Living in Thailand has changed how I think about Canadian healthcare, especially preventative medicine
I'm Canadian, but I live in Thailand. I'm heading to Bangkok soon for what is basically a full medical workup.
And to be clear: I'm not sick.
Nothing is wrong that I know of. I'm just getting older and decided I'd rather find out if something is starting to go wrong before it becomes something serious.
There's also a very personal reason I think this way.
My wife died of cancer.
It was growing slowly and silently inside her. By the time she had symptoms, by the time there was an obvious reason to start looking for something she was already Stage IV.
So when people talk about preventative medicine versus treating illness after symptoms appear, that distinction isn't theoretical to me. I've seen what "wait until something is wrong" can look like.
That's a big part of why I'm doing this while I feel perfectly healthy.
Here's what I'm getting:
- Full physical examination with an internal medicine physician
- Vital signs/BMI
- Ophthalmologist eye screening
- Audiologist hearing screening
- Complete blood count
- Fasting blood sugar and HbA1C
- Full lipid profile
- High-sensitivity Troponin I
- Kidney function
- Full liver function panel
- Thyroid panel
- PSA, CEA and AFP tumor markers
- Vitamin D
- Urinalysis
- Stool examination and occult blood
- Chest X-ray
- Whole-abdomen ultrasound
- Bone density scan
- EKG
- Ankle-Brachial Index
- Exercise stress test
- Carotid Doppler
- Low-dose CT lung cancer screening
- Colonoscopy
- Cardiologist consultation
- Radiologist consultation for the lung CT
- Internal medicine consultation to review everything
Total cost, including the tests, specialists and hospital fees: 51,000 Thai baht or roughly C$2,150.
And this is where living in Thailand has changed my perspective.
I absolutely support Canada's universal healthcare system. I don't want a system where someone avoids an emergency room because they're worried about the bill, or where getting cancer means potentially bankrupting your family.
But Canadian healthcare is, in many ways, reactionary rather than preventative.
If I'm sick in Canada, or for example have occult blood in my stool the system will investigate and treat me. If I develop symptoms that justify a CT scan, cardiac testing, specialist referral or colonoscopy, those things are covered, albeit in the absence of a critical illness it's not going to happen quickly.
But walking into my doctor's office while feeling perfectly fine and saying, "I'm getting older. I want to know if there's anything going on inside me that we should catch early"?
There's virtually no chance I'm getting this entire workup.
And that's the contrast I find interesting.
Thailand has universal public healthcare for its own population too, but it also has a huge private medical system where I can essentially say: I'm healthy, I want a comprehensive baseline, and I want to look for problems before they become problems.
I make an appointment, pay C$2,150, and get the whole thing done.
I'm not arguing that every one of these tests should automatically be given to every asymptomatic Canadian every year. There's legitimate debate about over-testing, false positives, unnecessary procedures and whether some screening actually improves outcomes.
But there's also something strange about a healthcare philosophy where we can spend enormous amounts of money treating advanced disease while making it difficult to investigate your health comprehensively when you still feel fine.
And yes, I understand that screening doesn't guarantee anything. My wife might have had exactly the same outcome even with more testing. I'll never know.
But having watched someone I loved go from apparently healthy to a Stage IV cancer diagnosis because the disease didn't announce itself until it was advanced, my perspective is pretty simple:
I'd rather spend money looking for smoke than wait until the house is on fire.
That's the part of preventative medicine I've come to appreciate, and something that Canada needs to seriously look at. Because honestly, doing this kind of testing will not only save lives, it will save money. Treating people with illnesses that are discovered early is a MUCH cheaper scenario than treating the critically ill.