The Jordan Harbinger Show - 1348: Medical Tourism | Skeptical Sunday

Episode Date: June 21, 2026

Though cheap surgery overseas sounds like the ultimate life hack, Nick Pell takes a scalpel to the potential perils of medical tourism on Skeptical Sunday.Welcome to Skeptical Sunday, a special edition of The Jordan Harbinger Show where Jordan and a guest break down a topic that you may have never thought about, open things up, and debunk common misconceptions. This time around, we’re joined by writer and researcher Nick Pell!Full show notes and resources can be found here: jordanharbinger.com/1348On This Week's Skeptical Sunday:How the "ultimate life hack" hides a brutal trade-off. Flying abroad for a 70% discount on a medical procedure means leaving behind malpractice law, insurance, and safety oversight. The money you save is often the safety net you lose, with no undo button and no legal recourse when something goes wrong.Why medical tourism brokers act more like salesmen than surgeons. Anyone can call themselves a "facilitator" with zero licensing, then pocket 10 to 40 percent commissions for steering you toward the highest-paying clinic rather than the cleanest one, often with an influencer doing the marketing.What the glossy recovery photos leave out. Survivorship bias buries the waterborne infections, wounds that won't close, and fatal embolisms. BBLs are the deadliest cosmetic procedure on record, and many botched jobs land back in US ERs, where your premiums quietly cover the six-figure repair.Why the darkest edge of this market runs on organ harvesting. Chinese sites promise new kidneys in weeks, a timeline that's biologically impossible unless you know when a donor will die. Investigators tie it to forced harvesting from Falun Gong and Uyghur detainees treated as living spare parts.How to vet a clinic before you book the flight. Start with CDC medical tourism alerts, confirm JCI or ISAPS accreditation, and verify the surgeon's license on an official government registry. Insist on hospital admitting privileges, and budget two to four weeks of recovery before flying home.Connect with Jordan on Twitter, Instagram, and YouTube. If you have something you'd like us to tackle here on Skeptical Sunday, drop Jordan a line at [e-mail] and let him know!And if you're still game to support us, please leave a review here — even one sentence helps! Sign up for Six-Minute Networking — our free networking and relationship development mini course — at jordanharbinger.com/course!Subscribe to our once-a-week Wee Bit Wiser newsletter today and start filling your Wednesdays with wisdom!Do you even Reddit, bro? Join us at r/JordanHarbinger!This Episode Is Brought To You By Our Fine Sponsors: Zazzle: 25% off first order: Zazzle.com ConciergeMD: 20% off all services/memberships: conciergemdla.com/jordan, code JORDANSimpliSafe Home Security: 50% off + 1st month free: simplisafe.com/jordanWhatnot: Start selling today: whatnot.com/sellSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Welcome to Skeptical Sunday. I'm your host, Jordan Harbinger. Today I'm here with Skeptical Sunday co-host writer and researcher Nick Pell. On the Jordan Harbinger show, we decode the stories, secrets, and skills of the world's most fascinating people and turn their wisdom into practical advice that you can use to impact your own life and those around you. Our mission is to help you become a better informed, more critical thinker. During the week, we have long-form conversations with a variety of amazing folks, from spies to CEOs, athletes, authors, thinkers, and performers. On Sundays, though, we do Skeptical Sunday, a rotating guest co-host, a night. break down a topic you may have never thought about and debunk common misconceptions about that topic. Such as astrology, recycling, toothpaste, diet pills, and energy drinks. If you're new to the show or you're looking for a handy way to tell your friends about the show,

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to get started. Today on the show, you might have seen episodes of botched where Dr. Debrough and Dr. Nassif have to piece somebody back together after a bargain surgery went south. In fact, a contributor in a way of our own show had to deal with that. At one point, we'll get into that later. Usually that story starts with a flight to another country and a price tag that seemed a little bit too good to pass up. On today's skeptical Sunday, we're talking about medical tourism. On the surface, it's the ultimate life hack, right? You fly to Turkey, you fly to Mexico, you get a Brazilian butt lift or a new set of veneers for 70% off and you recover on a beach somewhere, maybe on your stomach if you got the BBL.

