Warning: This post will describe a real, personal health issue. I will be using language that may be offensive for some. If you’re offended by terminology involving the male body, you may not want to read this post. Also, I apologize for some of the pictures being blurry.
Some real talk is about to follow, folks.
Life isn’t always sunshine and rainbows, even when you’re financially independent at 35 years old, living the life of your dreams halfway across the world.
When I wrote about my reasoning behind not wanting or having health insurance here in Thailand, I wasn’t expecting to put my theories to the test so quickly.
But that’s the way life works.
When life hands me lemons, I make lemonade. It’s just who I am. I have a positive attitude, always.
Developing what I thought might be a serious physical problem recently was a great test of my resolve, but I kept right on smiling and going about my life.
But I also thought that having something that required visiting the hospital was a great opportunity to share the process with you readers.
The bad news (the lemon) is that I have a health issue that will probably be moderately bothersome for the rest of my life.
The good news (the lemonade) is that the process of interacting with the health system here in Chiang Mai in a rather direct and serious way only served to further cement my belief that I’m making the right choices in not only living here indefinitely as a dividend expat, but also in living here without health insurance.
Pain
I developed an uncomfortable ache in my groin area somewhat recently.
Specifically, the pain was originating from the left side.
While disconcerting in and of itself, this pain rather quickly spread up to my lower left abdomen, turning discomfort into a fairly noticeable ache across the left side of my body. This ache could be reduced by laying down, but it was prominent when walking or exercising.
Being the analytical, pragmatic, and research-minded person I am, I decided it was time to practically get a degree in the male reproductive system.
I’m not a huge fan of visiting doctors in general. Whereas some people see a doctor as a first line of defense (making a doctor appointment as soon as they develop a sneeze), I see a doctor as a last line of defense. Outside of a medical emergency (in which case doctors are necessary and wonderful), I see doctors generally (but not always) as well-paid, educated guessers who hand out antibiotics.
And so I instead live a fairly healthy lifestyle that should reduce the wear and tear on my body and mind, which in turn should limit the need to see doctors.
To each their own on that. But that’s where I’m at with it.
And so far, so good.
Until this ache developed…
So I did some research on my symptoms, leading to a diagnosis on myself as I was trying to figure out what this was.
It didn’t appear to be cancer, which was great. However, I wasn’t prepared to totally rule that out due to the serious consequences of being wrong.
After some analyzing the issue and research, it came down to two likely issues:
The first was epididymitis.
The second was varicoceles.
Of course, testicular cancer was also a remote third possibility that I kept in the back of my mind.
The first issue could possibly require antibiotics that are given via a shot, which would necessiate a doctor visit.
The second issue would call for a bit more expertise than I have in terms of what to feel for.
And the third issue, while unlikely, was something I’d feel much better about if I had it professionally ruled out.
Seeing A Urologist
So I took some time on a Sunday afternoon to casually stroll down to Chiang Mai Ram Hospital, which is only one kilometer or so away from where I live.
I didn’t make an appointment.
I walked right into the hospital, where a very sweet nurse greeted me right away.
She asked me what symptoms I had and who I needed to see.
I told her what was going on. And I told her that I thought it’d be a good idea to see a urologist, due to the nature of the issue.
In the United States, seeing a urologist would almost always require an initial visit to your GP, upon which time you’d get a referral. This is extra time, cost, and rigmarole. And it’s another example of why I don’t like the healthcare system in the US.
I was quickly shown to a desk in front of the urology area.
They took down my information, gave me a patient card, and walked me over to the waiting area.
I waited for about 15 minutes.
Then a nurse called my name. I was shown into a vitals room. Height. Weight. Blood pressure. Temperature.
Everything was great.
I was told to take a seat again.
After another 15 minutes, the same nurse called my name.
I was shown into the doctor’s office.
There I met a urologist who spoke great English and was very professional.
He asked me what was going on. I shared my symptoms and ideas on what’s going on.
There was definitely groin pain originating from the left side. And this ache seemed to quickly spread up into my left abdominal area. The abdominal ache could largely be eliminated by laying down.
I told him I already ruled out something dietary relating to my intestines, as I had changed the foods I was eating temporarily to just make sure I wasn’t chasing the wrong problem(s). He agreed with me that the pain in the abdomen area was likely at least partly related to the groin pain (although I also found out that mild dehydration was causing me some issues).
The urologist then showed me to an examination area in his office.
He proceeded to physically examine my groin. This examination lasted for about 30 seconds.
The diagnosis was decided and swift:
Varicoceles.
An enlargement of the veins within the scrotum. It occurs in ~15% of all men. And it’s almost always on the left side.
I won’t delve too deeply into the issue, but there’s plenty of information out there regarding what it is.
Unfortunately, there isn’t much I can do about this, outside of pain/swelling management (via ibuprofen). I was advised there was nothing I did (or didn’t do) to cause this.
Because of shared nerves/veins, any groin pain/ache can radiate up into the abdomen area.
Surgery is an option, but the doctor said this is usually reserved for people who want to maintain fertility. Since this isn’t a concern of mine, surgery apparently is not recommended.
Checking Out
I then left the doctor’s office and had a seat back in the waiting room.
A minute passed by. The same nurse then called my name and had me follow her over to the cashier area, which is on the other end of the main atrium of the hospital.
I walked by numerous “stations” that fronted related doctor’s offices.
The nurse had me take a seat in front of a cashier window. She gave the cashier my paperwork.
I figured it might take a few minutes to process my paperwork.
Nope.
Only 15 seconds or so passed. The cashier then called the number on my patient card.
I walked up to her window. She gave me my receipt.
The total bill came out to 620 baht.
The urologist fee was 500 baht. The hospital then has surcharges that add up to 120 baht.
620 baht (at the current conversion rate) comes out to $19.89.
The entire process took under an hour. And you’ll remember I didn’t have an appointment.
Notably, a GP costs 300 baht at this same hospital. A specialist (rightly so) has a higher fee.
Conclusion
It’s $20 I wish I didn’t have to spend. Even more than that, I wish I didn’t have varicoceles.
But I like to see the glass half full.
I don’t have testicular cancer. I don’t have a life-threatening condition.
(I’d say I’m not dying, but my good friend here in Chiang Mai, Andrew, reminded me “we’re all dying”. Touche! That’s a major reason behind my whole drive to achieve financial independence, reclaim my time/life, and live on my terms.)
