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Inside Man

Club Med

Aired January 29, 2015 - 21:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


MORGAN SPURLOCK, MORGAN SPURLOCK INSIDE MAN HOST: Hey America, where would you like to spend your hard earned wages, the mall? On a new car? How about the doctor's office? Or a hospital? We Americans spend more on our health care than any other country in the world, but at least that means we have the best health care right?

Well not necessarily. U.S. health care is complicated and expensive, even if you have insurance. And for the millions of Americans that are uninsured or underinsured, what are the alternatives? Where do you go? Well you might just have to go on vacation.

This year alone, an estimated 1.2 million Americans will get some sort of procedure overseas.

Is medical tourism the future of health care? I'm going to find out.

You'll be inside Inside man.

Morning, the sore spot of my day.

Like two years ago I fell down a flag stairs and caught myself with my arms. I was falling like (inaudible) and something in there has been awesomely painful ever since. So I think it's about time to get check now. So I'm going to see Dr. Isics, (ph) he's been my primary care physician for over a decade.

I'm here to see Dr. Isics (ph).

UNIDENTIFIED FEMALE: Sure. Can you please sign.

ISICS' (PH): (Inaudible) and tell me (inaudible).

SPURLOCK: I mean, when I just want to start to do this, I can feel (inaudible) there, it's not...

ISICS' (PH): Keep going to me (inaudible), it doesn't stop.

SPURLOCK: It doesn't stop. Yeah, OK.

ISICS' (PH): Push me, push me forward, push me push me. Pull it back. I think you probably have a (inaudible).

SPURLOCK: OK. And what I'm to do about it right now?

ISICS' (PH): Well, in order to make a diagnosis, you got to need an MRI.

SPURLOCK: OK. How easy it will to (inaudible) MRI, is it quick?

ISICS' (PH): Oh yeah, you can have it in the same day, they were all over the place.

SPURLOCK: How much thing like that cost?

ISICS' (PH): Gees, I don't know, I mean it's a lot. I mean, you have an insurance?

SPURLOCK: I got insurance, yeah.

ISICS' (PH): Well that shouldn't cost you very -- it shouldn't cost anything (inaudible) you have a huge deductible

SPURLOCK: Yeah. Dr. Isics (ph) got me thinking, I'm very lucky, I have great health insurance, but what if I didn't? There are millions of Americans with no health insurance at all plans with high deductibles. So cost does matter and it makes sense to want a compared some shop with the lowest price MRI. And that just what I'm going to do. It should be a snap, right.

Yes, I wanted to get an MRI done on my shoulder, and I wanted to see how much that would cost.

UNIDENTIFIED FEMALE: We take the (inaudible) the patient is responsible for the (inaudible)

SPURLOCK: Well, do you know what my insurance would cover, or you still have to figure that out?

UNIDENTIFIED FEMALE: Well we wouldn't know how much the insurance will cover.

SPURLOCK: But I just wanted to find out if those are going to be covered by my insurance company and how much it would cost, things like that.

UNIDENTIFIED FEMALE: You have any co-payments, or any deductibles that that's part of your health plan, that's what you'll be liable for.

SPURLOCK: I understand.

UNIDENTIFIED FEMALE: I also let you know (inaudible).

SPURLOCK: A few calls in and this fills anything but straightforward.

If I hadn't any insurance how much it would cost?

UNIDENTIFIED FEMALE: So the MRI in the shoulder without contrast is 1,900, and with contrast it's 2,600.

SPURLOCK: 1,900 without contrast, with contrast is 2,600.

UNIDENTIFIED FEMALE: Yes.

SPURLOCK: OK, could you tell me what the cost would be if I didn't have insurance, like how much would cost to have an MRI done?

UNIDENTIFIED FEMALE: Which shoulder, right or left?

SPURLOCK: Why? Is it different cost if it's my right or left shoulder?

UNIDENTIFIED FEMALE: We charge $1,600 for MRI, (inaudible) just like 400, 680.

SPURLOCK: OK.

I've now spoken to six different centers and (inaudible) gave me the same answer.

Could you tell me how much MRI would cost for my shoulder?

UNIDENTIFIED FEMALE: I'm not sure.

SPURLOCK: I mean the fact that I can't just has somebody tell me what the price automatically is confounding to me. Because I know how this headphones cost the minute I buy them in the store. I know how much my iPhone cost the minute I buy it in the store. I don't know why something as simple as this couldn't just cost X and I should be able find that out really easily.

So meaning to tell me why this is messed up.

Perhaps Dr. Michael Spear, a leading expert on our nation's healthcare system will have the answers I'm looking for.

So may be you can tell me. As I was calling people about getting an MRI done on my shoulder, I was amazed by how many people work there, couldn't tell me how much it cost.

MICHAEL SPEAR: Right, right.