But it's the dream sold by influencers and reality TV alike. But behind the filtered recovery photos is a massive global industry that relies on wage arbitrage and a total lack of legal oversight. When you leave the country for a procedure, you're also leaving behind malpractice laws, insurance and safety regulations. You're essentially betting your life that nothing goes wrong because if it does, there's no undo button and no legal recourse. Today we're talking at the true cost of these savings.

We'll break down why the complications are often socialized by U.S. hospitals, while the profits stay private. We're also going to take a look at the darkest edge of this marketplace with the lack of transparency leads to genuine human rights horrors like forced organ harvesting. It's a look at what happens when the human body becomes just another link in the global supply chain. Here today to help me separate the cosmetic from the chaotic is writer and researcher Nick Pell. Nick, how many CCs did you get for your Brazilian buttlift?

Zero. I just got a ton of tattoos, but my wife really wants a ton of procedures. So saving my pennies for that. Yeah. Every single episode of Skeptical Sunday contributes to what your get my wife, freakishly large boobs fund? Yes, that is actually exactly what she wants. And freakishly large is a good way of putting what she wants. Okay.

My wife's desire to transform herself into a. walking advertisement for a Beverly Hills plastic surgeon is kind of why I know a lot about these procedures. And we've actually had conversations about exactly why she will not be flying to Turkey to get a thousand ccs of silicon put in her boobs. That's weird though, because we both know you guys love a bargain. We do love a bargain, but I like having a living wife better. Sure. Even if you trust a doctor in Bolivia, which, by the way, I don't. There's, tons of other issues, you're going to run into getting plastic surgery abroad in the best case scenario. Yeah, I think it's important to point out that there are tons of countries where you can

do medical tourism that's super safe. You know, I can go to Taiwan and get probably around 20 grand worth of health checks for like $4,000. I know that's still expensive, but stuff like scans for early stage cancer, tons of blood work, MRIs, CAT scans, CT scans, whatever, tons of exploratory stuff. I mean, I had like a thyroid scan and they're like, you have little things in there that we got to check up on in a year or two because that might be nothing. It's probably nothing, but it could also be like stage zero cancer, basically. And so like I'm going back this year and if it's bigger, they're going to do something about it. And if it's not, then they just let it go. And the truth is most people have something like that. You just find out about it when it's all over your body and you have to do chemo or you're going to die. So I'm like, let me get ahead of that. And Taiwan has the third. best health care system in the world, at least on the rancor that I took a look at. So it's not like, I'm not flying to a Caribbean island to get a dick implant. All right, anyway, what are some of the differences between the American health care system and health care systems abroad, just generally, besides the fact that ours is super expensive and everybody complains about it. I'm not,

you know what I'm talking about. Yeah, malpractice laws is the big one. Laws in general. It's a pain because malpractice insurance and litigation drive up the cost of American medical care, I'm sure you know because I'm sure you've heard doctors talk about it. Sure. But they also mean that you have a recourse if things go wrong. So if you're getting a thousand ccs of silicone pumped into your chest in Bolivia, there's a lot of things that can go wrong. Right. And people aren't thinking about that when they see somebody got a BBL in Thailand for a thousand bucks using basically a group on they found on Instagram.

In fairness, I'm sure tons of people go abroad, save a few bucks, get the exact same percentage. they wanted and they're fine, but you're taking a massive risk. The world's best doctors are in the United States. I'm not really aware of anybody who disputes this. This is especially true when you're talking about unnecessary elective cosmetic procedures. Countries with single payer and other forms of not for-profit health care just do not have the same robust market for doctors that we do in the good old US of A. Before people jump on me for this, according to news, week out of the top 10 hospitals in the world, four of them are in the United States. Okay. Johns Hopkins, Mayo Clinic, Mass General, and the Cleveland Clinic. Doctors in the

