Check-ups turn a healthy profit

As a card-carrying, law-abiding expatriate in the Land of Smiles, I am required to visit my local hospital once a year to obtain a medical certificate.

Everybody applying for work needs it, not just wayward expats eking out a living in the Land of Smiles, biding their time until some statute of limitations runs out back home.

It is a stipulation for having a work permit. One needs a medical certificate stating one is not suffering from five distinct ailments, which are syphilis, elephantiasis, leprosy, tuberculosis — and madness.

Yes, I know. A bit random. And I was enjoying the list until I got to the last one, whereupon a sudden chill was sent by my sympathetic nervous system right down my spine.

It was my regular doctor who informed me that if I could answer my name and address correctly, it was assumed I was not insane. Slightly irrational, yes, but eminently coherent when pursuing a work permit.

Every year I also get a real health check-up from the same hospital. That’s a much bigger deal and more serious affair.

Annual check-ups in Thailand are wonderful things. Where else in the world can you spend a couple of hundred dollars to get an ECG, abdomen check, blood test, hearing test, eye test, urine sample, lung X-ray — and free breakfast?

At my hospital you are greeted by picture-perfect young receptionists in trendy grey jackets who have clearly taken advantage of the cosmetic wellness clinic on the second floor.

My hospital always offered five different annual health check-ups. The cheapest costs 1,200 baht, but nobody bought that one since it was called BASIC in really big letters in the brochure and nobody likes to be called that.

The next three packages went by the more acceptable names of Programs A, B and C and were priced around 3,500, 5,000 and 7,000 baht respectively.

The final programme was the Executive Package with a price always hovering around the 10,000 baht. I could restock my entire liquor cabinet with that budget, a mindset that dictates the mandatory nature of my annual check-up.

Nevertheless over the last few years I’ve bought that one. The hospital always seemed to be having a “special discount” on this package and last year I managed to get away with it costing around 7,500 baht.

I always had to wait an hour for my results, so with my 100 baht free voucher at the hospital’s restaurant I would order a sensible salad and water just in case the prognosis was bleak and I’d be going macrobiotic for the last few months of my life.

An hour later I’d be back in the Executive Waiting Lounge — way too close for comfort to the smelly A, B and C Package waiting area. The Basics were standing outside in the smoking area.

Finally I would see my doctor, who would scan through the copious results and declare me fit and healthy “though perhaps you could lose some weight”. On the way out I’d buy a sausage wrapped in pastry along with a pandan-flavoured tea cake at the SP counter. Macrobiotic be damned!

That has been the ritual for the last few years.

Last Tuesday, while waiting for the results of my syphilis blood test, I went to the counter and casually enquired about booking my Executive Check-Up.

There was a pleasant young man, though slightly obese, sitting behind the counter. I briefly pondered upon the prudence of placing a slightly obese gentleman at a counter selling health check-ups, but perhaps the hospital was understaffed that day.

“We’ve revamped the system and changed the name,” the pleasant young man informed me.

He pushed a brochure before me.

He was right. They are now called “Perfect Check-Ups”.

My Executive Package was gone. In its place was the “Perfect Plus Program” … at 32,565 baht.

Had I the slightest scrapings of syphilis in my system it would have flared up instantly and virulently.

Have you ever been witness to an accident or emergency situation? For the first couple of seconds it doesn’t quite register what you are witnessing. That is how I felt as the number 32,565 loomed before my eyes.

Slowly I came to my senses. I asked for a glass of water, then enquired as to how my annual check-up suddenly became a price that was able to leap tall buildings in a single bound.

The young man pointed a pudgy figure to the bottom of the brochure. “Promotion Price … 24,000 baht,” he said, almost joyously, as if it were a number to be celebrated.

“That’s still three times what I paid last year.”

“Yes, but look at all the things you get checked.”

He was right. There was a formidable list of items, but as I discovered upon reaching home later that day, almost the same number as last year’s. Slightly more.

What had happened in the world between last year’s check-up and this one? Was Donald Trump to blame? Global warming?

“It’s not just a single doctor any more,” he said. “There are five specialists who participate in the process.” As he spoke he held up five pudgy fingers just to stress his point — either that or he didn’t think I could count to five.

Actually, he was wrong. In the past there were three specialists, which, when considering the full price of 10,000 baht, averaged out to 3,333 baht per specialist.

Surely the new price should be 16,665 baht taking into account five specialists. Alas, judging by the look on the young man’s face, this mathematical equation was as foreign to him as a garden salad.

That’s when he went in for the kill.

He explained that the hospital now charged according to age. You can still get the 10,000 baht check up … but only if you’re aged 20-35.

Once you turn 36, it’s 22,530 baht for the premium package … and once you’ve celebrated the big five-oh, it’s 32,565 baht (permanently discounted to 24,000 baht).

“It’s because you’re over 50,” the young man informed me.

“I was over 50 last year, too,” I informed him back.

What a conundrum. This was a greater weight on my mind than awaiting the results of a syphilis test.

Nothing is more important than maintaining good health, and my annual check-up was very important. But this was not one, small, inflation-based, incremental price rise. This was one giant leap for mankind.

This was an issue in the Thai media exactly two years ago. The Medical Council expressed concern at private hospitals charging exorbitant fees, a result of the rise in “medical tourism”. It generates more than 1 billion baht in profit annually.

Unfortunately demand has outstripped supply, and private hospitals have reacted by bumping up the prices. Don’t believe me? Go and enquire about a medical check-up at my hospital holding last year’s brochure.

I told the young man I would think about it.

A few minutes later the nurse returned with a white envelope in her hand. I was all clear. I had none of the Big Five.

That was when it hit me.

For the sake of my legal work status, I could never sign up for this annual health check-up.

Paying more than three times the amount for the same service from just a year ago — well that’s just sheer madness.

And to work in Thailand, one cannot be mad. It’s one of the Big Five. What if the Labour Department were to find out?

I walked out of my hospital, possibly for the last time, clutching that envelope in my sturdy hands. I had just proven myself to be sane. n