For the record, I am not a hypochondriac.
I have visited almost 80 countries around the world in the last 30 years. I have gotten sick in only a few countries. (The only thing that I am afraid of is appendicitis on an African safari.)
So I have been thinking about how treatment is provided and paid for in other countries around the world and what the impact of health care reform might be on our day-to-day lives here in America.
As many of you know a visit to an emergency room in this country -- for something as common as a cold -- could cost the same as a week's vacation in Bora Bora. Many Americans don't ever go to Tahiti, but they do visit their local emergency room at least a couple of times in their life. And the wait? Could be as long as a flight to another continent.
Let's start in the beautiful pink city of Jaipur, India. After dining at a five star hotel (not one recommended by my guide but I had insisted on going as friends had gotten married there) I had the worst case imaginable of Delhi Belly. My stomach became an earthquake.
After a long day and night visiting the John instead of the city's palaces, we decided to call for help. The doctor arrived, accompanied by an assistant who carried his bag.
One of our travel companions was the first to be treated -- an IV for dehydration.
The curious thing here was that the assistant served as the IV pole for over two hours. During this time, and quite possibly for the first time in his life, his eyes were glued to the beautiful women on MTV. When the treatment was finished, we asked for the bill.
He politely asked his assistant to step outside. The price came to $25.00 per person, including a 5 day prescription for Cipro. Later I found out why the doctor asked his assistant to leave the room. Cheap though it may sound, in India I should not have been charged more than $10 for his services, medicine included. My first experience with Cipro in the US was during the anthrax scare in 2001. The only place I could find to fill prescriptions for my family was a small pharmacy in Malibu, California. They sent me two bottles of 30 pills. Total cost? $800....
Now lets move on to Laos. While visiting I became extremely sick from a sinus infection, thanks to the farmers of Southern China. Apparently, during late March, or early April, it is customary to burn the rice fields in preparation for the new crops. This means that if you go outside any time of the day or night you may as well be sitting next to the Marlboro man. Or taking a ride with Cheech and Chong.
Next stop on my trip was Burma -- besides Zimbabwe, probably the worst place in the world to get sick. I started coughing blood. What to do? Call Aung San Suu Kyi for her doctor of choice? Not likely. Instead, the hotel recommended a member of a French team from SOS who informed me that the blood was coming from my nose and not my lungs. He proceeded to charge me $200 dollars, which amounts to roughly an annual Burmese salary.
Next was getting sick in my favorite city in the world; Bangkok, Thailand. The smoke got to me again but this time from the cars. I coughed so much during the night, first thing in the morning my wife went straight to the front desk to get her own room.
The concierge at the Peninsula recommended the BNH Hospital and my God what a good recommendation. If you ever have to get sick, this is the place. The first thing I noticed upon arrival was that the waiting areas were full of Barcelona chairs. Not 10 or 12, but a whole lobby. The doctor that saw me had graduated from medical school in the United Kingdom. First she ordered blood tests, followed by X-rays.The nurses looked straight out of a James Bond movie, or an HBO Real Sex episode.
While waiting for my results we had macchiatos at the espresso bar, which incidentally cost more than the 45 minute taxi from the hotel in Bangkok traffic. After a couple of hours, I was called back to the doctor. Good news. After consulting with a specialist and getting back my results, all I had was another sinus infection. I was sent to a window to pay and get my medicine. In the US, in a hospital such as this, it would have cost me $6,000 to $ 8,000 if I was lucky. The bill was $ 125.00. Of course, the macchiato was extra.
After 10 days of a gastronomical tour through Spain, having had dinner at the famous El Bulli two nights before, my blood pressure went through the roof. I ended up taking a taxi to the emergency room of a hospital in Barcelona -- the same hospital where the King of Spain's granddaughters were born. A doctor took my blood pressure, asked me for my medical history, and about an hour later gave me her diagnosis. While waiting I called my doctor in the US. His recommendation was that I take a plane back as soon as possible and stick to a very light diet. The doctor in Spain came to the conclusion that since I had changed my normal eating habits by eating more salt, I didn't need to interrupt my vacation -- just eat less salt and relax. I continued that same morning on a tour to a winery. The price for the ER visit? $100.
While in Hamburg, Germany I asked the front desk if they knew of a good doctor. I was dehydrated from walking 8 hours a day, for 5 straight days in the middle of the Parisian summer. Next thing I know, I have two men in fire suits, brandishing a stretcher and knocking at my door.
While covering the 2006 World Cup in Germany and playing soccer with colleagues from Univision, I was hit by another player and injured. The pain was so persistent that by the second day I could hardly walk. I went to the clinic at the press center. A German doctor who examined me came to the conclusion that I had the same injury as the forward from Croatia. I needed to be off my feet for a couple of days and wrap my thigh with an ice bandage. Of course I asked him if he was going to do an MRI. His answer: "do you think we are in the US?" I have been doing this for 30 years and I don't need a machine to tell me what is wrong with you. I see this every day. You know what? He was right.
Last, but not least, the perfect vacation, only 35 minutes by plane from Miami. It's better in the Bahamas. My daughter wanted to visit the pools and water parks of The Atlantis -- a mega resort whose pools probably hold more water than Niagara Falls.
Half an hour after arriving I ended up floating on an inner tube along the lazy river. Moments later, I was going up a conveyer belt like those at the airport. Next thing I know, a lifeguard is helping me out of the pool -- blood everywhere. I can't even walk. I feel paralyzed. They put a neck brace on me and tell me to take a cab to the local hospital. Once there, I was told I would not receive any treatment unless I paid $1000 dollars in advance. After many negotiations the hotel finally agreed to pay for the hospital, and some complimentary room service.
One of the lessons learnt from my travels is that in the majority of countries, an emergency room is just that, for an "emergency." In this country if you go to the emergency room, you may wait not only hours, but even a day or two in some instances, to see an actual doctor. Why? Because these rooms are full of patients who don't have insurance and go to them as a last resort. If you don't want to wait, you better be a big donor, or a personal friend.
All I can tell you is that I would not change my doctors in Miami for of any of those that have treated me around the world. I can't say the same for the nurses, especially those in Bangkok.