United States perform roughly 22% of all global cosmetic surgeries, 7.4 million procedures annually. And when it comes to plastic surgery, volume correlates heavily with skill. American doctors are just getting their reps in in a way that doctors abroad are not. Yeah. Okay. So I want to also just sort of say, like, we're not saying, hey, doctors in Turkey and Thailand are bad and they're going to kill you. This is, like, exclusively cosmetic surgery that you don't need and the skill of the health

system as a whole, not like the doctor that you are or your cousin is or you used in Bangkok is automatically terrible. I don't want to get emails about that because I was like, that's like not one. And the risk of getting an MRI is like zero. Right, yeah. Like if you're getting an MRI in Turkey, it's fine, unless they're bashing you over the head with a hammer or something when they put you in the machine. Like, it's fine. We're talking about a clinic in, I mean, the thing is, there's like guys in Mexico doing five BBLs a day and they're getting their reps in, Nick, but I worry that some of them might not actually be doctors. And that's kind of where I'm going with this. Not like, oh, Mexican doctors aren't real doctors, but like, no, this person is a, guy who dropped out a nursing school in the United States and went, screw it. My cousin runs a clinic in Tijuana, and he can show me how to inject silicone into somebody's butt. This isn't that hard. And they're doing a bunch of those, but yeah, that's not because they're qualified. It's because

there's nobody stopping them. So do we know how many people are engaged in medical tourism every year? The Medical Tourism Association estimates roughly 14 to 22 million people a year travel internationally for medical care. Medical tourism is valued at approximately 40 to 48 billion in 2025 and is currently growing at between 15 to 20 percent annually. As of 2024, 2025, estimate suggests that over one million Americans are again crossing borders for medical reasons. I can't even believe there's a medical tourism association. What is that for? Advocacy Group, I guess. It's a nonprofit trade organization. Okay.

Dedicated to medical tourism and the international patient industry and it's headquartered in drum roll. Yeah. West Palm Beach, Florida. Zero. I was going to guess Miami, but I think West Palm Beach is like basically that. But like, yeah. Okay.

So what are the biggest destinations? What are the biggest destinations for medical tourism? Mexico gets over a million international patients a year. Most of these are from the U.S. and Canada. Thailand is getting over 3 million annually. That's the big spot in the Asia Pacific region. Turkey sees hundreds of thousands of visitors a year, specifically for hair transplants.

They do about 1,500 of these every day. Wow. Stomachs, weight loss procedures is another big one. And South Korea reached a record high of 1.17 million foreign medical tourists in 2025. Someone close to me went to Turkey for a hair transplant, and I have to say they crushed it. It was really, really well done, which I guess shouldn't be a surprise when there's 1,500 per day being done over there.

That's like a chunk of their economy. That's crazy. What are the main procedures people are looking for? Hair transplants, obviously is serious, at least in Turkey, but I find it hard to believe that three million people are getting, I don't know, double eyelid surgery in Thailand every year. Surprisingly, the big one is dentistry. It's over half. Fifty-five percent of medical tourism trips every year are for dentistry. Cosmetic surgery is somewhere between 17 and 24 percent of the industry, and the rest is taken up by cardiovascular surgery, fertility treatments like IVF, and

orthopedic surgery. We're talking about not just cosmetic surgery for medical tour. I just, I don't know why. I guess I assumed all of it was just like, I want to Tommy Tuck. it's expensive. So these procedures, it seems like the people would skew older, specifically the cardio and orthopedic surgery. I mean, I don't know a lot of 25-year-olds or 30-year-olds going to get a orthopedic surgery done. Well, it depends on what you mean by older, because I got some bad news for you about my age and your age. Yeah, shoot. We're older people. Lay it out. Lay it on me. So baby boomers are the wealthiest age cohort in America, so they're more likely to just have it done down the street here in America.

The majority of medical tourists are between 40 and 60, and they want stuff like hip and knee replacements on the cheap. There's been a surge in people, 30 to 45, seeking surgery abroad. That's the prime demographic for lipo, BBLs, veneers, hair transplants. Also, it's weird that those four things are lumped in together because two of them are like, you might die, and the other two are like, you might have an ugly hairline. Yeah, at worst. Yes.