SPURLOCK: And some people who then knew the cost, said well, one place it was like $600 you get an MRI, another place it was $2,600.

SPEAR: There is extra ordinary variation in the cost of everything here the United States when it comes to health care. Number one, until recently most people didn't really care about the cost, some else is paying the bill.

SPURLOCK: Right.

SPEAR: So they weren't interested. Number two, the providers are not interested in communicating the true cost to the patients or to the consumers, they want to have those conversations with the insurance companies.

SPURLOCK: What is the influence that insurance companies and pharmaceutical companies have? Because those are almost kind of the two of the biggest machines.

SPEAR: Have a tremendous amount of influence. Put it this way, we spend almost 18 percent of our gross domestic product on health care in the United States, $8,000 per person, $3 trillion industry is an industry that has a lot of influence.

SPURLOCK: So if we're spending nearly $3 trillion a year, why are there so many people without health insurance? Well to answer this question, we needed to take a step back in time looking at the history of health insurance in America.

It all started with the great depression, our hospitals were struggling financially because many people were going there to die, not to get better. So an active self preservation, the hospitals created private insurance to drum up business and business was good.

Soon our country was full of private insurance companies, then post World War II, when the rest of the developed world was moving towards national health insurance plans, we decided not to do that. But to instead, you taxes in it to employers who provided private insurance to their employees. So employers sponsored health insurance became the thing and that's one thing started to getting complicated and expensive.

As the decades moved on, hospitals and providers started setting their retail prices as high as possible because they could and the result was health insurance companies raising their premiums to offset the cost from the health care industry.

But who cares as long as your employer is covering it, right? Wrong. This became prohibitively expensive for the poor, retired, unemployed and self-employed. And then the next thing you know, we have more than 40 million uninsured Americans.

SPEAR: The Affordable Care Act really is aiming to change a lot of this. There's millions of people who have health insurance now who didn't have it, there will be more millions more next year. Is it going to be 100 percent answer? No.

SPURLOCK: What about people, you know, (inaudible) people who are underinsured? People have insurance but it's still doesn't cover, you know, the full array of work that you have done, or they have a high deductible. How much the population was dealing with that problem?

SPEAR: Million have health insurance. They have health insurance, but it doesn't come close to cover in the actual cost of their health care needs.

SPURLOCK: Yeah.

SPEAR: And we see this even in many of the plans the people are buying under the Affordable Care Act. You have an option of buying what's known as a bronze plan, a silver plan, a gold plan, or a platinum plan. And if you buy a platinum plan, you're going to have a very low deductibles, very few co-pays, et cetera. If you end up with the bronze or maybe even a silver plan, you're

going to have high deductibles. But along the hole, some serious things happens to you, then you're going to have to pay that deductible, then in your trouble.

SPURLOCK: Is that right? We love to brag about ourselves being the greatest country in the world, should we be in the place where people to go bankrupt because they can't pay their bills?

SPEAR: Absolutely not. Not only is that not right, that's terribly, terribly wrong.

SPURLOCK: So if I'm sick, I can't afford to go in the hospital and I need to have some sort of big procedure done. What would I do? What are my options?

SPEAR: Option number one is if you can afford it, you pay the bill out of pocket, even if you're uninsured, even here in the United States, it's expensive, but you can try to do that.

SPURLOCK: Yeah.

SPEAR: Option number two is you could track to some sort of charity care here the United States. Option number three, if you can afford it, you could go abroad, you could try to go abroad, you can go to India, you can go to Thailand, you can go to Malaysia, you can go to Dubai. There are places around the world where you can get certain procedures done, where actually it will cost you less to fly to another country, stay in a hotel for a few days, get the procedure done, recover for a few days, and fly back to the United States, and have a perfectly good outcome, and still end up cost than you less than it would've cost you'd actually pay a hospital here in United States.

SPURLOCK: So I'll be able to fly, stay, have a surgery done, and come back for a less than what cost me if I went to the hospital in America?

SPEAR: Yes, that's medical tourism.

SPURLOCK: After speaking with Dr. Spear, I'm intrigued by the idea of medical tourism.

First we'll just look up medical tourism and see what comes up. See if we can find some places that people recommend. There's a hospital here and Seoul, there's a hospital in Turkey, Costa Rica, Thailand. This one in Thailand it's called Bumrungrad. I'm not sure how to pronounce that.

This says the real cost, this is interesting. So real cost information, a more reliable way to estimate what you'll pay. If you're going to have rotator cap, maybe that's part of what I would need to have done on my shoulder.

If I'd to have like proper surgery done, $11,000, 11 to 7 is the median cost. On the high end it would be 13 to 1. On the low end it would 10 to 7.

The fact that they're already telling you exactly what things will cost is amazing. I've never seen it's on hospital website in my life. It already makes me things that I can go there and get things done cheaper than I could here.

