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1. Similar to the pioneering Hackett-Hemwall protocol of prolotherapy, often referred to as the “sewing machine” approach.

HOW TO PAY

FOR A BEACH

VACATION WITH

ONE HOSPITAL

VISIT

I wish we were all naked all the time. I have always believed it’s what’s underneath that counts.

—Celine Dion

Edwin loved Celine Dion and seemed happy to tell someone about it.

During his radiology training in Iowa, he’d seen Stone Cold Steve Austin at the WWE, one dream fulfilled, but Celine Dion was still on his to-see list.

“We have a lot to do! Please don’t move. Here we go …” Edwin was also my MRI technician and companion for the next four hours. It was a long time to be horizontal, but the surroundings were beautiful. Hospital Metropolitano Vivian Pellas, a pristine private hospital in the center of Managua, Nicaragua, couldn’t have been nicer.

I’d come to Nicaragua almost three weeks earlier to focus on writing and world-famous surfing. The Kiwi, of Perfect Posterior fame, and I had rented a hillside villa with a pool overlooking the ocean. To skip the crowds at the beaches, we chartered a boat with a captain to the best secluded surf spots up the coast. En route home, the captain also helped us catch and clean fish our private chef could prepare for dinner.

Now, it was 12 hours before my return flight to San Francisco, and I was going to pay for the whole thing with one trip to the hospital.

An Introduction to Medical Tourism

Let’s look at the math to see how this is possible. First, the per-person expenses in Nicaragua:

EXPENSES

Round-trip Orbitz airfare to Nicaragua from San Francisco (one stop in Houston)—$385 + taxes

Chartered boat (per trip per person)—$20

First week housing ($2,000 per week for nine people in a 14-bed villa owned by a former NBA player)—$222 per week

Second week housing onward (gorgeous two-bed villa closer to downtown [www.palermohotelandresort.com])—$129 per night

Land Rover rental (per person)—$140 per week

Total for two and a half weeks, excluding food—$1,812

I’ve excluded food above to show costs above what I would have spent in the U.S. anyway, as I eat out at least two times a day in San Francisco. Here is the grand total:

Total for two and a half weeks, including food and wine (+$600): $2,412

So how do we get back to break-even and make the trip, in effect, free?

MEDICAL SAVINGS

I had seven MRIs taken at a negotiated price of $400 each. For comparison purposes, similar MRIs in San Francisco would have cost approximately $750 each, so 7 × $350 savings = $2,450 total cost savings.

I also saved roughly $640 on comprehensive blood and urine testing by having it done in Nicaragua rather than the United States. Thus, my total savings on medical expenses came to $3,090.

I enjoyed a surf trip in luxury, got a ton of writing done, and then took care of testing and imaging that I wanted to do anyhow. The total cost savings of $3,090 put me ahead (in essence, gave me a profit on the trip) of $687.

“But,” you might rightly point out, “what if I’m not a freak who wants seven MRIs?”

First, despite urban myths to the contrary, there is no radiation risk with MRIs, and I would therefore suggest one or two of them for nagging pains or injuries. Not to mention the preventative value: ask any cancer survivor if they wish they’d had MRIs earlier.

But MRIs aside, the beauty of this geographic arbitrage is the menu of options.

I never seriously considered medical tourism before 2009, as I didn’t have pending surgeries I couldn’t afford, nor did I want cosmetic procedures (butt implants, anyone?), which medical tourism agencies have made popular.

Testing and prevention, though, opened up a world of combining world-class travel with world-class medicine.

Due for a dental cleaning and checkup? Perhaps you want to run comprehensive blood work, which I recommend no less than every six months? Consider making a kick-ass trip out of it. That same exotic dream trip, something you might otherwise postpone forever because of expense, could end up as good as free.

Perhaps the lure of travel is