So what you're seeing is Gen Xers, who are just too broke to get medically necessary surgery done domestically and millennial digital natives who don't think any of this is at all suspect because they heard about it online and, you know, they trust influencers. In fact, their problem is that they're going to be more credulous of whatever it is that the influencers have to say than traditional advertising. So seniors are mostly not engaging in medical tourism because they don't need to? They are just not to the same degree. Like I mentioned, like boomers are the wealthiest age cohort in America, but a lot of them are on fixed incomes. So with the cost of health care constantly on the rise, they need to find ways to get today's procedures done at yesterday's prices. So they fly to Costa Rica, they fly to Panama, Thailand, and that's where they get their

dental overhauls or long-term cardiac care. There's also tons of people from countries like the UK and Canada with socialist medicine who just don't want to sit on a waiting list forever. So they go somewhere with a strong private sector or a stronger private sector anyway. That's also way cheaper than where they live. The one common denominator among age groups and nationalities is that it's mostly women. It's 60% of all people engaged in medical tourism. But Turkey got such a name for doing hair transplants, as we mentioned, that 90% of people who are going to Turkey for medical tourism are men.

Yeah, okay, that kind of makes sense. Do we have any stats on men versus women when we're talking about cosmetic procedures versus more necessary procedures? I guess I just assumed other than hair transplants, it was mostly women getting, you know, fake boobs, for example. Well, we don't have anything specific, but we do know that the overwhelming majority of people getting cosmetic surgery are women. that's north of 80%. It's fair to infer that this would skew harder towards women if we were only talking about cosmetic surgery. What's the history of this?

How did countries like Thailand and Turkey even get these industries in the first place? It seems so random, I guess. I don't, like, how does any of this happen, really? Well, globalization also creates global labor arbitrage. This is where companies decide labor is cheaper somewhere else, so they build their business where labor is cheap. Okay. Hence, why cars are not made in Detroit anymore.

Correct. But labor arbitrage doesn't just apply to manufacturing. Individual consumers might decide that a product or service isn't something they want to pay American labor prices for, but they're going to pay Turkish and Thai labor prices for it that they're comfortable doing. I mean, the last three companies I've worked for, the entire admin team is in the Philippines. I think it may even be the last four. Like admin teams for e-com businesses are like always in the Philippines or Indonesia or, you know, Belarus or somewhere. Malaysia.

Yeah. Yeah. Regulation and accreditation might also be lower somewhere else. And that's going to drive down the price because it's just not as hard or expensive to get going. What's the deal with the medical tourism brokers? I've seen these advertising online as well. Ha, the travel agents, no one knew existed. Exactly.

Yeah. They're sometimes called facilitators, but they might as well be called the salesman. So let's say you want to go to Turkey and get veneers. How are you going to do that? Well, that's a good question because I have no idea, but I would probably start Googling hospitals and Turkey with English websites or just Google like turkey veneers and pick one that didn't only have Turkish as a result. This already sounds like a really bad idea, and I would probably try to find somebody who can help me.

Yeah. So nobody knows how to go get veneers and jerky. Okay. As it turns out. No patience. Yeah. Nobody out of nowhere. Yeah, the patience.

Right. Well, there are people. They're the brokers. Right. So there's tons of moving pieces involved and the brokers, they fill the gap. And this is legal? I feel like we don't have that here. No, we don't.

It's not legal in the United States. There are specifically laws against kickbacks. You cannot pay someone for referrals in the United States. But as anyone who's ever been to a Mexican pharmacy knows, I think someone may be listening right now who has. This is not the case in other countries. No, I mean, I've definitely never purchased contraband in a Mexican pharmacy that the doctor who works next door told me to go to. That's never been anything I've done as a child. Yeah, I bet it wasn't the same thing I get off the dark web either.