But the question becomes now you fly halfway around the world and still save money. I mean that's the real question because that's what everybody (inaudible), so go fly to Bangkok, so let's fly go to Bangkok and see.

(COMMERCIAL BREAK)

SPURLOCK: Welcome to beautiful Bangkok, Thailand, land of temples, Tak Taks and nearly two million medical tourists. That's right. Thailand is the top destination for people leaving their home country for treatment.

In 2013, alone these vary visitors were responsible for pumping nearly $4.7 billion into Thai economy. I'm here to say if medical tourism is viable alternative for those who can't get what they need out of the U.S. health care system.

I've made an MRI appointment to my bad shoulder at Bumrungrad International Hospital, one of the largest hospitals in Southeast Asia which treats over a half million international patients every year.

Bumrungrad has been instrumentally in shifting the perception of medical tourism from (inaudible) third world (inaudible), the world class care.

In fact Bumrungrad became the first hospital in Asia to gained accreditation from the Joint Commission International which is an important sealer approval for anyone considering treatment abroad but even knowing its reputation, it's still nothing what I expected. This place looks more like a five-star hotel than a hospital.

SPURLOCK: Hi. How are you?

UNIDENTIFIED FEMALE: Good morning. Thank you so much.

SPURLOCK: Thank you.

UNIDENTIFIED FEMALE: This patient have an appointment already and this is the (inaudible).

SPURLOCK: All right, thank you.

Thank you.

It looks -- yeah, hi.

UNIDENTIFIED FEMALE: Morgan Spurlock.

SPURLOCK: That's me, Morgan Spurlock. Thank you. Yes. That was so fast. I even sit down like three seconds. I fell down on some stairs a few years ago and as I was falling I grabbed myself and then basically pulled my shoulder back and it's been painful ever since.

UNIDENTIFIED MALE: Where exactly is the pain? Did you...

SPURLOCK: The pain is like right in this area.

UNIDENTIFIED MALE: Yes.

SPURLOCK: Yeah.

UNIDENTIFIED MALE: Look up at the ceiling.

Push. OK. Push.

SPURLOCK: Oh it doesn't feel good.

UNIDENTIFIED MALE: That not every good.

Pushing up.

SPURLOCK: Yeah. When I get the MRI, how quickly would you get results?

UNIDENTIFIED MALE: You come out right. We read it together.

SPURLOCK: Oh great.

UNIDENTIFIED MALE: Yes.

SPURLOCK: OK. Fantastic. Thank you.

Well, that was easy. Now to get the MRI. All I have to do is go down to the ground floor. No phone calls. No appointments. No waiting, just an elevator ride.

So now here I am to get my MRI done and I'm pretty excited about that.

UNIDENTIFIED FEMALE: Go down slowly.

SPURLOCK: Perfect.

UNIDENTIFIED FEMALE: OK, (inaudible).

SPURLOCK: And back upstairs and say the doc for my follow up.

UNIDENTIFIED MALE: How's your back?

SPURLOCK: I'm back.

UNIDENTIFIED MALE: yeah.

SPURLOCK: Thank you.

UNIDENTIFIED MALE: So the MRI was show right here. SPURLOCK: OK.

UNIDENTIFIED MALE: You can see many area of white shadow which means the tendon disintegrate. It's not a real cap. The tendon is under high tension and it's not properly heal itself.

So what we need to do is to reduce this damage and let the tendon heal.

SPURLOCK: The good news, I don't have a tier according to Dr. Wenyu (ph).

My official diagnosis is a damage rotator cup and he feels confident and I shouldn't need surgery. If I follow his prescribed regimen of (inaudible) exercises for next three months, but how does my wallet feel? Well, let's take a lot.

The price of an MRI in America typically ranges from $500 to $3,000. Here in Bangkok the cost of my MRI and two consultations with my doctor came to $400 flat. With a bargain like that it makes me wonder what else I can get done here.

I want to get a closer look at all of the hospital has to offer.

Dr. Num.

The hospital medical director, Dr. Num Tanthuwanit is giving me a special behind the scenes tour.

NUM TANTHUWANIT, HOSPITAL MEDICAL DIRECTOR: Usually we get about 520,000 international patients from 190 countries (inaudible).

SPURLOCK: That's incredible.

TANTHUWANIT: And receive their health care with us. Including Thai patients we get about 1.1 million visitors each year.

SPURLOCK: That's remarkable.

TANTHUWANIT: We have about 20 different languages. We have about 150 interpreters.

SPURLOCK: Wow. The doctors who were here, where were they trained?

TANTHUWANIT: My expert doctor is actually kept their fresh graduate training privacies. About 300 of our doctors are American board certified.

SPURLOCK: Each floor of the hospital has its own outpatient clinic catering the 55 different subspecialties and efficiency is job won here with the pharmacy on every floor and one centralized blood lab that can process samples in one hour.

