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[I'm With Stupid]

Where do you get travel insurance from? I just found out that most UK insurers won't cover you if you're not a resident, and I have some trips planned to countries where I wouldn't want to be landed with the cost of medical treatment. I've Googled expat travel insurance, but the one price I was quoted was three times what a UK resident pays, so I figured there might be a better (local?) option.

[dazednotconfused]

Hi, I've used World Nomads before, when not living in the UK, and it was hassle free. Can definitely recommend them, their prices were pretty decent and they're a good company.

I had a question about insurance too.. (hope you don't mind hi-jacking your thread)...

What cover do you have while in Vietnam? Do you just buy health insurance out there or get a backpackers/ long stay travel insurance?

I'm arriving in Vietnam in September and am just starting to sort all this boring stuff out.

[mark_in_saigon]

in the west, it can actually be a good decision to self insure, some large organizations do that. Insurance just spreads out the cost over a group, plus takes a bite for admin and profit. So the majority pays more than what they ever use, and a few pay less. Even with an employer who contributes, you are still paying indirectly. Okay, so in the west, prices are so high, if we have money, we probably all need to buy into that mess (or system). In VN, prices are so low, the argument can be made that self insurance is viable. I had a major problem that could have killed me, they fixed it, and now I am fine. Without insurance in the west, it would have killed me financially. Here, it was about $1,600. Emergency removal of gall bladder, by the way. Anyway, do not assume it is automatically irresponsible to not carry insurance here. If you can afford these prices (and who among us can't?), then not having medical insurance is not necessarily irresponsible. I think some of this is just mentally adapting to the different systems, and the way of life here. On my deal, if I had tried to go somewhere else, it would have been too late anyway, so it was kind of a live or die with the country you have chosen as your new home kind of a deal.

On a vaguely related subject, think of the motorbike insurance we carry. What does that cost, 3 bucks or something, right? It costs us more in time to mess around getting it than what we pay at the counter. How much good do you think that really does us? The good it does us is give one less thing for the cops to mess with us on if they pull us over. That is about all the value that 3 bucks is going to buy, right? Anyway, it ties into my point, if you are gonna take your chances here, the question of insurance becomes less important than other considerations.

[deadlift]

Mark, could go into a little more detail about your illness and treatment? I mean, which hospital did you go to, and how was the quality of care?

I ask because some time ago I had appendicitis, but because I had a retrocecal appendix (it hides behind another organ) it resisted diagnosis for several days. The poke test didn't work, ultrasound and CT scans were inconclusive, and all pointers suggested some kind of liver infection. All in all, my insurance coverage saved me about $8,000. This was in SOS and FV hospital, and based on several (non-medical) visits to local hospitals, it's worth the premium.

My insurance allowed me to have laproscopic surgery, which is safer and less invasive than the normal appendectomy, which I would have had had I been at Cho Ray. I was allowed to recover for three full days without being hounded for money by the hospital. When the staff of FV made an error and demanded payment before allowing me to undergo emergency surgery, a call to my insurance provider's 24 hour hotline sorted it out immediately. Had my condition been more serious (such as the aforementioned liver infection) I would have been on a plane to Bangkok, with my fiancee at my side, for no charge.

I've heard of someone who suffered a compound fracture of the shin-bone, requiring surgery. Because he was uninsured, his friends had to come up with 10 million for treatment, and then a further 15mil to allow him to stay in hospital to recover. This is at Cho Ray.

So I disagree with your assessment of the necessity of insurance. You ask "who can't afford it?" but my question is how can you be sure than you can afford to pay for the care you need? What if your condition is more serious? What if you suffer a run of bad luck? What if you can't communicate or access any funds? Insurance will mitigate 90% of those concerns.

We have to remember that here in VN, if you can't pay, you don't get treatment.

