Why is Healthcare So Much Cheaper Outside the U.S.?

A recent survey reported that a single day in a hospital in the U.S. costs, on average, $1,514 (up to as much as $12,537), while in France it costs $853.

An appendectomy in the U.S.—including physician and hospital bills—costs $8,156 on average (up to as much as $29,426). The same procedure in France costs $4,463.

Hip replacement surgery costs an average of $25,061 (up to $87,987) in the U.S., but just $10,927 in France.

Median price for routine heart bypass surgery in the U.S. is $46,547 (up to $61,649). In France the average cost is $22,844.

A routine doctor’s visit in the U.S. costs an average $95 (up to as much as $176). In France, though, you’ll pay just $30.

And why do prices vary so greatly in the U.S.? Because they’re mostly paid through insurance claims, and prices are negotiated by insurance companies. You pay what they say you’ll pay. The prices you pay can vary greatly from region to region, from market to market. And don’t be fooled into thinking you’re paying more for quality for a name-brand hospital. Because that’s not necessarily the case.

(By the way, if you live in a U.S. city that’s experienced a lot of hospital mergers, you’re probably paying more than you should be…that’s the nature of monopolistic pricing.)

In other words, it can pay to move overseas or to shop around internationally for your healthcare. You’ll see some huge savings, as the pricing examples I’ve just given for the U.S. and France clearly show.

“The Low Cost of Healthcare Literally Saved my Life”

International Living’s Colombia correspondent, Nancy Kiernan, and her husband Mike moved from Maine to Medellín four years ago. As well as enjoying the great climate and the lower cost of living, Nancy speaks from experience when she says she’s impressed with the healthcare in the city.

“We are very satisfied with the city’s health and dental-care systems,” Nancy says. “From something as simple as getting a blood test or your teeth cleaned, to surgery and root canals, healthcare professionals in Medellín provide excellent service.”

Curt Noe, a retired traffic engineer from New Jersey, moved to Medellín in 2007. “I arrived with a pre-existing condition of cancer,” he states. “I expected to have a problem getting health insurance here and was pleasantly surprised that I was completely covered by the national health plan (EPS) after only a six-month waiting period.”

During his first few years in Medellín, Curt flew back to the U.S. for second opinions and follow-up appointments.

“I realized I didn’t need to spend the money to do that, after my U.S. doctors said that the care I am receiving in Medellín is on par with what they would do.”

Healthcare costs are far lower there too. In 2015 the cost of a hip replacement in the U.S. averaged just over $40,000. In Colombia, the same procedure averages only a little over $8,000.

In Southeast Asia, the story is the same. “Not only were the meds I needed easily available, but the low cost of healthcare literally saved my life.”

That’s what expat Roger Carter has to say about the excellent healthcare he’s found in Southeast Asia. And Roger is just one of the growing number of expats discovering the excellent (and highly affordable) care that this region has to offer.

In Southeast Asia today, you can access English-speaking doctors trained in Western hospitals—often without an appointment. Hospitals accredited by the Joint Commission International (the gold standard of healthcare accreditation) are common. Expats report receiving equal (or better) care here than they did in the States.

Healthcare in this region is stunningly affordable. You can see a specialist for $20 or less. You can get prescriptions for as little as 5% of the U.S. cost. And you can complete a hospital stay with top-of-the-range treatment for a fifth or less of the price back home. Need surgery? No problem. A procedure that would cost you $18,000 or more in the U.S. will set you back $2,000 in Southeast Asia.

The top notch but low-cost medical care available in Costa Rica is a huge draw for retired expats and also makes it one of the world’s top destinations for medical tourism.

“One of the most important reasons we moved to Costa Rica was the low-cost medical care,” says International Living editor Jason Holland. “And not just that it’s cheap but that it’s good, essentially North American standard.

“My wife was pregnant. And after being laid off in the U.S., the cost to have the baby there was astronomical. In Costa Rica, the total cost was $3,000—the obstetrician, anesthesiologist, hospital costs…everything. And the care was excellent.

“After that we had plenty more opportunity to use both the public and private healthcare system. Through the Caja government-run system, we paid $180 a month for full coverage for our family of four. And when we visited private doctors it was $50 per visit, cash.”


Spend Less on Your Prescriptions, too

In most of the rest of the world, healthcare prices are established centrally by the government. Laws and court systems don’t allow for frivolous lawsuits. Suing someone can take years and judges have no incentive to dole out multimillion-dollar awards. So malpractice insurance is very low, as are doctors’ and health workers’ fees and hospital and clinic charges—savings that are passed along to customers.

  • You’ll get not only excellent quality medical care but you can buy your prescriptions for much less than in the States:
    In Malaysia, the high-cholesterol medication Zocor will cost you less than $22 a month, while the generic, simvastatin, costs less than $5.50 a month. Private hospital-room charges there start at $28, but for $90 a day you can have an en-suite room with cable TV.
  • A prescription I take costs $30 a month in Ecuador and $80 in the U.S. A full dental cleaning in Ecuador costs just $30 to $45. Partial plates run about $325, and a complete set of dentures costs about $900, including office visits, fittings, lab work, and impressions. Teeth bleaching costs $25. A porcelain crown is just $250.
  • In Nicaragua, you can have lab work done for as little as $8—and as in most all of the rest of the world, you take the results with you to whatever doctor you choose. An overnight stay in an internationally accredited hospital costs about $100. An electrocardiogram is only $25. And a doctor’s visit routinely costs as little as $10.

Importantly, you’ll find that in most of the rest of the world, healthcare expenses are relative to the local cost of living.
It just costs less to live in Asia, Latin America, or certain parts of Europe than it does to live in the U.S.

Housing and construction costs are lower. Taxes are lower. Food costs less. And salaries are lower. Foreign doctors often make a sixth of the salary of their U.S. counterparts.

Healthcare plans, too, can be amazingly affordable outside the U.S. In Panama, Costa Rica, or Mexico, for example, a couple might spend $250 a month—depending on age and other factors—for comprehensive, low-deductible private health insurance. In Ecuador, you can join the IESS social security plan—despite pre-existing conditions. A couple will pay just about $80 a month for that…and it includes prescriptions.

When you retire overseas, you’ll save on both healthcare costs and on general costs of living. So why wouldn’t you at least consider it?


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