Furthermore, this $20 is significantly less than I would have had to pay in the States, especially after factoring in the health insurance I would have had to carry between the time I left the US and today. We’re talking thousands of dollars here. Instead, I’m out $20. Not too bad. I’m already greatly ahead on my long-term bet against living in the US and carrying health insurance there.
Perhaps most importantly, though, I saved a ton of time. The process that’s involved anytime one has to interact with the US healthcare system is one thing that turned me off from it in a major way.
Although I don’t have anything serious, I probably would have been even more unlikely to visit a doctor (or at least delayed things longer) in the States for this same issue simply to avoid the headaches. And that’s a real shame that I think impacts many, many people.
Avoiding the headaches is fantastic. Avoiding almost all of the costs, too, is very tasty icing on the cake.
I wish I didn’t have to share this story.
But I’ve always attempted to be as transparent as reasonably possible with things.
And since many people who decide to retire abroad and live off of passive income are likely going to do so at an older age, the process and cost of interacting with the local health system is an interesting (but unfortunate) topic that should be broached.
If I have to interact with the health system again in any major way – I hope this doesn’t happen for many years, if ever – I’ll be sure to share that, too.
Seeing as this was the most potentially serious health concern I’ve had in many, many years, and seeing as how it happened in a foreign country where I lack health insurance, this was a great time to share the experience.
This process only served to reinforce my belief that the benefits (in both financial and non-financial terms) of geographic arbitrage are rather significant, especially when it comes to healthcare. This process would have been far more confusing, time consuming, and expensive in the States.
What do you think? Did this process surprise you in any way? How would this process compare to your local experience?
Thanks for reading.
P.S. If you’re interested in becoming financially independent, which could allow you to live abroad and take advantage of geographic arbitrage, check out these resources that I personally used on my way to achieving financial independence in my early 30s.
Those are some pretty low fees indeed! No wonder you have no health insurance. It’s still a financial risk, but you are trying hard to stay healthy, which should reward you in the longer term.
Good luck with your health issue, hope it does not surface too often, does not sound like a comfortable situation to be in!
Team CF,
Yeah, I thought this was a great example (but unfortunate for me) for perspective on what that is like over here. And it’s not just the money/savings. The fact that it was so fast, with almost no rigmarole, is just wonderful. Couldn’t have been more pleased or impressed with the whole experience.
I wasn’t super keen to share this personal health story/issue, but I felt it was really important and useful to get this out there. And maybe it will make a few readers feel better about their own issue(s), since this affects roughly 15% of all men.
Best regards.
Man, I hope you feel better soon
Thanks a lot for sharing your experiences. Immense educational value!
Henrik
Henrik,
Glad to hear that.
This isn’t the kind of thing you usually hear/read about (nor is it something I was super excited to write about), but there’s a lot of value and insight to be had. In fact, there’s arguably more insight to be had precisely because it’s something that most people don’t share.
Cheers!
Hey Jason! Glad you are ok (in the grand scheme of things), and as usual, I chuckled to myself thinking about what you just paid to go to the ER and see a specialist vs the experience(s) I have here. As someone who went to Medical School, I never go to a doctor because I do self exams (yup, even the turn your head to the left and cough part), so instead of $20 to the hospital or doctor, I just take myself out to lunch for a total medical bill of ~$7.00USD 😛
That said, I was just informed (reminded actually) that since I just turned 50, it is time for my first colonoscopy, so being that I can’t do that myself, and believe you me I would if I could, LOL, off to the hospital I go. Can’t wait to see that bill, but at least it won’t be like when I broke my ankle and had to pay $6500 out of pocket. I am with you, and hesitant to go see a doctor, so I am glad you did. I, too, have an issue down below in that due to many injuries to my legs, my musculoskeletal system is a bit unbalanced, and it pulls on a muscle that runs through the genital area (known as the piriformis), and ultimately pinches a nerve that does exactly what you were feeling, just on my right side. My chiro knows what to do about it, but I can understand how much it hurts, and how scary that can be until understood better. It sounds like your self-insuring is a smart move, and that $20 is $$ well spent if you ask me.
It also struck me as interesting that you felt compelled to put a warning at the beginning of your post… are people really that sensitive / chaste? Keep on being you and sharing please. I wake up each day wondering if I am going to get a little glimpse into the life you are creating. Speaking of which, it appears you are heading into the low 100’s as far as temperature over there.. with humidity / burning, it must be quite hot!
Andrew,
Man, I’m with you all the way. I did as much research and self-examination as I could. But I just felt like this was one of those scenarios that required a bit more expertise. I thought the odds were good (over 90%) that my issue was benign, but the small chance I was wrong wasn’t worth the potential savings. If this were the US, though, I would have certainly hesitated more. I would have also spent more time, more energy, and more time getting through the same process. Couldn’t be happier about being rid of that.
Sorry to hear about the pinched nerve. I’m now quite familiar with what pain in that region feels like. I’d be happier to be not in the 15% of men that have it, but it’s a relatively small problem. It obviously could have been much worse. All in all, I’m pretty happy about it.
I did feel compelled to put that warning up there because most of the readership is from the USA. The US has become, unfortunately, an overly-sensitive place where someone, somewhere is being offended about something. I just thought I’d include it so as to avoid any issues.
It’s quite warm over here. Just means I move along a bit quicker from place to place. It’s a time saver! 🙂
Best wishes.
Thank you for sharing your story and I hope you fully recover soon. About this time last year I was struck with lower back pain that slowly increased over a few weeks. I did extensive research online and self diagnosed my issue as a piriformis injury. I am a competitive cyclist and had raced just a few weeks prior and did very well. My training was also going great until a few days before my next race. My injury got so bad that I could no longer operate my vehicle which has a manual transmission. I have a very high tolerance to pain, I could not even get out of my driveway. The worst part of all of this was I could no longer get any sleep. I first went to my GP who took x-rays which were inconclusive. An MRI was set up as well as a referral to a pain clinic. There was a mix up to where I was supposed to go and I went to the wrong place and had to wait 3 more weeks to see them. During this time my ability to sleep had gone away. The 800mg ibuprofen did absolutely nothing for me and I simply had to suffer. By the time I got to the pain clinic after a 3 week wait, I had not slept for over 72 hours due to the pain. They gave me upper epidural shots and a prescription for Tramadol. I refused pain meds from my GP over fears of addiction, but broke down so I could sleep again, My GP then referred me to a neurologist and physical therapy. My entire summer of 2017 was a complete blur. The Tramadol gave me my life back and allowed me to slowly get my sleep back. My piriformis self diagnosis was WRONG. I had a protruding disc in L4 that was aggravating my sciatic nerve. After a month off the bike, stretches , no more sit ups (doing planks only now) or overhead weight training, I am ~80% back to normal and was able to race again in March with decent results.