TANTHUWANIT: All they need to do -- it's been pre-labeled with the patient's barcode.

SPURLOCK: They just dump them in.

TANTHUWANIT: Dump them in and then carries along its journey.

SPURLOCK: That's incredible. It's Amazing.

TANTHUWANIT: This is (inaudible) atrium suite.

SPURLOCK: It's ridiculous. And this is like the bedroom. OK. This is nice. Hold on. I'm just going to like take a little load off in here. I'm feeling better already, so thank you doctor.

TANTHUWANIT: Anytime. You're welcome. Pretty much after they walk out of (inaudible) the examination room they come here within few minutes. The bills provided.

SPURLOCK: OK. So just in case you missed that, at this hospital you get your bill instantly.

The amazing thing about this please is literally everything you want to have done is all under this one roof. Like I've got this thing with my hip that I've been putting off for months getting look at. I'm 43 years old. I should probably get a colonoscopy but I don't really want to and they also have this whole kind of health thing called the executive check up where they'll check out anything that could potentially be wrong with me. And that all happens here it all happens in one day. So I'm going to take advantage of that.

Hello. Thank you. This is the list of everything that I'm going to get done this morning, full blood test, complete blood counts, fasting blood sugar, lipid profile, cholesterol HDL, cholesterol HLD ratio, LDL cholesterol, and then check for gout, uric acid, kidney function panel, liver function panel, thyroid panel, hepatitis screening, tumor markers.

Great.

UNIDENTIFIED FEMALE: This way please.

SPURLOCK: I'm getting urine examination, and a stool examination, electric cardiogram, exercise stress test, chest X-ray.

UNIDENTIFIED MALE: Both hand on your hip, sir.

SPURLOCK: Both hands on my hips.

Ultrasound of whole abdomen, eye exam.

Everything is OK.

UNIDENTIFIED MALE: Sure.

SPURLOCK: No problem.

UNIDENTIFIED MALE: No problem.

SPURLOCK: Orthopedic consultation. I did something to my hip. Do you think (inaudible) to make sure I continue to stretch that out?

UNIDENTIFIED MALE: Yes.

SPURLOCK: Just we get the flexibility back in it.

UNIDENTIFIED MALE: Yes.

SPURLOCK: Well, that was fairly painless and now for the highly anticipated colonoscopy.

So what exactly is the procedure that you're suggesting I have?

UNIDENTIFIED MALE: So it will be CT scan colonoscopy.

SPURLOCK: Yeah.

UNIDENTIFIED MALE: Two sided camera and then when you swallow it takes pictures inside your intestine and your colon.

SPURLOCK: The capsule has cameras in it.

UNIDENTIFIED MALE: Yeah. And then it would be transmitted to the special box and you will be carrying around and then we will watch under computer.

SPURLOCK: No big deal just going to swallow a camera.

For the time I swallow it, when it comes out how long is that usually take?

UNIDENTIFIED MALE: I would say like six to eight hours.

SPURLOCK: Six to eight.

UNIDENTIFIED MALE: Yeah. The preparation would be tonight. I think that will make your run to the toilet. It will be five or six times.

SPURLOCK: So, I have got my sac of duderific (ph) magic this is going to flash my body like apparently I've never been flashed before.

It's going to completely clean me out tomorrow morning. I'll come back, I'll drink another of this and then I'll be ready to swallow the camera and then you will go where no men ever been before.

(COMMERCIAL BREAK)

SPURLOCK: I'm in Bangkok, Thailand getting an inside look at a hospital that caters foreign patient seeking cheaper and more efficient care than they can get at home. And what better way to test out medical tourism than to get a procedure myself. And let me tell you, I'm not half passing this.

So this is the morning of endoscopy, so I'm basically going to swallow a little camera today that is going to go into my body. It's going to go down into my stomach through the small intestine, large intestine, into my colon. Just like the new fangle way of getting the colon examination without having the kind of go in from the outside.

I've been having to flush my colon. I drink two of this last night and this is like a really heavy liquid that your body doesn't absorb. So I drink two this last night. I was on the toilet all night long and most of this morning.

Oh yeah, here we go.

So now I'm going to have two more. She said I'm going to go to bathroom four times.

Oh my gosh. So OK we got the...

(Crosstalk)

UNIDENTIFIED MALE: Yeah. So as for now we're taking pictures.

SPURLOCK: OK.

UNIDENTIFIED MALE: Help you with this and then either way like you, swallow the capsule and put it in your mouth like with water or whatever you feel comfortable with.

Hold that in your hand.

SPURLOCK: I'm ready to go. I have sensors taped to me which will transmit images to a monitor that is at the end of the wires and this tiny little camera has always started recording.

UNIDENTIFIED MALE: And you can see like this is the real time. You can do a selfie.

