If I get sick, I'm moving to Malaysia
My experience in a Malaysian hospital and why it was so much better than in the US.
My husband and I showed up at the Malaysian hospital at 8:30 am and were given a checklist of things we wanted to get tested.
I selected:
Full cancer screening
Pap-Smear
Ultrasounds for the ovaries, uterus, lower and upper stomach
Ultrasound for breasts
Chest x-ray
I paid $342.46. My husband paid $246.56 for a version without the women’s health checkups.
I was given a set of scrubs and rotated through the clinic. First, the blood test because I was fasting, then water to drink for my ultrasound. My abdomen (lower and upper) and breasts were checked out by one ultrasound technician who explained what she was seeing in real time. Then I peed in a cup before rotating into the gynecologist for my pap smear and the technician for my chest x-ray. There were fewer than five minutes between each visit, and each was only one room apart.
It was 11 am.
After that, we were given a catered lunch in the cafeteria, and could choose to visit whichever specialist we liked. They were all located in the same building, so I headed for the neurologist while my husband went to see the dermatologist and gastroenterologist. I get aura migraines and my doctor wanted a brain scan, so he scheduled an MRI for 2 pm—yes, the same day. I went downstairs for the MRI, then came back up to the neuro office so he could review the results with me. The whole visit, including MRI, cost $312.30, and gave me a very in-depth understanding of what was going on in my head. Meanwhile, my husband’s dermatologist pieced together ailments his US doctors couldn’t and ordered him some prescriptions while his gastroenterologist ordered testing. He paid $151.67 including prescriptions.
At 4 pm, we headed back to the screening room where we got the results from all of the tests we completed that day. We each received a neat packet filled with our blood test results, scans, and diagnostics, and a doctor ran through all of the results with us in great detail.
All said and done, we were at the hospital from 8:30 am to 5 pm and spent $1,052.99 total, for two people with no insurance billed. We saw every doctor we could want to see immediately, without appointments and without referrals. The neurologist was the only doctor I had to wait for—his staff profusely apologized that he was the only one in the office that day—and I only had to wait half an hour. Appalled that none of my doctors back home ever asked for an MRI, my neurologist said, “We have the best medical system in the world, and somehow the West still doesn’t know about it.”
Every doctor, by the way, spoke perfect English.
If you live in the US like me, you already know how incredibly foreign this sounds. At home, I waited six months to get a pap smear, and when they wouldn’t see me because I was on my period, the next available appointment was six months later. When the gynecologist wanted imaging and referred me to an ultrasound, I had to wait another month for the appointment. Whoever completed my ultrasound wasn’t actually a qualified doctor who could tell me anything about what we were looking at. She kept saying things to her colleague like “Let’s measure that,” before rattling off dimensions to her colleague. When I asked what she was measuring, I was told the doctor would need to look at it and get back to me.
I didn’t get my results until three days later, and no doctor called to explain the results. I received online messages from a nurse practitioner that I had an ovarian cyst that wasn’t considered dangerous unless it grows or causes my ovary to twist—no other abnormalities were detected.
Ok… so do I need to be monitoring for this cyst for “growing” or “twisting”? Do I need to check back in in a couple years? ChatGPT says yes, but that’s all I have to go on. To get the same testing done again I’d need another doctor referral, which means another gynecologist visit, which means another very long wait cycle, and all for something I’m not sure I need. On top of that, I’m not sure it’s worth the stress. I nearly died from anxiety waiting to learn that I wasn’t going to die from ovarian cancer—thank goodness it wasn’t anything serious!
By the way, I spent $1,106.63 for that gynecologist visit and ultrasound, and that’s just the portion I paid out of my own pocket. The rest was paid by our health insurance provider, which was also very expensive. At the time, my husband’s employer was deducting $500 from his paycheck each month for health insurance that was “provided by his work.” That’s $6,000 a year we paid for coverage that didn’t cover much of anything. And this, as two healthy people with largely preventative needs, and with “good” jobs and “good” insurance.
I didn’t get my money’s worth. I paid for very expensive imaging of my uterus and ovaries and didn’t even get to see the images, much less receive an explanation of what was going on in them. It was like paying for extremely marked-up wedding photos only to never get the photographs back.