This opened my eyes to how bad our health care system really is. I have great insurance through my employer, but it was a major PITA going through the entire process with billing and coverage issues. Nobody seemed to care about the end solution in my situation either. The pain doc had the best advice which was to get an inversion table for traction and to “slow walk” the neurologist if he suggested surgery. I used to see a chiropractor before all of this and his treatments did absolutely nothing for me. I have not seen my chiropractor in a year now and no longer see a need to do so.
I think had I lived in Chiang Mai, I would have had a much better/cheaper experience. Oh yeah, I slowly weaned myself off of the pain meds 5 months ago and had no issues.
Joe,
Terribly sorry to hear of that. None of that sounds fun at all!
I think had I been still living in the US when this issue popped up for me, my story would sound somewhat similar to your own. And I’be out a hell of a lot more time and money for my troubles.
The US has a lot to like. Don’t get me wrong. But that healthcare system is atrocious.
Glad you’re feeling better and off medication. Addiction runs in my family, so I know how you feel. I hate taking any kind of pain medication.
Cheers!
I’m sorry to hear that you had health issues. I hope you are feeling better and get pass this.
The hospital looks beautiful and the price is even better.
FV,
Thank you. It’s all good, though. Could have been much worse!
Thanks for dropping by.
Cheers.
Sheesh, sorry to hear about the health issue. I’ve been learning myself that all the time and wealth in the world doesn’t mean much if your health is holding you back.
On the bright side, looks like you are in good hands, and for very good value!
MCK,
Absolutely. Health is one of those things that’s easy to take for granted – until it’s not there. My health and fitness is probably in the top 10% of the world for males my age, but you never can tell. Always a chance that some weird affliction hits you and totally destroys your world.
Fortunately, this is truly no big deal. It’s an occasional ache that can be pretty much completely alleviated by ibuprofen. It could be a lot worse. I’m super lucky. 🙂
Best regards!
I am sorry to hear about your health issues. I hope you feel better soon!
In positive side, it is an opportunity to check the Thailand medical system and their fees. $20 to meet a specialist is extremely cheap option than U.S.
Thank you for sharing !
FJ,
This isn’t something that’s shared too often, which does us all a disservice. I felt an obligation to go ahead and discuss the experience.
All in all, I feel even better about my decision to live here while forgoing health insurance.
Cheers!
Hey Jason sorry to hear about the health issue. i wish you all the best on that. I have to say you would have payed a hole lot more here in the USA than that to have seen a doctor. I go once a year for my annual physical and rarely go after that. My health has been good so far in my life so has been my family I hope that doesn’t change. I wish you all the best health.
Cheers
Michael,
Thanks!
I thought this was a great opportunity to provide a glimpse into how the healthcare system, at least at this particular hospital, works here in CM. It’s really incredible. Unfortunate that I had to interact with it in this manner, but I’m very glad it wasn’t worse.
Makes me feel even better about living here. 🙂
Best wishes.
Thanks for sharing this story, Jason, even though you may not have wanted to. I’m sorry to hear about the situation and that it’ll be an ongoing thing. However, your optimism is infectious and your positive attitude does you credit. Plus, I think the inside look at healthcare in another country is really helpful to readers like me, stuck in the bizarre/backwards US system. I am amazed at how little that visit cost you!
Andy,
Thanks!
Yeah, it wasn’t something I really wanted to share with the world, but I felt more or less compelled to. Just glad it’s providing some value and perspective. 🙂
Best regards.
Wow. First, I’m sorry to hear about the health issue popping up, and that you may need to deal with it for the rest of your life. That does suck. 🙁 You are looking at it in such a positive way, though, so kudos on that! Second, I’m jealous of the experience, in that you didn’t have to have an appointment (scheduled weeks out), there was hardy any waiting, they were thorough and quick with you, and you paid right away, and it didn’t cost so much. I mean my jaw dropped when you did the conversion. I thought it was originally in US$. Oh. My. Gosh. $20?!
Here’s my experience, and I apologize for the length and possible anger, as I’m just sitting in a bucket of hot stew at this point and I guess I need to vent, if you don’t mind: In the past 6 months, I’ve had some health issues pop up. I’ll address just one: I was bumped around with this issue from Dr to Dr for about 3-4 months (Oct-Jan) until I was finally told that normal Drs actually don’t know anything about this particular problem. Hah! Instead, I need to see a special doctor of a particular kind. Wow, so there’s multiple visits and $$$ gone for Dr #3 or 4(?) to admit they all knew nothing and should have sent me to this more specialized person months ago. So I go see this new Dr (#4 or 5 now?) after scheduling my appointment another 3 weeks out (so now this is Feb), who gives me a prescription and a “come back in 4-5 weeks if not better”. I knew the prescription probably wasn’t going to do anything, because it didn’t before, but like you said..You need the referral to go up the chain so I had to appease this Dr first with all his thoughts/attempts [that I had previously heard from the other Drs (but we had to re-try. Again)]. So I do the meds again (which btw all medications are costing me money, too), and in late March, I’m back in his office for my follow up (because surprise, it didn’t work), getting referred to a next-tier (Tier 2?) specialist, who by the grace of god gets me in later that same week. Tier 2 Dr determines I need a CT scan, leading me in to that appointment the next week. I wait a week, get the scan, then it takes another full week to hear my results (I very likely need surgery!). Of course, I need to see a super duper tier 3 specialist for a consult, which may take another 3-4 weeks to even have them call me to set something up for another few weeks out to talk to the Dr – that’s just for the consult. (By the way, a day before that first follow-up, I had to have another procedure done, at the end of March, for a potential CANCER scare, given to me in January. That’s 2 months waiting for even that procedure to see if I have cancer. WTF). So here I am a week later, waiting for this new office to call me to get me in for a consult.