SPURLOCK: Here's a selfie.

UNIDENTIFIED MALE: Yeah. So you can have selfie with this.

Keep a little bit of water in your month.

OK. So now, you can see.

SPURLOCK: Look.

UNIDENTIFIED MALE: It's actually in your stomach now. OK.

SPURLOCK: And this is recording the whole thing?

UNIDENTIFIED MALE: Yeah, yeah.

SPURLOCK: So what are we seeing right now.

UNIDENTIFIED MALE: This is stomach in the part of the body of your stomach.

SPURLOCK: Here we go. Look at that you can't even tell.

UNIDENTIFIED MALE: I can not tell like you having a colonoscopy right now.

And you can work.

SPURLOCK: I can still work. I got my little video (inaudible) pack that's according to the camera that's in my body right now. It's going to make its way through my body. It's going to come out in about three to six hours. We're going to have one heck of movie.

Welcome to the inside man. You're really inside man right now. Feeling good.

And while I'm having this colonoscopy, the folks in Bumrungrad had been nice enough for let me work here to experience the hospital from the inside out and to meet some fellow patients. I know how I got here but what about the other patients from overseas.

Here's how it works. Let say you're ready to be a medical tourist at Bumrungrad. You apply and the hospital reviews your application.

UNIDENTIFIED MALE: He has headache and also mild hearing lose.

SPURLOCK: If your application is accepted, it is presented to the specialist. They will decide whether they can or can't treat you.

But the good thing is that you believe you can help

UNIDENTIFIED MALE: Yeah.

SPURLOCK: That's great.

If approved, the hospital will then provide the patient with a flat price for the service. Mind you this price is that same whether the patient is insured or uninsured and then on-staff fixer will coordinate the accommodations and travel.

One international flight later, and that patient is the waiting room in Bangkok waiting for their appointment.

By the way, I'm having a colonoscopy right now.

Hey, how are you?

ANDREW DEY (PH): Good morning. Andrew Dey (ph). I have an appointment with Dr. Berapan (ph).

SPURLOCK: OK. Dr. Berapan (ph). Just -- well swing around here while I go check in. This is Andrew Dey (ph). He's got an appointment with Dr. Berapan (ph).

UNIDENTIFIED FEMALE: Good morning.

SPURLOCK: Andrew works for a government contracting came to Bumrungrad about three weeks ago for surgery.

Go and have a seat.

So what brings you in today?

DEY (PH): Coming in for follow-up from Bank Surgery I have with Dr. Berapan (ph).

SPURLOCK: OK. Where are you from?

DEY (PH): State of Georgia born and raised.

SPURLOCK: How does a guy from Georgia end up by a hospital in Bangkok?

DEY (PH): After a lot of research online (inaudible) I've started coming here by annual physicals and I've been very pleased. And so, when the back started giving me some issues, I didn't have any second guesses about where I wanted to go for possible treatment.

SPURLOCK: Why the decision too even start looking in a medical tourism versus just going back home to the states?

DEY (PH): One, cost-effectiveness.

SPURLOCK: Yeah.

DEY (PH): In the states, we would be liable for much more co-pay, deductibles, things to that nature.

SPURLOCK: Yeah.

DEY (PH): And we're able to get this type of treatment done so much so more reasonable overseas versus in the states.

SPURLOCK: I mean, it seems almost insurance companies should be pay for you to fly over because at the end of the day it's going to be cheaper for them.

DEY (PH): They will save money. They will save money.

UNIDENTIFIED MALE: The nerve is free out of surgery but the recovery of the nerve, because you had the worst case, so you need recovery on the nerve. You know that and the numbness is the last thing to disappear.

For surgery, I ...

SPURLOCK: Hang on a minute. He has to stay here to recover? What a nightmare. Am I right?

Now that that is a view. Wow.

DEY (PH): That's awesome.

SPURLOCK: Awesome. Nice view.

DEY (PH): Nice view.

SPURLOCK: Nice view. DEY (PH): Yeah.

SPURLOCK: Better than any hospital view I've ever seen.

DEY (PH): It really helps in the recuperation, you know.

SPURLOCK: I'm feeling better already just being here.

DEY (PH): Not only physical but mentally, you know, you can recuperates. So...

SPURLOCK: Right on. How much is a hotel a night?

DEY (PH): Roughly $100 a night.

SPURLOCK: Hundred bucks a night. That's fantastic.

Granting, not everyone can afford a hundred dollar a night (inaudible) as scratch pad. But considering how much you save by getting treated here, it's actually a pretty sweet deal if you can swing it.

Oh, that's what I'm talking about. Oh, yeah. This sure beats another hospital. Recuperation Thailand style.

DEY (PH): That's right.

SPURLOCK: Now I get it. I've seen the medical part. In this here is the tourism part. Not bad.

