doctors are coming back now because of
hospitals such as this one?" asks Simon.

"Yes, a large number are coming back," says Bissell. "Because they have
something to come back to."

Dr. Praveen Khilnani, a pediatric intensive care specialist, worked at
several American Hospitals, including Mass General. Dr. Vikas Kohli is
a pediatric cardiologist who worked at hospitals in New York and Miami.

Both need sophisticated equipment to care for their patients, something
India didn't have before the birth of private hospitals like Apollo.
They both wanted to come back to India despite the fact that medical
care costs much less here, partly because doctors make much less.

"How much less do you make here than in the United States?" asks Simon.

"Maybe a tenth or a twentieth of what we were making the U.S.," says
Khilnani.

They wanted to come back, they say, because they felt their expertise
was needed here in India much more than in America.

"There are probably 1,500 to 2,000 pediatric cardiologists in the U.S.
I would be one of them," says Kohli. "In India, there were just four of
us. I was very passionate about working for Indian kids."

Since there are so many Indians who require the kind of care that only
they can offer, why is there such a strong drive to attract foreign
patients?

"Who doesn't mind extra money flowing in?" says Kohli.

Stephanie Sedlmayr didn't want to spend the tens of thousands of
dollars it would take to get the hip surgery she needed. And she
didn't have insurance, either. So with her daughter by her side, she
flew from Vero Beach, Fla., to the Apollo Hospital in Chennai. She'd
never been to India before, but she already knew quite a bit about
Indian doctors

"My doctor, actually, in Vero Beach, she's an Indian doctor. So, why
not go where they come from?" asks Sedlmayr, who says her friends
questioned her decision. "Hardly anybody said, 'Oh, great idea.'"

But she didn't just come here to save money; she came for an
operation she couldn't get at home. It's called hip resurfacing,
and it has changed people's lives.

It hasn't been approved yet by the FDA, but in India, Dr. Vijay Bose
has performed over 300 of them. He showed 60 Minutes the difference
between a hip resurfacing and hip replacement, which is the standard
operation performed in the United States. He says his patients usually
recover faster because his procedure is far less radical and doesn't
involve cutting the thighbone.

Instead, Bose fits a metal cap over the end, which fits into a metal
socket in the hip. The result, he says, is that patients end up with
enough mobility to do virtually anything.

"So my patients, you know, play football, basketball, whatever you
want. Not a problem," says Bose.

Until the FDA approves it, the only way to have this operation in the
United States is by getting into a clinical trial. But be warned: It
isn't cheap.

How much does it cost in the States?

"I believe it costs something from $28,000 to $32,000 U.S. dollars,"
says Bose.

And in India, Sedlmayr says it costs $5,800: "Private nurse after
surgery. And, feeling always that they were just totally attentive. If
you rang the bell next to your bed, whoop, somebody was there
immediately."

Sound too good to be true? Don't forget: It's at least a 20-hour
trip, there is malaria in parts of India, patients have complained of
intestinal disorders -- and if something goes wrong, you could end up
suing for malpractice in an Indian court.

And one could only wish you the best of luck. But Sedlmayr feels
she's already had more luck than she had any right to expect. By the
time 60 Minutes left India, she was into the tourism part of her
treatment, convalescing at a seaside resort an hour's drive from the
hospital.

"Is this standard, that when somebody gets surgery at the hospital to
come to a resort like this afterwards?" asks Simon.

"Yeah, they suggest it. They recommend it," says Sedlmayr. "[It cost]
$140 day for myself and my daughter, including an enormous fabulous
breakfast that they serve until 10:30."

"I think a lot of people seeing you sitting here and what's usually
called post op, and hearing your tales of what the operation was like,
are going to start thinking about India," says Simon.

"Yeah, and combining surgery and paradise," says Sedlmayr.