In the past few weeks, the EOB and bills have started rolling in to the tune of over $2,000 just to be told I need to see a Tier 3 Dr and I also need to cough up money for surgery. I feel like so much of that time and money got wasted. SO and I just saved enough cash over 2 YEARS to go on vacation for 3 weeks at the end of this month, and this vacation costed us less than this $2K bill… so now I have to have this problem on vacation (which basically makes everything we were going to do un-doable due to the condition) and this should have been fixed months ago for way less money.. I just..I can’t even, Jason. I’m so upset at how this entire process was handled. (This reminds me to call and ask for a payment plan for all of this.)
Take care of yourself, and I hope your condition doesn’t become too bothersome.
Jamie,
Wow. Sorry to hear about all of that. Health is something that’s so easy to forget about and take for granted. I try to do everything I can, every day, to put my body and mind in the best possible position. But even that isn’t always enough. We all get older, we all develop issues, and we all eventually move on from this life. I can’t control all of it. But I can control my diet, my exercise, my lifestyle choices, and my mindset. 🙂
I hope your issues are sorted out soon. That’s a real shame. My problem is very minor in the grand scheme of things. I hope your problems turn out to be small, too.
Best regards.
Amen to that! 🙂 And truly, thank you. There are so many curve balls that life can throw at you, and all one can do is be as best prepared as possible, and that’s where I’d like to be someday sooner rather than later!
Thanks for sharing your story, Jason. The health system there sounds really great and affordable. Great insights for anyone that may have concern using the health system overseas. (I imagine a lot of folks considering early FI overseas might have concerns about the unknown, including the health system.) More than anything, its good to hear your doctor identified the issue and found a plan of ongoing treatment. Hope your pain goes away quickly and you’re able to manage the pain with your new regimine. Wishing you great health and happiness, my friend!
Ian,
Happy to share and provide some value and perspective. 🙂
Yeah, the reason I felt compelled to share this story is because most people who are considering moving abroad for retirement are going to be older, which means they’re going to be more concerned about, and possibly exposed to, the local healthcare system. I’d be remiss if I didn’t share a little bit about what to expect in that regard.
Thanks for dropping by!
Best wishes.
Sorry to hear about your health issue. Hope the ibuprofen helps.
Damn, the bill is cheap! This is the public hospital, right? I know it’s affordable, but didn’t know it was that cheap. Self insure is a no brainer in this case. I guess a more serious health problem would cost more, but still would be a lot cheaper than in the US.
I think private hospitals are more expensive.
Thanks for sharing.
Best wishes
Joe,
Ibuprofen definitely helps, but it’s truly not a big deal. Part of it is mental. Especially when you don’t know. Knowing means you kind of block it out and move on.
Yeah, I remember writing about not having/wanting health insurance here… and a lot of readers (who are from the US) just didn’t get it. I understand that. You’re used to one system and cost structure. But you can’t extrapolate that out to everywhere. The world doesn’t work like that. This adds some perspective. I think I’ll come out far, far ahead in the end in my “bet” against living in the US and carrying health insurance.
I’m pretty sure this is a private hospital (it’s listed as such on multiple sites). It’s not a government place. It would have been even cheaper like that, but I wanted a certain level of service.
Thanks for dropping by!
Best wishes.
That sounds like a great health system and very affordable. Sucks that you’ll have to manage with that pain. It’s amazing that you didn’t need to make any appointment and only had minimum waits. 🙂
Tawcan,
Yeah, it was a rather incredible experience. Sure makes having any kind of health issue (which is never fun) a little less unpleasant. 🙂
Cheers!
Pretty awesome/scary story. This type of visit, even with my extremely heavily subsidized ACA plan, would likely be several hundred dollars out of pocket. $5 copay for the GP (which is only slightly cheaper than your GP cost at full price!). Then I pay the $125 deductible for a specialist, then 20% of any extra charges above that. Given specialists are $200+ for a single visit WITH the insurance negotiated discount, I’d be looking at $145+ assuming no lab tests and just 2 quick exams from GP and specialist and out the door.
Justin,
Right. So that’s more than seven times as much money for this particular issue. Plus, you have to carry the health insurance. Plus, you have to deal with the appointments, time, and rigmarole. It’s really unfortunate, because it can be done a hell of a lot better. It wouldn’t necessarily be like here, but it could be done like a lot of other developed countries. I guess there’ll be some kind of tipping point down the road, which will force change. Time will tell. 🙂
Best regards!
They will probably run a ton of tests too. That seems to be the modus operandi here. Dig deep enough and they’ll find more health issues, minor or not.
I was just telling my wife about this post and how easy/cheap it is in Thailand vs. here. You are right – I forgot to include the additional cost of preventative medicine. There would undoubtedly be a ton of labwork (which is still pretty cheap after insurance discount) plus I wouldn’t be surprised to have an x-ray, MRI or some other diagnostic service to rule out other stuff (to prevent lawsuits).
Great share Jason.
My feelings are similar about the US Health System. I do have a very good GP and I see him once a year. Being on Medicare Advantage, the annual physical is free. And, I only pay $19 a monrth for a PPO.
So, Medicare does work in the USA in most states. However, I do anything to not see a doctor here as the costs are crazy for serious stuff. I do have two children who are doctors, so I check with them for anything serious first.
My experiences overseas have all been positive. I remember when I was in Alexandria, Egypt one time and the whole city had been taken over by a horrible flu/cold epidemic. I got it the first week there. Went to a doctor, waited for five minutes as I filled out the paper work, and the doctor apologized for my wait of another five minutes. Diagnosed in a few minutes and gave me three medications (two antibiotics from the states). Total cost was $12 for everything, six for the doctor and six for the medications. And, they worked!
My last big deal was in British Columbia when we were kayaking on the many lakes there. An emergency occurred (peeing blood caused by blood thinner) and needed to reach the nearest hospital asap. I went to emergency, the doctor saw me right away. Diagnosed the problem, told me what had to be done, gave choice of overnight in emergency room for $500 or hospital section upstairs for $2000 a night.
Sent me to a larger hospital in Prince George the next day to see a urologist where I had an operation with a two day stay in hospital. Total costs, all told to me before operation, were $10,000. Care was excellent. I paid by credit card a $2000 first payment and they asllowed me to pay the rest over six months. My medicare plan (PPO) eventually reimbursed me for everything except $500.
Why we do not have medicare cover everyone in the USA is the mystery of American medicine.