Malaysia, however, has one of the best medical systems in the world. In addition to being a developed country with technologically advanced hospitals, they have one very important kicker: They are incredibly efficient.
You might have noticed from the stories above that, just to get an ultrasound of my ovaries in the US, I had to deal with several different administrators, working in several different office buildings, over a span of several months. I didn’t see a doctor on any of those visits—they only (hopefully?) reviewed my test results like some ominous Wizard of Oz behind the curtain. I didn’t even mention that, to get a mammogram, I had to see a separate doctor on a separate day, and when those results came back inconclusive I had to schedule another visit with another ultrasound technician. Meanwhile, in Malaysia, I went straight to the ultrasound specialist without a referral and they checked my ovaries, uterus, and breasts all in one visit. All while telling me what they were looking at in real time.
What gives?
Despite what everyone thinks, we can’t boil this all down to socialized medicine. Canada has long wait times just like the US, even though it has socialized medicine and the US doesn’t. What Malaysia does differently from both countries is simple: They eliminate the maze of gatekeepers, put all disciplines under one roof, and give patients open access to all doctors. This takes much less of everyone’s time, which makes care much less expensive to provide.
The US and Canada are like a car manufacturer that produces every part in separate warehouses—one for engines, one for tires, another for doors—then ships them all to another facility for assembly. That car will be much more expensive to make no matter who is paying for it—whether insurance companies in the US, or the government in Canada. But a vertically integrated manufacturer that makes and assembles all parts under one roof will produce more cars, faster, and with less waste. That car will be much less expensive, both for the manufacturer who makes it and the customer who purchases it.
Malaysia’s healthcare system works like that. By keeping all the parts—doctors, specialists, imaging, and diagnostics—in one place, and allowing open access to them without referral or gatekeepers, it eliminates the cost inefficiencies of the US and Canada.
After we experienced it ourselves, my husband and I both agreed that, if we ever came down with something serious like cancer, we’d feel much more comfortable moving to Kuala Lumpur for the duration of treatment, knowing we would be significantly better cared for at significantly less cost. It would be cheaper to fly to the country and stay there for a year than it would be to get the care in the United States, and we wouldn’t have to worry about lengthy wait times to schedule treatments and surgeries. This made me realize I’m more afraid of having to deal with the US healthcare system than I am of actually getting the disease. It’s the anxiety around getting care that feels so stressful.
While in Malaysia, my husband learned that he had several elevated indicators that needed to be tested again in three months—unfortunately we wouldn’t be in Malaysia by then. “American healthcare is rubbish,” one of our doctors said. She apologized that we’d have to go through a web of providers in the US to get our final results. Sure enough, when we got home, my husband had to pay $967 for a series of blood tests that included the results he needed—even then, no clinician went over the results with him. He had to upload them to ChatGPT for analysis.
In case you’re keeping track—so far we’re at more than $8,000 for the very limited scope of care and lackluster results I received in the US, compared to $500 I spent in Malaysia for incredible care and near full-body analysis and understanding.
An inefficient medical care system is a fixable problem. Malaysia removed all of the barriers to getting care and made the experience more efficient in the process. Their system is socialized, and Malaysian citizens enjoy free or nearly free access to healthcare, but the US doesn’t even need socialized healthcare to get the same results. We need to change how the factory runs, not just who is funding it. If we don’t, we’re only hurting the American people who either suffer through the inefficiencies or bail to get better results elsewhere.
Thanks for reading,




The cost difference between US medical care and Malaysia medical care is shocking and the level of customer service is also shocking. I spent a couple years in Penang as an expat. My 80-something year old father took a fall on a nature walk. We took him to Penang Adventist Hospital. 2 nights in the hospital, multiple CT scans, full diagnostic workup, neurologist consultation and more cost just over 3k USD. That would likely be close to 6 digits in US.
To @Rachel Ooi's point it's not all roses. I found medical care to be far more cash-and-carry in SE Asia. But at least it's not 6 digits US every time you go to the hospital.
I just had prostate cancer surgery in US. I have not seen the bills yet but I'm expecting well into the six digit range for that. I was in and out of the hospital in 7 hours.
Elle - I've followed you for a long time, I love your writing. This is so eye-opening. You come up with the most wonderful ideas and expose so many inefficiencies.
Want to do one an article on school systems next?