I spent the morning of March 25 at St. Luke’s Hospital, a very fine Manila hospital on a par with our best city hospitals in the US.  St. Luke’s is a teaching hospital with doctors trained all over the world, many of them in the US.  Their offices are tiny compared to those of their American colleagues but their training and the care they give is very good.  

            My Filipino dentist does not have an instant digital display of my teeth (he still uses x-rays), but he does great work.  And at a fraction of the price of my wonderful dentist back home in NH. 

            The tests I had that day, ordered as part of a routine physical with my new GP, included a full abdominal ultrasound with prostate check.  The results, including film and interpretation, were available to me in 24 hours at a cost of $128.  This could cost me $910 here.  The full blood workup I had that morning cost $350 with results by the afternoon: a  $904 value in the US.  A chest x-ray with doctor’s interpretation cost me $18.25, a $260 – $404 value at home.   I base the US prices on research I have done in this region.

            If I had these tests done in New Hampshire, I wouldn’t actually pay those prices, as my insurance company would knock the cost down and then pay a portion of the bill.  Nevertheless, the costs for medical care in the US are much higher than in the Philippines.  The savings from a major procedure could easily pay for a round trip airfare from the US to Manila.  It’s no wonder that so many Americans and Europeans seek their medical care in other countries:  Mexico, Thailand, the Philippines.  They have spawned an industry called “medical tourism”, which offers in-country tours and sometimes luxury accommodations right next to the hospital.

            This does not help the Filipino for whom even these “low” costs are out of reach.  What is cheap to an American may be crushing for a Filipino.   Nor does it help the many Americans who shoulder high medical costs with no option to leave the country. 

            I don’t really understand why medical costs are so high in the US.  I know we are all responsible – consumers as well as providers and insurers – and that we can, if we choose, create a better system.