The big push in Oregon now is the installation of urgent care centers. That’s why CVS amd Walmart are entering the urgent care field as hospital emergency rooms are overcrowded, expensive with long waits (3-6 hours not uncommon) and a great place to get sick. I witnessed the same thing happen in New Zealand which has non profit and for profit medicine. The last place to go on my list is a US hospital.
David,
Thanks for sharing!
The US healthcare system is a very strange beast. It’s one element (of many) that keeps me from even thinking of coming back.
Many individual aspects make up the whole of one’s quality of life. Healthcare is in there. And I must say that my recent experience has shown me that I’m in much better hands over here, all in all. I’ve heard of similar experiences (for different issues) from other people living here. The service, quality, and value are all wonderful. Couldn’t be more pleased.
Cheers!
Hey Jason,
Wow, that was some experience. Initial fear I would say if it was me, the unknown pain…
Yes the U.S. healthcare system is crazy. Too many people, too many with their hands out.
One time when I was in China, my wife had some asthma problems, so we went off to the local clinic. (Let me tell you the hospitals in China are as crowded as train stations, don’t go there.) Local clinics are much saner. So for her doctor’s visit, multiple medications, etc., came to the equivalent of US $20.00. When we got back to the us, I send copies to my insurance company, and much to my surprise I was reimbursed!
SIYD,
The fear made the pain worse, I think. I feel better now just knowing it’s not something serious. I’m really grateful. And lucky. 🙂
That’s great you were reimbursed. Nice to catch a break sometimes!
Cheers.
Thanks for sharing this personal issue you recently faced. Glad to hear it wasn’t something life threatening either. I think this statement, “I probably would have been even more unlikely to visit a doctor (or at least delayed things longer) in the States for this same issue simply to avoid the headaches,” rings true for many individuals. If it isn’t life threatening I’ll wait seems to be the mantra for fear of headaches, time lost, and most bothersome, ridiculous expenses. Health care is good in the U.S. as it is in many other parts of the world, but it does come at a great expense.
Keith,
Right. I would have delayed seeing a doctor and become even more stressed out/bothered by it, if I still lived in the States. And I’d be out, oh, about $3,000 or so by now (the cost of having health insurance between the time I left and now). $3k to fear using what I’m paying for? It’s nonsensical. Thanks. But no, thanks.
Best regards.
I also have a varicocele in that region. It was confirmed by ultrasound about 8 years ago. I felt a small lump and experienced some pain, which is why I wanted to get checked out. I get occasional pain from time to time but for me it doesn’t seem to spread to my abdominal area. I honestly forget that it’s even there most of the time. I’m glad you got checked out and it wasn’t anything serious.
Mike,
Thanks for sharing that!
I’m not sure if it will get better in time. I will say that I experience less physical pain now that my mind isn’t so focused on it. A big part of pain is mental, so it’s helped to eliminate anything serious.
Ibuprofen also helps. The urologist told me there are shared veins and nerves there, which is why the pain can radiate or refer. In addition, there’s extra weight there, which doesn’t help.
Best wishes.
Hi Jason,
Sorry to hear your health issue, I hope it will be a minor health issue and wish you faster recovery.
Thanks for your transparency and for sharing your experience with us despite the sensitivity of the topic .
I admire your positive attitude and your willing to share this experience despite been unpleasant, painful and sensitive personal topic.
I have a Medical Doctor relative, who visited Thailand few years back for additional Health diagnosis on his mother, he was very pleased with the quality of the hospital and the medical attention provided during his trip.
Regards,
atm,
Thanks for the support! 🙂
I’m glad the post shed some light on the healthcare over here. It’s hard to have perspective on that if you’re only used to the US system.
Your relative’s positive experience speaks volumes. Appreciate you sharing that.
Cheers!
Feel better bud!
J,
No pain, no gain? Haha! 🙂
Cheers!
Hey Jason – long time reader (since DM days) and first time commenting. As soon as I started reading the post, I knew it was Varicoceles as I went through the exact same process when I was in my mid-teens. I left feeling two things: 1)Happy it wasn’t cancer, 2)Upset/frustrated that there is little to do to help. I’m in my mid 20s now and the pains/aches have largely disappeared. The biggest help for me was switching from boxers to compression type underwear (I felt that sports companies make the best ones – plus a good way to support our NKE investment!). They provide the extra support that helped me drastically.
Happy to go through some more details with you if you’d like! Best of luck! It definitely gets better.
John,
Thanks so much for the information there.
You know, you’re right. Some of my underwear are tighter fitting. And I notice less discomfort when I wear the tighter-fitting stuff. Extra support, less of that “heavy” feeling that can radiate. I’ll keep that in mind moving forward. 🙂
Glad you found that to be a helpful solution for your own situation. Definitely not fun. I empathize!
Best wishes.
Very nice article, I’m sorry to hear about the circumstances though. Hopefully it’s something that is easily managed without causing you too much pain, cost or hassle. I love a lot of your articles, especially the financial ones – purchases, stock evaluations etc. as I am still in the accumulation phase. But I’m glad you were able to shed some light on the healthcare in other countries and put to bed some of the fears and ignorance of those living here in the US. I lived in Korea and saw the Dr. for the flu and chest infection, took about 30 minutes and I had my medicine (including antibiotics) ready for me going out the door. They were all individually sealed in little tiny baggie’s, 5 altogether – 1 for each day. No hassle and cost me about $7.50. Keep up the good work Jason and take it easy for a couple of days.
Gerard,
Thanks so much. Knowing it’s not something serious, and using a little ibuprofen, goes a long way toward reducing pain. Could be a lot worse. I’m really fortunate. 🙂
That’s a great experience in Korea. $7.50 would cover something like 12 hours of health insurance in the States for me. It’s a joke. I just can’t/won’t expose myself to that kind of system. Couldn’t be more pleased with the healthcare aspect of my life over here.
Best regards.
Just curious, were you able to communicate with the hospital staff in English?
Don,
Yes. There was no issue there whatsoever.
Cheers!
It is similar here in Japan. We have national health insurance. I cracked my sternum on Sunday and went to a clinic yesterday.
20 minute wait with no appointment, very professional doctor gave me an ultrasound and found the cracked cartilage, talked about treatment options.
Total cost? 350 yen (about USD $3) out of pocket.
sendaiben,
Gotta love it. I think a lot of Americans extrapolate the US healthcare system out to everywhere in the world. They assume it’s dysfunctional and highly expensive everywhere. That’s just not the case.