[mark_in_saigon]

First, I was in An Sinh. Then I was in Cho Ray. An Sinh was doing well, but the fever made it dangerous, and so they wanted me to move to Cho Ray, the monster hospital. Please note I am saying things like �it may not necessarily be irresponsible� rather than �I absolutely guarantee you this is the case�. I am not an expert on this, but I am offering my experiences and what seemed to be a reasonable conclusion. As we all know, we can never know exactly what is going on here. I also had that lap� surgery, and can tell you, the surgery itself was excellent, and I was able to look over the surgery facilities a bit before the operation, that part was very impressive. I can also say that the overall experience had some very questionable moments, as one �doctor� advised me that surgery was not urgent (after they had controlled the fever), yet another had advised my gf the truth, it needed to be done NOW as my organ was going into what they call necrosis (death). NOW was the right call, and my gf made sure I went in that direction, I let her manage my case, as she knew more about what was going on with her people than I did. Anyway, my conclusion based on the costs (and both hospitals gave me a similar estimate of cost) was that the payment was incidental to the event. I mean, a couple of grand is still a lot of money to me, but it is just one small discussion point compared to how this would play out in the western system. On the surgery, they called in a real Dr. educated in Indiana, he came in that night especially for me. I chatted with the team before it started. There were about 3 doctors around me when I went under, and about 4 other people. The surgery part, I cannot guess how much that would have cost in the west, but I am pretty sure that tens of thousands would have been billed just on that part alone, someone told me the whole deal would have been closer to 6 figures. That thought is so scary I never pursued it to be honest, I was just very grateful that the VN system took such good care of me.

Again, I am not an expert on medicine, especially in this system, but I do understand that insurance is not like buying forgiveness, it is a scheme to spread risk at its essence. If the risk is only a small amount, (a few grand is pretty small to us), then my main point is, not having insurance does not necessarily make you a bad person, or is not automatically a bad business decision. It is something to consider, here. In the west (or a western style hospital in the east), it is a whole other question. One final thought, HAVING insurance here COULD cause them to boost the price or the kind of provider you get funneled into. Western guy, western price, western service provider, Asian scheme for fleecing your money, or your insurance provider�s money. I am not saying I know this to be the automatic process, but it would not surprise me one bit.


By the way, on my deal, after I was out of the initial recovery area, I was given a private room on the 10th floor (I think it was), the entire floor was for foreign patients ONLY, and was there for over a week. One freaking day of that in the west would have been more than $1,600. Was it the Taj Mahal? Not quite, but it did have aircon, a real bath, and was cheaper than dirt. All in all, I was very very pleased with how the VN gave me some very special service, despite some of the crazy things that I saw and experienced. In the west, the aspirins I ran thru would have been more than $1,600.

Perhaps the most important part of the whole deal was my gf. Despite her just being a young lady without an impressive resume (to them), she is smart, speaks pretty good English, and was totally dedicated to my well being. She stood up to any doctor or anyone else that tried to circumvent my well being (not that they are evil, but you have read about these things, like that recent case where a doctor slept while the patient died, because he thought it was not a big deal, despite the family giving him a bunch of grief about her condition), she also interfaced with my family, who shot over some cash by western union when I could not manage my funds at that moment. But they did do the operation based on our word that the money would come thru. The first hospital had made a charge of 15 hundred or so, and then when they transferred me to Cho Ray, they could not return the money for 5 days or something, but I had to get the surgery right away, so that part was also kinda stupid. So, the vn helper is what was most important, or vn gf we could say, and just getting the system to chug along. Again, the cost was secondary to the overall event.

[I'm With Stupid]

Thanks for the suggestion. I actually went with this insurer in the end, in case anyone's interested.

I had backpacker insurance for my first 6 months in Vietnam, after which I switched to my employers insurance. It's definitely viable to self-insure in Vietnam, but I'd still be worried about doing it. The problem is that you never know what the most you'll ever have to pay out will be. With property, you know what you're putting money aside for, so you have an idea of the worst case scenario. With medical treatment, even in Vietnam, there's no upper limit to what you could potentially have to pay.