re: Why can't we have stuff like this?

Yes. I think I may do this as well if Im able.

Not sure but it was large, pristine, modern and relatively near the river. Not Bumrungrad. Hotel staff literally forced me to go by tuk tuk because I was delirious. I believe it was the closest to death I've ever been.

Cause and effect
With hospitals needing to complete for their business models because of losses and stress caused they started consolidating whether by choice or survival. As people dropped their money into investment houses/hedge funds the black rock of the world started buying and forcing their will upon. This isn’t just hospitals but everything they can. Look back into the 60’s-80’s and then look at 90’s forward, you can see the expansion in Wall Street and the demise of local & regional businesses

When in Bangkok we always stay in/near Banglamphu, directly on the river. I wasn't feeling well, had an irregular heartbeat, no energy, etc. I asked the hotel staff where I could go get it checked and they sent me to a hospital that sounds like what you describe; supposedly the royal family used this place. We crossed the river on a river taxi and it was about a 10 minute walk further. They took my info, made me a plastic card, like a credit/ID card, and I waited about 45 minutes before I was seen. Blood pressure and temp were taken, and the nice lady doctor asked me some questions. Everything was okay. When I returned to reception to pay the guy just said, "No charge." It had to have been a public hospital because there were rows of people in hospital beds lined up in this big open area and they looked to be pretty poor. Families were there with them, etc. Another time I took my wife to another hospital in Konchanaburi to get a wound treated and we got great service there with little wait; cost around 7 euros.

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The first two questions, I don't know. However, regarding this, Bumrungrad Hospital, Bangkok Hospital, and others are regarded as private hospitals and available only to those who can afford or have insurance. There are "public" hospitals that are free or significantly less expensive, and those are where the low income patients go. Those would take those indigent cases. But wait times for those hospitals for the low/no income are looooooong. Those are the ones funded by the government, I think.

Bumrungrad is "private" hospital but it is publicly owned and traded on the Thai stock exchange. And it is not a large conglomerate of hospitals. It is one hospital, as far as I know.

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Thanks! Respectfully, I think you have (at least in part) answered your own question with that answer. The private sector has a profit motive but that can compete with quality. The shift in how government views, funds and interacts with healthcare is why costs in the US have increased so much.

One problem, at least as I see it, is EMTALA (Emergency Medical Treatment and Active Labor Act).

This law applies to nearly all US hospitals (over 98%) because it covers any hospital that participates in Medicare by accepting Medicare payments. It does not apply to non-hospital settings like private doctor's offices, urgent care clinics, outpatient centers, or ambulatory surgical facilities unless they have an on-campus emergency department (ED).

Hospitals must provide an appropriate medical screening examination to anyone who comes to their ED and, if an emergency medical condition (including active labor) is identified, they must stabilize the patient before discharge or transfer. This holds true regardless of the patient's insurance status, citizenship, or ability to pay and those criteria imposed by EMTALA have specifically led to the closure of hundreds of EDs and hospitals over just the last 30 years (this has been especially true in the Southwest where the anchor-baby issue -and issues of illegals showing up at ERs for even minor issues- is far more prevalent).

To underscore this, for the 40 years before EMTALA, the average hospital closures per year was 20-25, post-EMTALA it's 30-35. For just ER's it went from 5-7 closures per year to 38-43 per year.

Over the same time period (80 years), the cost of medical school has skyrocketed. When adjusted for inflation (2024 USD) the average medical school tuition looks something like this:

1945 - $8,713
1960 - $7,943
1981 - $20,221
1995 - $37,596
2010 - $58,121
2024 - $59,720

One of the big drivers is how government funding for part of medical school tuition shifted from States to the federal government in the late 70s/early 80s. A problem here is that once the federal government assumed that burden, it then began dropping it and states did not take it back up (largely due to the 1980s recession). As that continued, the percent covered by the totality of both levels of government dropped from 40% to ~15% today. Along with that, grants and scholarships haven't kept pace with the percentage of costs they cover. This has led to more debt for medical school, which means medical professionals have to charge more to make ends meet.

Another big driver is that even though applications to medical schools has increased over the years, the growth of available seats hasn't kept up proportionally.

To bring all of this into an economic nutshell: we've seen the government's approach change from funding supply to funding demand. When that happens in any industry, price goes up. And now it's so bad that people believe healthcare is impossible without healthcare insurance (which feeds demand even more).

well i'm a 64 year old white male living in the united states, and i had 140k dollar open heart surgery and my out of pocket was $2,600.00 give my regards to your mail order bride loser i'm sure it's almost like being loved!

I don’t know the cost, but “one stop” medical exams such as yours are available. Some companies and law firms require them for certain senior people in their organization.

Medical costs in the U.S. are high largely because of inefficiencies and complexities in delivering services. The insurance industry and its unholy marriage with healthcare is likewise a cause of higher prices for care. I don’t have the detailed, comprehensive solution at the moment,, but I’m pretty sure it will enrage those on the far Right…

just fyi i get the exact same thing at my pcp, with the exception of the Ultrasound Whole Abdomen and Eye Exam (Acuity and Tonometry) by ophthalmologist in Health Screening Center right here in little rock arkansas for a $20 co-pay, if you ever decide to give up the sex tourism thing and come home, things aren't as bad here as you think.

Take out am expensive life insurance policy, at your age, they'll do most of that. When you get the results back, decline the policy.

Problem solved.

ETA: it won't be free, you probably have to pay a one month premium.

EKG and ultrasound were under $500, cash for me. An US by itself is $100. All of the other blood tests can be done at Labcorp for about $100.

One of the problems with these kinds of threads is that almost everyone doesn't look at cash prices, but at insurance led pricing.