Hope your sternum heals up soon. Not fun!
Best wishes.
I’m so glad your ailment wasn’t serious! I hope your pain goes away soon! OMG~ the price and level of service in the hospital makes me want to bail the US! Freaking awesome!
Howard,
Thanks. The whole process made me feel better. I walked away feeling great. It’s not often you’ll walk away with a smile after interacting with the US healthcare system.
Best regards!
Sorry about that. Your story reminds me how much better we could be doing in this country. It would be interesting to see the differences between the two if surgery or hospitalization were required. I’m sure the cost would be lower, but I wonder about the quality of care.
JayP,
Yeah, it’s a shame. Perhaps there will be a tipping point over there at some point. Maybe not. People are pretty good at ignoring problems.
From what my research has indicated, many surgeries run 80% to 90% less here. And the quality of care is excellent.
Cheers!
Wow, amazing anecdote. First of all, glad it isn’t more serious! (like an arm amputation or such).
Second of all, your bill converted into US dollars is probably the square root of what you would pay to see a GP here in the states without insurance.
DL,
Definitely. It could have been something more serious. I’m very fortunate.
The square root, indeed. The math begs me to stay abroad. 🙂
Best regards.
I have not been in many hospitals in my days but that is one CLEAN and MODERN looking hospital !! America should be ashamed of them selves ! Imagine coming here and having to go into one of our hospitals YUCK !
Bob,
It was a phenomenal experience from start to finish. 🙂
Cheers!
Jason,
I am a retiree living in Panama and though slightly more expensive than yours, I have had similar medical experiences here. For example, GP visit, exam for sinus infection $8, trip to a orthopedic surgeon for back issues including exam, x-rays and prescriptions $60. Obviously, easily paid out of pocket.
However, even though I am in basically good health, I would feel too financially exposed not to have some sort of catastrophic health care coverage. One trip to a hospital requiring major surgery and/or extended hospital care could easily make a significant impact on many retiree’s income reserves.
As a side note, likely due to its proximity to the USA, the “medical tourism” business has come to Panama and prices are rising particularly for dentistry and medical specialists.
Dan,
Right. Easy to pay a lot of costs out of pocket. I don’t feel too exposed, but I’m also in a pretty unique position across the board.
Medical tourism is real. It’s a shame when you have to leave your own country because the medical situation is so out of whack. I certainly don’t have to leave Thailand for medical concerns.
Thanks for dropping by!
Cheers.
Glad everything worked out for you and you at least know what you are dealing with health wise, and so glad I am not your doctor because my amateur diagnosis was an inguinal hernia. So much for my medical career. I live most of the year in Canada where healthcare is free and not given a thought, but in going to Vegas last year I got badly sunburned, went to the hospital, and after a quick diagnosis by the doctor and an injection of some sort by the nurse to relieve pain & swelling, I was presented with a bill for $640. Thankfully it was covered by my credit card medical coverage, but it really does make you aware of how expensive medical treatment can be in a foreign country, even for something so minor.
Brian,
You had a crash course in US healthcare, my friend. Just one reason (of many, really) I can’t live there.
No healthcare system is perfect, but the US has a long way to go. Maybe at some point they’ll get there. Maybe not. Either way, I’m glad to no longer be exposed to it.
Thanks for dropping by!
Best wishes.
Jason,
Thank you for sharing this experience! Very fascinating! I truly hope you are able to deal with the health situation and it does not cause you too much trouble in the future. Thanks for the blog, I always find it very interesting and insightful. Thanks again.
David,
Thanks so much!
It’s an unfortunate health development, but it could have been way worse. I’m lucky in that respect.
Happy to share this insight. I don’t think a lot of people are actually all that familiar with healthcare costs over here. This illuminates that a little bit.
Best regards!
Hi Jason,
You can check out my experience at the Bangkok Hospital in Chiang Mai. Excellent affordable service. Not sure if I can put a link here but you can delete it, not. I think you will be amazed at the level of quality service in Chiang Mai compared to the states.
I like your blog. Very helpful and encouraging. If you stay in Thailand you don’t have to worry too much about your health bankrupting your finances if you should have a major health issue. But in the states it is a major concern if you are uninsured.
Jay,
Couldn’t agree more with you. Bankruptcy via health issues/bills in the States is a real concern. In fact, many Americans go bankrupt every year from such issues, even WITH health insurance. It’s crazy. I don’t have such a concern for as long as I stay here. And since I plan on staying for a very long time, I should be okay.
I’ve heard nothing but great things about the level of care and value in Bangkok, too. I actually have a friend who is in management over at Bumrungrad. So I’m somewhat familiar with it. It’s like staying at a luxury hotel in the States or something. Really amazing.
Chiang Mai Ram was nothing if not impressive. Very happy to have that right down the road.
Cheers!
My wife has Type 1 Diabetes and this is one medical condition that is not inexpensive in Thailand. Unfortunately they have older insulin’s that cost as much as back home in Canada. They don’t even have the newer insulin my wife uses…so that was disappointing to us.
Just curious with your comment on wanting to stay in Thailand for a long time. I understand that your currently in Thailand on an education visa, but those are only for a year. Are you able to continue to obtain education visa’s year after year? Are you taking some classes that qualify you for that visa? One of my frustrations with Thailand was how difficult they make it for you to stay in the country long term. What is your plan going forward for staying in Thailand for the long term?
David,
Ahh, sorry to hear that. I don’t have any personal experience with that, fortunately. But taking a gander at surgery, most medicines, and doctor costs, healthcare here seems to be as much as 90% cheaper than the US, especially after factoring in health insurance costs. But I’m sure that doesn’t translate over in every single case out there, which is why it always behooves one to investigate their options.
As for the visa, I’m on an ED visa. You can stay here for many years on an ED, but I do agree with you that Thailand isn’t the easiest country in the area regarding visa rules. However, the nearby countries that are easier (like a Vietnam or Cambodia) have different drawbacks that still puts Thailand leagues above them. But that’s just my take. Again, it’s always wise to find the best options for your own situation.
Best regards.
I agree Thailand is an amazing country which is why I wish they would make it easier to for foreigners to stay. So many people I know have to make border runs which ends up being quite costly. Are you taking a Thai Language course or something similar? What are the costs associated with getting an education visa?