(COMMERCIAL BREAK)

SPURLOCK: My curiosity about medical tourism has led me to Bumrungrad Hospital in Bangkok, Thailand.

I've been working at Bumrungrad to learn how the hospital functions and to meet patients who consider medical tourism the best option for their health care treatment. Patients like retired American consultant William Brockwell.

So what brings you here today?

WILLIAM BROCKWELL, AMERICAN CONSULTANT: Pacemaker check. They replaced my pacemaker last week. I'm back here to have the doctor check it out and make sure everything is going good.

SPURLOCK: Did you have the pacemaker put in here?

BROCKWELL: No, a replacement. I original had one put in Florida.

SPURLOCK: OK.

BROCKWELL: And then the battery is going dead, right. So I come to get the battery replaced.

SPURLOCK: So how does the experience, you know, the hospital here, clinic here versus in the states? BROCKWELL: Here, they are more efficient. They take more time with you. And surprisingly the conditions that the hospitals seem all are cleaner and better.

SPURLOCK: Here?

BROCKWELL: Yes.

SPURLOCK: Really?

BROCKWELL: Yes.

SPURLOCK: See that's the last thing anybody would ever think?

BROCKWELL: Yes. Yeah. You know, but there's hospital was actually surprise me when I came.

SPURLOCK: What surprise you the most?

BROCKWELL: How efficient they are.

SPURLOCK: Like, give me some examples. What happened?

BROCKWELL: The most I've ever sat and waited for any procedure here has been 15 minutes. In the U.S., I've sat up to two hours...

SPURLOCK: Right.

BROCKWELL: ... waiting to get waited on.

SPURLOCK: As we all have I think.

BROCKWELL: Yeah.

SPURLOCK: Yeah. Now, compare the cost side of it. You know, from -- you got a pacemaker put in the states. How much that procedure cost in the states?

BROCKWELL: About 80,000.

SPURLOCK: 80,000.

BROCKWELL: Here, it was -- the bill they handed me was about 25,000.

SPURLOCK: So, it's a third.

BROCKWELL: Yes. Yeah.

SPURLOCK: Wow.

Did you spent a night in the hospital while you're here?

BROCKWELL: Yeah, one night.

SPURLOCK: And how much is one night in a hospital?

BROCKWELL: For nursing and everything was about 120 bucks sort of two-person room.

SPURLOCK: For two-person room, your whole hospital night stay was $120.

BROCKWELL: Yeah.

SPURLOCK: That is crazy. It's crazy. A $120.

A bandage in America would cost you $120.

Now that William is in good hands, I'm off the physical therapy center to help other westerners to get hospital care they came here for.

Andrew Brown (ph)? Andrew?

ANDREW BROWN: Yes.

SPURLOCK: Oh yeah. Come on.

How are you?

BROWN: Hi.

SPURLOCK: Good to see you.

BROWN: I wasn't expecting to see you.

SPURLOCK: Come on back.

BROWN: OK.

SPURLOCK: Andrew was a journalist who's been coming to Bumrungrad for treatment on and off for almost a decade.

Where were you before here?

BROWN: I was in the U.K. for about a year as an inpatient there that's why I had an accident, a medical accident.

SPURLOCK: What happened?

BROWN: Well, I had blood clot ...

SPURLOCK: OK.

BROWN: ... which was undetected for about six to seven hours. And by the time it was detected I was too late. I was quadriplegic.

SPURLOCK: Wow.

BROWN: And at that point, I couldn't do anything. I couldn't move anything beneath my neck or breath. And even a year later when I arrived here, I couldn't walk.

SPURLOCK: OK. So what brought you to Bangkok? How did you end up here? BROWN: It's cheap.

SPURLOCK: Yeah.

BROWN: The doctors here are very good. And it's very affordable. So if you (inaudible) pocket this is a very good place to be particularly if you got a neurological disease.

SPURLOCK: Yes.

BROWN: Because it requires a lot of physical therapy. And other time that is really costly if you're paying the prizes that you would pay in Europe or the States. You get better value.

So if it's cheaper and this as good then it's kind of no-brainer.

SPURLOCK: Right. So how did you get to the point from being there where you were quadriplegic to here now walking around?

BROWN: They got me on a program where I did 25 hours of therapy a week compared to much less. I've been getting like two or three hours ...

SPURLOCK: Yes.

BROWN: .. a week in the U.K. And within about, I would say a few months of arriving here, I was able to do some walking with a walker.

SPURLOCK: That's incredible.

BROWN: And then I graduated to sticks.

SPURLOCK: And that's just from physical therapy or did you have additional surgeries?

BROWN: I didn't have any additional surgeries.

SPURLOCK: No? That's amazing. I would never, never even guess that you were quadriplegic 10 years ago.

BROWN: Right.

SPURLOCK: Yeah. It's incredible.

