The Wall Street Journal Asia
By Steve Mollman

Facing age 40, Paul Luciw decided an extensive health checkup was in order. It was for more or less preventive maintenance, though, so his medical insurance wouldn't cover it. His local hospital in Hong Kong said it would cost the equivalent of about $1,300 for the battery of tests including an eye exam and chest X-ray.

But Mr. Luciw, who travels the region as managing director of Asiaxpat.com Ltd., an online portal for expats in the region, had heard of other options. He got a quote from Bangkok's Bumrungrad International hospital for about $300.

With that kind of savings, Mr. Luciw notes, "you can pay for a top hotel, your flights -- you get a weekend away -- and the checkup for the price of just the checkup in Hong Kong." So, with a few buddies who also wanted checkups, he made a mini-vacation out of it earlier this year.

He and his friends aren't alone. Increasingly, people living in Asia are crossing borders to save money on cosmetic, dental and even serious medical procedures as countries such as India, Malaysia and Thailand build high-tech medical centers targeting foreign patients.

Health-care services in Thailand are about 40% cheaper than in Singapore, and they cost about a quarter of those in Japan, according to Ruben Toral, marketing director at Bumrungrad International. He says the number of foreign patients at Bumrungrad jumped to more than 380,000 this year, from fewer than 168,000 in 2000.

Wanda Heim, a 37-year-old housewife, saved more than $5,000 by having her breast augmentation surgery done in Kuala Lumpur, instead of Singapore, where she lives. She saved that much even with lodging and travel factored in. Cost, of course, isn't the only thing that matters. "There are two elements to this: Who's cheaper? Then: Can I trust this guy?" says Gary Ng, a Singapore-based analyst who covers the health sector at investment-research company CIMB-GK Research Pte. Ltd. "If I have to have my heart or my brain opened up by someone, I've got to have a huge confidence level before I go into the operating theater."

To win that confidence, hospitals competing for medical tourism dollars often turn to credentials they have received from accreditation and certification bodies. These can be presented in a confusing manner, however. On one Malaysia-focused medical-tourism Web site, you are urged to "Click here to begin searching for a ISO-9002 accredited medical facility."

ISO-9001:2000 certification, as it's officially called, sounds reassuring, but it "isn't specifically a health-care standard," notes Alan Bryden, secretary-general of the International Organization for Standardization, or ISO. "It applies to the processes an organization implements to ensure that it meets the quality requirements of its customers," he adds. "If it is implemented by a health-care provider, then it applies to that organization's way of working, but not to the actual medical treatment it provides, nor to the medical devices it uses."

More reassuring for potential patients perhaps is accreditation from Joint Commission International, a U.S.-based accreditor of health-care organizations around the world. "(JCI) standards are designed to improve patient safety, and they address the important functions that are common to all health-care organizations," says Margaret O'Leary, manager of international accreditation at JCI.

But fewer than 15 hospitals in the region have received such accreditation including Clifford Hospital in Guangzhou and Bumrungrad International in Bangkok. The full list can be found at http://tinyurl.com/a3eqg .

Legal matters also need to be carefully considered. "Before you get on the plane you should be in touch with the hospital asking them for details of their contractual terms," says Damien Laracy, senior partner at Hong Kong law firm Laracy Gull. A hospital's standard contract will usually specify under which country's jurisdiction any legal action will take place, and what the maximum liability is.

Aside from accreditation and legal matters, there are simple logistics to consider. For this there are travel agencies that specialize in medical tourism. Ms. Heim, for example, used Gorgeous Getaways Pty. Ltd. of Australia to arrange her cosmetic surgery. "They take care of all (the) little things and misunderstandings that occur when you go for surgeries overseas," she says.

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