David,
Agreed. I wish they made it a little easier, but Thailand already ranks as one of the friendlier countries in that regard. It’s not like you can just roll into, say, Germany (or the US, for that matter, if you’re a foreigner) and chill indefinitely. There are easier places, but you’d just have to look at their merits on the whole.
I note the costs of the visa in my expense reports. You can add about $100 or so onto my monthly expenses to account for the visa costs, but your course, where you take it, and everything else can cause variances in your costs. There are many ways to stay here long term, but you just have to do your research and be creative about it. 🙂
Cheers!
Hi Jason,
Your situation is another example to show how life is very unpredictable.
It’s better to achieve FI early and live life on our own terms.
Ben
Ben,
Time is our most valuable asset. And it’s become less plentiful by the minute. I can no longer imagine nor tolerate trading it away cheaply or easily.
Best wishes!
Hi Jason,
Well said. It will be worthwhile to take some form of calculated risk even if the FI number is almost achieved.
24 plus years of annual expenses is also final. There are also flexibility in tweating the annual expense accordingly. Reducing the estimated annual expenses will bring the figure above 25 years of annual expenses.
The main essence is the flexibility.
Ben
Ben,
The math is mostly moot. 🙂
https://www.mrfreeat33.com/is-financial-independence-necessary/
https://www.mrfreeat33.com/why-much-of-the-math-on-early-retirement-is-moot/
Cheers!
Congrats Jason u had the same experience as a rich person in the USA. They walk right in don’t have to see the pcp and pay a bill that they think is reasonable. It all depends on your point of view. Being rich is nice. I’m happy you moved to a place where u can use the US dollar to full advantage
Rich,
Yeah, I wouldn’t know how that goes. Any interactions I’ve had with the US healthcare system had plenty of rigmarole. And it’s unfortunate that the only bypass is money. Shouldn’t really be that way. You don’t even have to be (locally) rich over here to get the service I received. My Thai girlfriend has a similar experience anytime she needs anything. However, if you’re poor, you’re going to be dealing with the national system. That said, the fact that Thailand even has a national system that takes care of their people puts the US to shame (considering the disparities in GDP).
Cheers!
So true !!!! I totally agree
You are a good guy and I hope you are feeling better. Stay healthy my friend. I love how you have leveraged the dollar and investing a true inspiration!
Thanks for sharing.
It sounds familiar. I had an allergic reaction in the night. I was near a not-so-nice hospital in rural China. I was very wary. It seemed understaffed and underequipped. Did they even know what they are doing?
Long story short: They diagnosed me and treated me fast. Start to finish it took 30 min and cost about $7 including the fee for the chart, nurse, doctor, and clean needle. Each of which were billed as a dollar or two. In the states it would have taken 7 hours and hundreds of dollars. No exaggeration. I also likely would have gotten a lot more useless tests done as part of defensive medicine.
It opened my eyes.
Wealthy Doc,
Thanks for sharing your experience.
I think Americans are brainwashed. Into many things. One of those things is that healthcare abroad is “scary”. I now realize what’s truly frightening is the US healthcare system. Like you, my eyes are opened. 🙂
Best regards.
It’s interesting to read your story and all of the comments about how good and cheap health care is in other places. We have a similar story – our son broke his foot in the middle of the night (fell out of a bunk bed) while we were in rural Morocco. I had nightmare visions of running from ATM to ATM to pay for it, but in the end, we paid about $20 ($12 to upgrade the plaster they used to set his cast to “American” plaster and $8 for crutches). It would have been free if we had forgone those choices.
slnoonanj,
Always unfortunate to experience any kind of health issue. No one wishes that on anyone. But it’s very nice to know that you’re easily going to be able to afford some kind of emergency, if one were to befall you. In that regard, living here is a tremendous relief. 🙂
Thanks for sharing your story!
Best wishes.
I had a very positive medical experience in Chang Mai years ago. I needed a malaria test. I left my hotel and started walking to find a doctors office or hospital. A few blocks away was a malaria clinic. I walked in and they did a blood test. 20 minutes later she said “no malaria”. The test was free! Then I went back to my hotel bathroom (a familiar place at that point) to recover from whatever I had.
-RBD
RBD,
Gotta love that!
You didn’t have malaria AND you got to keep your money. Thailand isn’t too shabby. 🙂
Cheers.
I really appreciate your story. I have a friend who works as an engineering contractor, and lives part time in Philippines. He got a kidney stone and arranged for a flight to Thailand to have it blasted and then a week at the beach for recovery. Top-notch care and a great week included very inexpensively.
Contrast that with last year for me, I fainted on a trip to the beach in Santa Barbara area. The ambulance trip was $1700 alone, plus the other emergency bills. I have a bronze Obamacare plan as an early retiree and it nearly got me to the 6K deductible. And I spent a ton of time trying to negotiate these bills down, which I was at least able to do a bit of. Still, the ambulance is something you can’t shop for or anticipate. I tell my friends now, if I faint, DO NOT CALL AN AMBULANCE!
Susan,
Sorry to hear of your experience. That’s a shame. It shouldn’t be like that. I imagine there will be some kind of breaking point down the road, forcing change in the US healthcare system. In the meanwhile, I’ll just avoid it.
Best regards.
Thanks for sharing your experience! I’m glad all ended well! I have been to hospitals in the US, Canada, and China. US ones are expensive (non-generic prescriptions? Insane!) and service is quite variable. I’ve had both good and bad experiences, where I felt I paid a lot for the level of professionalism I actually received. In Canada, the wait times are incredibly long, but I’ve always had a good experience when I finally see the doctor. In China, my experience was quite good, but I kinda wondered whether they treated me better because I was a foreigner. There seems to be a bit of favoritism there (if you know someone, you can see a more experienced doctor, or get preferential treatment). Anyway, these are my personal experiences.
Jess,
You sometimes don’t realize how good or bad you have it until you experience something so completely different/opposite. After seeing the level of quality, accessibility, and value over here, my eyes have been opened.
I’m not sure about preferential treatment over in China. I can only say my Thai girlfriend advised me that her experiences with the Thai healthcare system mirror my own.
Best regards!
Thank you for writing about your experience. Americans are under the illusion that they live in the greatest health care nation in the world without realizing that modern medicine is a global standard, and it doesn’t have to cost you an arm and a leg, bankruptcy, or long term debt. Your educated decision is not a financial risk; its seeing the overpriced kool aid that we drink here in the States for what it really is. Take care of yourself!