BROWN: I am a very lucky, very unlucky person.

SPURLOCK: Yes.

BROWN: You know, I'm unlucky to have had this injury but to have found this particular niche...

SPURLOCK: Yes.

BROWN: ... in the medical world is great.

SPURLOCK: Yeah. That's remarkable. Not only is this (inaudible) alternative run ensured or underinsured Americans who need affordable care but it's proving to be an option for those with national care looking to supplement their treatment. It's amazing to see the medical tourism as essentially afforded Andrew the opportunity to walk again.

What they at Bumrungrad is in God's work. It's just having business. And one that breaks in an annual revenue of nearly $0.5. Just ask their CEO Dennis Brown.

This is probably the most beautiful hospital I've ever been in my life. Feels like we're sitting in the lobby of a hotel right now.

DENNIS BROWN, CEO OF BUMRUNGRAD HOSPITAL: Well, you are. We just happen to divide medical care at the same time. We build it like that.

SPURLOCK: Why?

BROWN: Because that's patient population expectation. We are providing care to the people who are spending this (inaudible). Same reason why hotels build five-star and two-star. And they're imagining to a specific market segment expectation.

SPURLOCK: Yeah.

BROWN: We do exact same thing.

SPURLOCK: Is part of the problem, you know, when you look at like medical system here, medicals in the United States is that we've turned patients into dollar signs.

BROWN: I don't want to down play making money because we make money.

SPURLOCK: Of course.

BROWN: There is a lot of influence from the payers. The insurance companies, the government, all have I say in your health care and the hospitals are required to focus on what those payers have saying. So sometimes the patient gets lost and becoming an object rather than a person.

The different here is for the most part, the patients, the payer.

SPURLOCK: What would motivate someone from the United States to want to get on a plane and flight 24 hours for medical care?

BROWN: Well, we have two basic reasons. One, they can't afford the U.S. That's one of the reason they don't fit into the corporate medical insurance, they somehow are left out.

And the other maybe, they're frustrated with some of the aspects of the U.S. healthcare system. So people are coming here more because of access, the level of sophistication of the doctors, of the technology that is not available at home.

It's only really perceived as inexpensive to develop country patients. If you ask the average Thai, they will say we're expensive.

SPURLOCK: Where as the average American will say its pretty good deal?

BROWN: Correct.

SPURLOCK: Yeah. Seems though that the people who get the best health care are the people who have money.

BROWN: As the most things, people who with the most money get the best houses. People with the most money probably eat at the best restaurants.

We charge what we charge and if you can afford it, you are able to purchase it.

SPURLOCK: The Bumrungrad motto was brilliant and its simplicity. Lower the cost, kill the wait times, take out the middle man of the health insurance company and create a service that people are willing to travel halfway around the world for. It's just good old-fashioned capitalism and ironically there's nothing American in that.

(COMMERCIAL BREAK)

SPURLOCK: This week I've donated my body to science in the name of medical tourism. Well, sort of.

I underwent a long overdue colonoscopy. But it's not just any colonoscopy.

I've been able to try out a state-of-the-art capsule procedure which involves me swallowing a mini camera to film the inside of my digestive tract.

I'm going to unleash the flush beast. I think it's time to release the camera. I'm going in. That just went through. It just went through me. It just went through all of me.

That's me holding the pill on my head.

UNIDENTIFIED MALE: Yeah, you're holding the pill and this one is facing to...

SPURLOCK: It's facing in the room.

UNIDENTIFIED MALE: Yeah, it's facing to me in my nose.

SPURLOCK: Yeah.

Yeah. Oh my gosh. And now it's in my body. Oh my god.

UNIDENTIFIED MALE: Going very fast in your small intestine.

SPURLOCK: Cool. So now, this is my colon.

UNIDENTIFIED MALE: Yeah. SPURLOCK: So was it in my colon for three hours?

UNIDENTIFIED MALE: Yeah, maybe two hours, 3.5 hours.

SPURLOCK: Wow.

UNIDENTIFIED MALE: So this is turning around, so we see in all the direction.

SPURLOCK: Yeah. This one is the front.

UNIDENTIFIED MALE: Yeah.

SPURLOCK: Yeah. So it's going this way.

UNIDENTIFIED MALE: Yeah.

SPURLOCK: And it's coming this way.

UNIDENTIFIED MALE: Yeah.

SPURLOCK: And it's all healthy. This is all like -- what's that part right there?

UNIDENTIFIED MALE: It's all normal?

SPURLOCK: It's all normal.

UNIDENTIFIED MALE: Yeah. It's coming like down to the last part of your colon now.

SPURLOCK: Yes.

UNIDENTIFIED MALE: This is like the last turn, it hit the (inaudible) and then after this turn it will just straight, like short segment of your rectum.

SPURLOCK: Yes.

