Today La and I went to a clinic to get her checked out for what we thought was probably a stomach bug, but were worried could have been Denge Fever, which has been an issue this rainy season. Turns out it was just a stomach bug–a bacterial infection of the small intestine, to be exact, and yes, I asked for permission to post about my wife’s health. What struck me, though, was our bill for her visit.

When I was sick with the flu last year in South Carolina, I had no medical insurance and went to a Doctor in a Box and thought I got a good deal when I paid $250 for my visit, and about $100 at CVS for a super cough syrup and a Z pack of antibiotics. Today, after waiting about the same amount of time I waited in the Surfside, SC Doc in a Box, Laura emerged with a clear diagnosis (I reckon diagnosing food poisoning is very routine) and a prescription. The clinic had the meds right there for us (a week of antibiotics), and presented the bill. A whopping 260 bhat for the visit and the drugs. That’s about eight bucks, folks. I feel like buying a new I-pod with the money we saved. Or maybe a brand new $300 Unix-based laptop.

I’ve been trying to wrap my head around this. How is that 260 bhat doctor visit possible?

The first factor that came to mind was litigation. I don’t know yet for sure, but I’m willing to bet that doctor malpractice suits are fewer per capita in Thailand compared to the USA. We know that malpractice insurance is a factor in driving up health care costs in the USA.

The second factor that came to mind was the cost of the drugs. Again, I’m not sure, but I’m willing to bet that those same drugs would not be as cheap in the US, even though they may have been created in the US. If this is the case, one reason why they might be cheaper overseas is because American consumers foot the majority of drug R&D costs, as foreign governments make deals to allow drug sales in their countries at very low costs.

Maybe a middle ground in the affordable health care debate would be to allow for more no-referral-needed doc-in-the-box type clinics to handle more of the everyday medicine that often clogs hospital waiting rooms: runny noses, stomach bugs, and flu. Surely these businesses know how to say, “yes we can treat this, take a number and get in line,” or “no, this is serious, go to the hospital.”

And second, allow Americans to re-import drugs from other countries, like Canada and Mexico, whose prices are fractions of what Americans are forced to pay at home. Either that, or engage American Big Pharma the same way we’ve been demanding windfall profits taxes from Big Oil. Big Pharma is much more profitable than Big Oil. We seem to have accepted that American drugs are expensive, while insisting that gasoline and heating oil remain at prices of the past. Totally unreasonable.

I really hope our government approaches the affordable health care challenge this way, rather than creating another expensive program that will further burden the middle class tax payers.