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here is no nationalism when it comes to pain; no distance is too far to travel for a cure when money is not an issue. For some better-off Indonesians patients, better healthcare is usually one flight away.

“They wanted to cut into my chest first then specify the cost of the surgery afterwards,” Widjil Trionggo, 54, said of his experience consulting with cardiologists at a hospital in Jakarta.

The doctor suggested that Widjil, who had blocked arteries, undergo balloon angioplasty, in which doctors would place stents in his arteries.

“They said they didn’t know how many stents they would need to put in my chest,” he said.

Discouraged by the prospects of not knowing the cost of his surgery in advance, he flew to Penang, Malaysia, where doctors suggested he undergo bypass surgery.

Another medical tourist, Siaw Kian, 57, said that she preferred to obtain healthcare abroad rather than near her home in Jambi since overseas hospitals offered better service — and prices — than the best hospitals in Indonesia.

“Service is fast. We had good information on what the doctors wanted to do and the charges were almost similar, or even cheaper than if we had gone to hospitals here,” she said.

After her son broke his arm, Siaw Kian took him to a hospital in Malaka, Malaysia, where she said she paid doctors about 5,000 ringgit (US$1,652) to install a rod to help the broken bone mend.

An international hospital in Indonesia wanted to charge the same amount to remove the rod, Siaw Kian. She and her son then returned to Malaysia, where the hospital charged 2,000 ringgit for the procedure.

Seeking medical treatment abroad has become a common practice for certain Indonesians. For those who live in Sumatra, treatment in Penang or Malaka is a convenient option. Richer patients from Jakarta can travel to Singapore for treatment. Indonesians spend about Rp 100 trillion (US$11.5 billion) a year for healthcare abroad, according to the Health Ministry.

Nur Rasyid Lubis, the deputy director of Adam Malik Hospital in Medan, North Sumatra, said that it was common for local residents to seek healthcare abroad.

“People want quick service, or quality service that matches the charges, so they go abroad. After all, Malaysia and Singapore are quite close,” he said.

Competitive hospital fees in Malaysia have attracted more and more Indonesians. According to a report published by the Frost and Sullivan business research and consulting firm, Malaysian hospitals treated 288,000 Indonesian patients in 2008, up from 221,538 patients in 2007 and 170,414 in 2006.

Meanwhile, Singaporean hospitals treated 226,200 Indonesians in 2007, down from 266,500 in 2006.

Several tour operators offer specially tailored packages for patients. Major private hospitals in Malaysia and Singapore have special referral systems and international customer departments that specifically cater to the needs of international patients.

The hospitals work with reputable travel agencies and hotels to provide comprehensive tour packages along with healthcare services.

Travel agents can also arrange such services, since they can accept fees from hospitals.

Reza, who works for a travel agency in Bandung, West Java, said his company has been cooperating with hospitals abroad to offer medical tourism packages since 2004, after Malaysian low-cost carrier Air Asia offered service to Indonesia.

One medical tourism packages he offers clients is a three-day, two-night stay in Malaysia for $500, which included the cost of the air travel, hotel rooms and an examination.

“At first, people bought medical tourism packages to go to Singapore. But recently we have had more people interested in going to Malaysia for medical examinations because their prices are more competitive,” he said.

Reza said his company could sell between 10 and 20 medical tourism packages a month.

However, he added, due to Internet-savvy customers and competition between travel agents, the number of his customers has been declining.

“People who are used to traveling can check on the Internet and arrange their own travel. The travel agents have to be creative to attract consumers,” Reza said.

Apriadi Gunawan contributed to this report from Medan, North Sumatra