Before we get into a list of pros and cons I want to be perfectly frank. My experience with medical care in the US has been less than stellar, cost aside. My mother rests her soul went into a high-end hospital in Orange County for minor surgery, caught a staph infection, and lost one eye. I am not purposely trying to be harsh about US health care, but it is the only other experience I have to draw from.
My overall experience in Bali for the last 16 years has been much better. I have heard foreigners bad mouth the system here but have personally not found a justification for that. A big part of that may be the language barrier, although many of the doctors here are trained abroad and speak English. My advantage is I have an Indonesian wife who navigates all that for me. People who choose to stay at Aahh Bali Senior Residence can use their personal assistant if they opted for one do the same for them, or Google has a pretty good translation app. It makes a huge difference. In this article, Universal plans refer to the National Health Service.
PROS OF MEDICAL CARE IN BALI
1. The medical care in Bali whether you choose to self-insure using public hospitals or private or the Indonesian Health care system cost is going to be dramatically less than you are used to coming from a country without a Universal Health Care System.
2. So the first Pro has to be the unbelievably low cost. I had a prostrate sonogram recently at a private hospital. The total wait and procedure time was about 2 hours, from walking in to walking our. It cost me $35 without any type of insurance.
3. Medication is a fraction of the cost in the US and many things are available without a prescription, such as antibiotics, statin drugs, ED medication, and much much more. If it is nonaddictive it is probably available without a prescription. EX: A statin med I was paying $130 a month for is 7¢ a pill here. The average cost of insulin is $28, and these are without medical insurance.
4. Indonesia offers universal health care that includes dental and vision. This is not available to tourists but can be to those who plan to stay long-term. Once you commit to a long term stay and apply for a KITAS retirement visa, you can also apply for Universal Healthcare. It’s called BPJS Kesehatan. (Link) To give you an idea with Class 1 coverage (the best) a hospital stay has 0 deductible. It’s free. And the premium in Rp150,000. At the current exchange rate that’s $8.55 a month. You will have longer wait times on the public healthcare than private, but probably not more than you would in a US ER. You can call ahead and get a number in the queue so you don’t have to sit there the whole time. The only caveat is that if you miss your call you start over in the queue.
5. Indonesian Universal health care includes medication and there is no co-pay for anything.
6. Want a quick check on your blood sugar, cholesterol, and uric acid? Under $10 at a pharmacy, or here at Aahh Bali we have test kits.
7. In Bali you have a choice between private and public. Private obviously means out-of-pocket and the public can be covered by the Universal health plan once a person qualifies. If you were paying out of pocket for the public, the private would not be dramatically more expensive. Tourists are usually drawn to (at their peril) private Western-run clinics like SOS or BIMC, which charge US-like prices and have a spotty reputation. However, the Mayo Clinic is opening a branch in Sanur (south Bali), and Bali is gearing up to be a medical tourism destination.
8. Indonesia’s Universal insurance is similar to any other national health service like the UK, Australia, and Canada, which have their pluses and minuses.
9. Dental care is covered under the universal plan but does not include cosmetic things or cleanings. Cleanings run about $35 but I must say it is the best I have ever had. People come here from Australia to get their dental care. Dentists here are amazing, at least the ones we would recommend. Gentle, painless, and very reasonable. I got 2 bridges and an implant for what one implant would have cost me in the US. They also will not suggest you do things that are not absolutely necessary.
10. In general I have felt the doctors here are much more caring, less arrogant, and less mercenary than I am used to.
CONS OF MEDICAL CARE IN BALI
1. First and foremost do not expect the public hospitals to be pretty. Most, on the surface, appear run down and in need of repair of the physical building. Mostly paint and broken tiles. However, I can assure you they are clean. There is an old saying “just because you may be poor, you don’t have to be dirty”. Research has shown incidents of staph infections in Indonesia were scarce whereas 20,000 deaths and 120,000 cases were reported by the CDC in the US. So seemingly run down, they have an abundance of cleaning staff and a very good patient-to-caregiver ratio. Private facilities tend to be better maintained.
2. Just like anywhere, all hospitals can not do all things. You may be seen at one place and if they don’t have the facilities for a particular test or treatment you will be referred to somewhere else. Our rural hospitals can do most normal things, but a referral to Denpasar is not uncommon.
3. Long waits are not uncommon in Universal plans. You can get a number in the queue online in most situations. Long is also relative. I’ve waited up to 6 hours in a US ER, but never that long here. ERs here like anywhere are triaged and the most critical are seen first. One thing I have not found here. I’ve often heard of long waits to get seen in other countries for universal health care and in the US. I have not had that experience here. Waits for an appointment are relatively short as are being seen by specialists. My daughter in the US has had to wait 6-9 months to see a specialist. Here, usual worst case is weeks.
4. Indonesian hospitals probably will not have the most cutting-edge equipment, but the basics are there. If you require something they don’t have Jakarta is two hours away and Taiwan is ranked second in the world and is five hours away. FYI, the US is ranked 30th and Indonesia ranks 52. Like anywhere the bigger the city the more resources they have.
5. Indonesia’s Universal insurance is similar to any other national health care service like the UK, Australia, and Canada, which have their pluses and minuses. But the monthly fees are unbelievably low. I will put this on the Pro side as well.