Carolina,
Couldn’t agree more with what you’re saying.
Overpriced Kool-Aid, indeed. And it’s a shame so many people drink it by the gallon.
I always felt like it was a raw deal. It’s just that I wasn’t prepared to go abroad until somewhat recently. Very happy I made that jump, as it now gives me the perspective necessary to see just how raw that deal is.
Best wishes!
Could definitely be worse! I’ve heard very good things about all of Thailand and Vietnams healthcare systems. I broke my ankle last year in South Korea and while it wasn’t anything near to what you Americans would have had to pay, having insurance still would have saved me some dollars.
Keep up the great blog!
Colby
Colby,
Absolutely. I could be in a much worse position.
Sorry to hear about your broken ankle. Hope I never experience that. But if I were to break my ankle, I’d much rather break it here than in the US.
Cheers!
Wow! First off, congrats on spending a full $20 on your medical bill. Although we could never get that low in the US, there are certainly steps we could take to get much closer. I’ve known multiple people who have left the US for medical precedures because it was cheaper — even when the travel was added into the mix. Your story makes it very clear how much cheaper it can be!
Secondly, I just went through and read your About page. Inspiring story man! Although you retired young, it certainly wasn’t out of luck. I’m always motivated when I read stories of people who retired early because they essentially worked as much in 10-20 years as most people work in a full career — which is clearly what you did.
I look forward to seeing more of your great content both here and Dividend Mantra (if that’s still a website owned by you).
Thanks again for the inspiration!
Rob,
Absolutely. Medical tourism is alive and well. Hopping over to Mexico is quite common, especially for Americans who live closer to the border. It can often make economic sense, especially on larger procedures. I probably wouldn’t have hopped over there for a check like this, but some kind of major medical concern might make that a good idea for many people.
Appreciate the support. I worked extremely hard to get here. I was like a very intense machine there for a little while, with a singular focus. But it was all worth it. Have zero regrets about that. 🙂
Hope you continue to stop by and enjoy the content!
Best regards.
Love hearing these stories about medical experiences in other countries. I moved to Australia 2.5 years ago, and just about every medical issue I’ve dealt with has been so easy and cheaper compared to the U.S. I have to hold health insurance for my visa, but it only costs $120/month (and no deductible). Also, visits to a GP only cost $85 and specialists slightly more. It’s more expensive than Thailand, but everything is just more expensive in Australia. Their Medicare system in Australia cuts out so much waste and inefficiency from the healthcare system so everyone, especially doctors and patients, benefits. If only our home country could learn!
NYP,
Thanks for sharing. Very interesting to hear how they do it in Australia. Sounds a lot better than the US.
The US has a long way to go. Perhaps they’ll make some real progress after some kind of turning point in the attitude of the people. I really don’t know.
What I do know is that $10 GP visits and healthcare that is generally 90% cheaper gives me a lot of peace of mind.
Best regards.
Glad you found out what’s wrong, Jason, and that’s it’s something you can manage. I’m not a doctor, but I always gravitate to researching things first as well and using home/natural remedies. If you haven’t researched this already, consider checking if your condition could be better managed or mitigated by addressing the inflammation in the body, such as due to eating certain foods (modern gluten) and/or checking if your lymphatic system is working optimally. That’s the one that gets rid of all the toxins in your body via lymph nodes. I only recently got into learning about this understudied system, did a lymphatic cleanse and got lymphatic massages, which are so helpful and feel so darn good too! Just a thought. 🙂
I loved your comment about doctors being well paid, educated guessers who prescribe antibiotics. Ha! I often feel the same way and find myself educating my doctors during my visits. One of my favorite recent experiences was at my annual check-up, where the doctor asked if I was getting enough iron in my system, since I don’t eat meat. I said: “Well, isn’t iron present in green leafy veggies?” She said: “Yes”. So I replied: “Well, that’s how.” Duh!
Thank you for sharing your personal experience and the logistics. I’ve heard of Thailand as a medical tourism destination, and not surprised now. Who knows, when we retire next year and start traveling, maybe we can treat you to some lemonade when passing through Chiang Mai. 🙂
Mrs. E,
Thanks for dropping by!
Doctors are great at certain things. When I need surgery, or to have a broken bone fixed, or something major, I’m all too excited about modern medicine. But for less serious concerns? There’s a lot to be desired there. Doctors are typically trying to get you in and out as fast and as efficiently as possible. On to the next one…
If you guys ever do find yourself over here, definitely drop a line. I’m always happy to meet up with people. I’m actually meeting up with a reader tomorrow. 🙂
Cheers!
I’m an american ears, nose and throat surgeon who is a huge fan of Jason. Jason shows up in with groin pain in US. Yes. requires visit to pcp (~$200). requires second follow up visit to pcp post initial treatment…nsaids, et ($200). requires referral to urologist ($250) plus 3 week to 2 month wait. urologist sees. 99.9% chance it is varicocele but there is a 0.1% chance it is testicular cancer. order u/s and labs. 3 week wait and $750 (doc doesn’t want to get sued…already paying $40K/year in malpractice despite no suits…true for me). u/s normal but go to urologist for f/u to review ~$150/visit. that’s ~$1500 same result as his $20 and much saved time. Our system in US is f***ing razy.
SightseeMD,
Thanks for the rundown. That’s pretty crazy! 😱
Those costs, by the way, are before factoring in the health insurance. I had a HDHP in the US, so I would have paid a bunch of out-of-pocket costs on top of the hundreds of dollars per month in carrying costs that were necessary to shield me from bankruptcy. I only paid $20 over here, and that’s including the $0 I pay in health insurance.
I don’t see myself ever living in the US again, but that’s especially true with the way the healthcare system is currently set up over there.
Best regards!
Outstanding Jason! With the bold decision to move to Thailand. Did you get to Myanmar yet? How do you spend your days, since you’ve been there about a year now. We talked before on SA site.
Joe,
Thanks!
I haven’t been to Myanmar yet. I’m not sure if I’ll ever make it over there, unless I have some particular reason to go. I made it to Laos a little while back and stayed for a few days for visa purposes, but I didn’t enjoy it. I have plans to do a lot of local and international travel. All in due time. 🙂
As for how I spend my days, this probably helps:
https://www.mrfreeat33.com/reprogramming-my-mind-to-enjoy-a-routine-which-has-helped-me-become-happier-and-more-successful/
Cheers!