Right. And a lot of other countries paying for referrals isn't just, least. legal and allowed, it's completely normal. So if you've been to Mexico, you know that if you want a drug from a pharmacy, lo and behold, wouldn't you know it? There's a doctor right next door to the pharmacy who's going to diagnose you with whatever your heart desires and you're going to walk over to that pharmacy with the script that he just gave you after, you know, you told him what you wanted a script. Yeah, right. Right. And you're going to get it, you know, like basically anything short of of oxycontin, they're not going to give you opioids,

but other than that, they'll give you anything. Right. I feel like my testosterone is really low, even though I'm 20 years old and I work out all the time. I definitely need some help with that. Okay. Go to the vet next door and make sure get this particular thing from a vet. I remember when I lived in Mexico,

I wasn't into that particularly, but there were tons of guys at the gym, and I remember being like, let's go eat. And they're like, hold on, we got to go do something. And we would walk to literally like a veterinarian. and they would be like, oh, yeah, I need something for my horse, and the guy would just start laughing and, like, hand over a big ass bottle of, I don't know,

horse steroids, I guess. Trembloon. They would just be like, cool, thanks. Trend balone. Yeah, it was like Equipo. Something called Equipoes or something. I think Equipoes is Trembalone. Oh, maybe.

Yeah. Because they all have like six different names. And maybe it's not. I don't know, but. It is bold anone, undeclinate. A veterinary anabolic steroid. used primarily to treat debilitated horses, improving appetite and weight gain,

is an androgenic steroid. Its function is to enhance muscle growth in red blood cell production. Side effects include overaggressiveness, not for human use. Okay, well, that explains a few things with these guys, you know, getting in fights with hot dog vendors,

essentially, for absolutely no reason. And each other all the time. Yeah, anyway, so, okay, tell me about the brokers. The brokers work on commission. That comes with a whole host of ethical issues. they get anywhere between 10 to 40% of what your procedure costs. And that means not only might they push you towards procedures you don't actually need or want, it also means that they're going to send you to the clinic with the highest commissions,

not the ones with the lowest infection rates or the ones who are the best at doing what you want or need. Yeah. They're also often partnered with influencers who they use to market their services to a broader audience. Yuck. Yeah. Okay. All of the sudden the infection factory looks like a medspa in Beverly Hills and someone's like swimming in a pool after their liposuction or something and they're like, this place is great. The food is amazing. And I can just, I've seen these reels or whatever where they're like laying out and I'm like, didn't you just get like whatever stomach Botox? You know, they're just like hanging out and showing it off. I never even figured that they were getting paid but also, I mean, I figured they were getting paid, but I didn't also think that there was a broker that they were sending people to that was also getting, I mean, that just seems, this is a recipe for disaster. Yes. So they're not going to show you the person who got Mercer. Right. And spent weeks fighting that infection off. I mean, why would they? By the time you realize that what you thought was a luxury recovery suite is actually a filthy old hotel with no medical staff,

you're out thousands, you're in a foreign country and you can't move. Yeah. I mean, some of these hospital. I've seen some of the Thailand and in Taiwan hospitals as well, and they're super nice, but you don't necessarily know what you're getting when you book this thing sight unseen, right, with the AI photos. So how does one become a broker? They like to call themselves case managers or health coordinators, and you become one the same way you become a nutritionist. You start calling yourself one. I see. Okay. I'm a nutritionist. Congratulations. Yeah, exactly. Like, yeah. I'm a nutritionist now because I said I am one. There's no official procedure. Yeah,

what do you call, accreditation? There's no license. There's no certification. You just wake up one morning and declare yourself to be one, and lo and behold, you are. Look, y'all, if you're going to let a doctor remodel your face in a strip mall overseas, at least make one good decision today. Like supporting the sponsors that support this show.

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and a lot of them sound great until you actually need something. Then you're waiting on shipping. you're chasing them down, you're sitting through rushed appointments where nobody really explains anything. That has not been my experience with concierge MD at all. What stands out most is how responsive they are. Orders get sent to the pharmacy quickly, and in my experience, medications have shipped the next day or shortly thereafter, but it's not just speed, it's about communication. They take the time to explain what I'm taking, how it works, why it matters. They don't talk down to me and they're not trying to rush me off the phone after a few minutes. That is surprisingly rare. And for me, health and performance aren't one size fits all. I want a physician-led team that looks at the bigger