UNIDENTIFIED MALE: And it would come out. OK, and now this is the rectum. It's were it came out.

SPURLOCK: That's one of the craziest things I've ever seen.

UNIDENTIFIED MALE: This is isn't (inaudible).

SPURLOCK: It's so cool. Yeah. Well as terrible as a lot of that process was, from drinking that stuff to not eating, spending a good 24 hours on the toilet, there are some positives. Nothing in there, nothing bad, no (inaudible), that's a plus.

I don't have to do that again from another five to seven years. That's amazing. The only downside, you've all now seen the inside of my colon. So, I'm sorry.

And now it's time for the most painful part of any hospital visit, getting the bill.

Hi, I'm here to pay my bill.

Yeah.

UNIDENTIFIED FEMALE: Two days for the treatment, examination and medicine is about 94,833.

SPURLOCK: 94,833.

UNIDENTIFIED FEMALE: Yes. You see the details from the treatment today. Do you want to check first?

SPURLOCK: Sure, yeah. So 94,833 Baht, is actually about three grand.

So let's take a second to recap. I got a shoulder RMI, a full blood test and physical, which included an EKG, a chest x-ray, an abdominal ultra sound and an eye exam, consultations with four specialists, and a capsule colonoscopy. All for about $3,000.

In America, the average estimated price for this entire list for the uninsured is more than twice the price or could be even as high as $14,000. And let's not forget the cost for my round trip air fare from New York and the cost of my hotel for three nights. That brings the grand total to $4,300, still cheaper.

And I had all these tests done in about two days. So it's hard to argue about the efficiency of something like this. It's amazing.

You know I came here electively for something relatively minor and it still costs a lot less. But I can imagine that if I needed something more involved like hip replacement or open heart surgery, the time and money saved at a facility like Bumrungrad could mean the difference between my having the procedure or none.

How many people are avoiding health screens and procedures in the U.S. because they don't want to deal with the headache of our system, it's got to make you wonder.

(COMMERCIAL BREAK)

SPURLOCK: It's been quite a week and a little surreal to think that I flew halfway around the world and back for a host of medical tests and procedures and still spent less than half what I would have in the states. I'm heading back to where it all started, Dr. Isics' (ph) office in New York City to tell him that I did in fact, get that MRI he recommended.

ISICS' (PH): What brings you back today?

SPURLOCK: Well I just want to come have a chat with you, I've got an RMI, had it look at.

ISICS' (PH): (inaudible).

SPURLOCK: Yeah, I got it done in Bangkok. ISICS' (PH): That means (inaudible).

SPURLOCK: I went and got my shoulder looked at. I got colonoscopy. I got a full medical check up. I got my hip looked at. And the whole thing cost $3,000, all in total, it was three grand.

ISICS' (PH): Including colonoscopy?

SPURLOCK: Including colonoscopy.

ISICS' (PH): (inaudible) Just like (inaudible) or something. My patients, a number go to Thailand.

SPURLOCK: You had patients (inaudible).

ISICS' (PH): Yeah. And I mean, they will pay you to go to Thailand or Mexico and have a great vacation in a great hotel just for the cost of some prescriptions...

SPURLOCK: Yeah.

ISICS' (PH): ... in United States, especially dental work. In Romania, South Africa, they equally get dental work at 1/10th the price there.

SPURLOCK: Yeah. Do you think things like this will become more common? Do you think more people will travel to get surgery, to get things done, as things get more expensive.

ISICS' (PH): This is becoming more common, it's a lot more common. A lot more common.

SPURLOCK: The insurance companies, would they benefit if they started sending patients overseas? Would it be better for them?

ISICS' (PH): Of course it would be -- (inaudible) maybe somebody out there haven't even thought of it yet, but maybe they don't think of it now.

SPURLOCK: Maybe no.

ISICS' (PH): They'll do everything to drive their profits.

SPURLOCK: That's right. Awesome. It's so great to see you. I appreciate it. Thank you.

ISICS' (PH): You too.

SPURLOCK: After traveling to Bangkok and coming back, I mean I really see how medical tourism is a real viable option for people.

Just (inaudible) for everyone, but if you're someone who has to have a major surgery that's going to cost, you know, thousands and thousands of dollars, and you don't have insurance and you have a high deductible, you can actually get on a plane, go somewhere, get incredibly competent health care in an environment that is safe and clean, with incredibly qualified professionals for cheaper than you can here.

You know, right now there's about a million a year who were traveling overseas to have this type of work done. And what if that becomes 5 million, 10 million? Then I think you're going to suddenly have people say, "We can do better." You can see insurance company saying, we shouldn't be (inaudible) people the way we are. And that's when may be you and I will finally get the health care at a price and at the quality we deserve.

I mean, I do believe there's a way we can set up a system that can both do good and do well at the same time.

(COMMERCIAL BREAK)