Medical Prices and Where to Draw the Line.
Once again I was shocked, bemused and slightly angered by the blatant medical prejudice experienced by a patient of mine at the mercy of the local medical system, or should I say lack of system.
A young mother who had been seeing me through her pregnancy, was told by the Garuda airline office that she would need a medical letter stating the dates of her pregnancy and that she was fit to fly before leaving to give birth in her home country. This is indeed standard procedure. She was also told that she would need to get that letter from a certain doctor at a certain hospital. Starting to sound fishy?
The task at hand was simple, and for a man of his experience and seniority, it should not have been too difficult to figure out how pregnant a woman actually is, especially as she had full records of the pregnancy including previous scans and examinations. The doctor however felt that he needed to do another ultrasound scan to be absolutely sure of the dates, so the patient cordially agreed. The cost? 2,500,000 rupiah! The standard price for a scan performed by a qualified obstetrician at other hospitals in Denpasar is about Rp. 250,000, or if you want the color 3 D scan it will set you back about Rp 500,000. The end to this story is that this particular lady was the wife of a senior employee at a 5 star hotel. As the medical expenses are covered by the hotel, the lady immediately reported this to the hotel administration, and then after words were exchanged between the doctor and the hotel staff the price dropped to Rp 250,000!
It goes without saying that this lady as a 'bule', a Westerner, who therefore has a limitless supply of funds, and is stupid enough to believe that it would be acceptable to pay 10 times the standard price because she is white! It has long been a practice of doctors and hospitals here to charge many times more the local price if you are not indigenous. This has to change. I can appreciate that most westerners are on a higher income than people in the kampung, however skin color alone should not be in indicator of how much you can charge.
I remember when I was pregnant with my youngest son and the doctor that I was consulting in Denpasar insisted on charging me three times what he charged the others, even though I was married to a Balinese, driving a VW Safari, and the local ladies were in Merc's! Hello? Where is the justice? The good news is that there are now several hospitals in Denpasar that will bill you on class of care rather than color of skin. Prima Medika hospital has a class billing system; however you do have to have a KITAS to be privileged to this.
International clinics such as BIMC and International SOS have a fixed pricing system, although they are not hospitals as such. BIMC has overnight stay facilities but be prepared to be charged an hourly rate. Both centers are not designed to facilitate the local community so don't expect 'local prices'.
At the end of the day, it is always wise to ask the full cost of the consultation or procedure BEFORE you are seen. Unfortunately standardization of medical costing is a long way off here, so we will be battling on for fair billing for some years to come. It goes without saying that you MUST have health insurance cover here (No your Australian Medicare and USA Green cards don't work at local hospitals!). If you would like more information on recommended local doctors / hospitals, or health insurance cover