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Heart in Right Place: Medical Tourism Surgery Ends in Thailand

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The shortness of breath, the aching, burning and painful feeling in his chest was not to be mistaken for indigestion. Even at 30,000 feet above the Pacific Ocean, Michael Raymond still couldn't get used to living with coronary artery disease, but at least he knew his heart would soon be in the right place.

I was in a lot of pain, the California resident later told the Press Democrat. I was popping nitro (glycerin) like it was going out of style.

Shortly thereafter, Raymond was receiving a doctor's care in his business-class seat on board a United Airlines plane nine hours into a 12-hour flight bound for Asia, where he would undergo a life-saving medical tourism procedure at Bangkok Heart Hospital.

No Stranger to Pain

Raymond was no stranger to heart attacks. His first came in 1998, when he was living in Kona, Hawaii, and working as a landscaper breaking lava rocks in the hot sun. He spent a week in the hospital and received a stent a device that widens constricted arteries in the right side of his heart.

Then in 2003, after moving to Windsor, Calif. to be closer to his wife’s family, he was playing a round at the Chardonnay Golf Club in Napa when he felt that tell-tale tightening in the chest. He was swinging so well that he refused to get off the course. He finished with a score of 72 and two more stents in his heart.

When I’m shooting like that, there’s no way I’m getting off the course. I’d rather die shooting par, he said jokingly.

When Raymond lost his job as center manager with the Marin Art and Garden Center five years ago, he also lost his healthcare coverage. Two years after that, his continuing coverage ended. A badly blocked heart meant that he could not get coverage on the individual market. No one would insure him.

Too Wealthy, Too Young, Too Sick

Too wealthy to qualify for Medi-Cal, too young for Medicare and too sick for individual insurance, Raymond knew that he needed a long-term solution to his heart problems. But, without insurance, his only option was to hope for good health.

In September, he started feeling that tightening in the chest again, so he saw a doctor at a local walk-in clinic, which recommended that he see a cardiologist. Two weeks and $1,000 later, the cardiologist recommended cleaning out the blockages in his heart with a tube inserted through an artery in his leg, a procedure called angioplasty.

Raymond asked for a quote on the procedure. Four days later, the hospital told his wife, Christina Raymond, that the cost would be a whopping $36,000, and that was just for the operating room –not the doctors, anesthesiologists, medical equipment or recovery room.

At that point, I said ‘We’re out of here,’ said Raymond. I can’t afford this. We’re going to Bangkok.

Even when Obamacare kicks in next year covering people with pre-existing conditions like Raymond, many U.S. patients are still expected to travel abroad for treatment, either to avoid paying high out-of-pocket costs or to avoid long waits for some procedures.

So much has been said about healthcare reform, but not enough has been talked about medical tourism until now, said Renée-Marie Stephano, president of the Medical Tourism Association. Many Americans who don't have the luxury to wait and see how Obamacare will impact them personally this year or next — are turning instead to medical tourism opportunities and the attractive and timely healthcare savings they can represent today.

Orient Express

Thailand, with its 30 internationally-accredited hospitals and many western-trained doctors, has a growing medical tourism sector. About 2.5 million people visited the country last year seeking medical treatment.

Raymond first heard about Thailand as a medical tourism destination when he ran a bed-and-breakfast in Hawaii. Guests from Australia, New Zealand and Europe extolled the benefits of the Thai healthcare system. A basic angioplasty without stent implantation in Thailand costs about $4,000 including round-trip airfare, a fraction of the cost for the same procedure in the United States.

With an appointment at the Bangkok Heart Hospital scheduled in October, Raymond and his wife flew from San Francisco to Tokyo, where they were to switch planes and fly on to Bangkok.

But Raymond’s mid-air heart attack derailed their plans. Upon landing in Tokyo, the plane was met by a crew of firefighters who escorted Raymond and his wife into an ambulance on the runway.

I was freaking out, Christina Raymond said. My hair fell out for a week from the stress.

They were whisked to a nearby hospital where Raymond had an emergency angioplasty with three stents. He was cleared to fly on to Bangkok four days later. The surgery and hospital stay in Tokyo cost Raymond $20,000 on his American Express card.

The day after arriving in Bangkok, and despite having missed his original appointment, Raymond was in an operating room. Doctors performed two angioplasties and inserted four more stents into his beleaguered heart.

They fixed everything, Raymond said. I experienced great service. They keep you pain free.

Five days later, Raymond walked out of the hospital with what felt like a new heart. He and his wife spent the next eight days visiting the gilded temples and colorful markets of Thailand and staying at the Lebua State Tower, a hotel featured in the movie The Hangover Part II. His wife even had some dental work taken care of.

The entire adventure cost Raymond $59,000 in credit-card debt. Considering the cost of all the procedures, stents and nights spent in hospitals, Raymond estimates the ordeal would have cost $300,000 in the United States.

What blows me away is the cost, said Raymond, whose grown son and daughter are helping with the bills. For three years, I just said ‘I hope something doesn’t happen to me.’ And then, three months away from getting healthcare, it did. It’s pretty sad that I had to go outside of the country to get affordable healthcare.

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