picture. Energy, sleep, recovery, hormones, longevity, travel, lifestyle, and helps me understand what is actually going on. They even helped with documentation that I needed for a trip to China and sent a travel thermos fridge thing to help keep medication cold during the flight. Small detail, but it showed that they really were paying attention. Concierge MD works around your schedule and keeps everything connected under one roof. Go to conciergemd.com slash Jordan and use code Jordan. Don't forget about our newsletter, We BitWiser. It's a bite-sized gem from us to you every single Asterisk, most Wednesdays. Under two-minute reads, really, really fun to write, really, really fun to read, according to

y'all. So go to Jordan Harbinger.com slash news. That's where you can find it. Now, back to Skeptical Sunday. So throwing your hat in the ring being the whole requirement. That's kind of like starting a podcast. Okay. So brokers, they also try to pitch it like a vacation I've seen this.

They'll encourage you to, you know, see the sites. And that, to me, seems a little dangerous depending on what kind of procedure you had. I mean, I guess my point is the broker is also not a doctor. A doctor would, I don't speak for all doctors, but I'm going to go ahead and say a doctor's never going to tell you to hoof it around the Istanbul farmer's market less than a week after you had a bunch of invasive surgeries done on your body. No, and you can absolutely do medical tourism that's relatively safe. Dental care.

It can go wrong, but like the how wrong can it go matters here. But these elective procedures from someone who knows what the, they're doing and does follow up, you know, that's the other piece of the puzzle, like you mentioned Taiwan, like Taiwan has an excellent medical system. Other countries are not known for having excellent medical systems. And generally, sort of the cheaper the cosmetic surgery is, the less it's going to, potentially the less safe it's going to be, I should say. Yeah. And then the other thing is, you know, if the goal is kind of like speed and stacking as many surgeries as possible on the same trip, you are going to have a bad time. Yeah, you know, I hadn't thought about

that, but you're right. It's kind of like, hey, I've got one week. Should I get a hair transplant, come back, then a year later, six months later, fly back to Turkey, get this thing done. It's like, no, get the hair transplant, the silicone face injections, the tummy tuck and the BBL at the same time, because, you know, like, you're here and you only have two weeks of vacation, you know, don't you want to? So anyway, but let's talk about that later because I have more questions about that, but why are so many Americans doing this other than cost, which I'm sure is a big driver? It's a big world out there. And Americans being the number one medical tourists, I probably shouldn't be, but it is surprising to me somehow. Well, a big part of this is an incentive gap.

Physicians are just not going to make a killing doing veneers and BBLs in England like you would in the United States. Okay. There's also the size of the market. America is kind of unique in that it both has a large population and its population is absolutely. affluent enough to have a robust market. Okay, but China, Russia, Australia, Brazil, they're all kind of big in terms of population and size. Well, Australia, I guess maybe not so much. But don't they have the same level of disposable income that average Americans have?

Is that why? I mean, maybe they don't. I have no idea. No, not at all. No, they don't. They don't. China, India, that's why America sits in a sweet spot, large population with disposable middle class income.

I see. As an American, you can move to basically any other country in the world and pay as much, but get more. By the way, I don't want people to think I'm absolutely a moron. I know people in China, Russia, and Brazil make a little bit less. I just meant relatively speaking, isn't there a huge middle class? But I guess not really. Not like the United States. Not like the United States.

America is the like the perfect market for everything for this reason. Yeah. China's got to be on the come up for that, though. And I have sort of seen like China getting more cosmetic surgeries and stuff. stuff like that. But anyway, whatever, that's neither here nor there. Yeah. So in America, a middle class person can save their pennies and see a top end plastic surgeon. You could see a top end domestic surgeon as a plastic surgeon as a, you know. Yeah. You're just going to be paying it off for like two years and so. Yeah. You're going to be paying it off forever. You're going to be saving up, blah, blah,

but you could do it. But then it's like, okay, you know, well, I could do it in Brazil and it's like half a week's wages, you know? Right. Yeah. Yeah. Yeah, yeah. Most people, that is not within their reach. That's a really good example of the like the difference between the American middle class and the Chinese or the Russian or English middle class, for that matter. The point here isn't to be alarmist, though, it's just to let people know that the world of cheap cosmetic surgery abroad can come with some very high costs. So people who do this, do they kind of think they're going to get the exact same surgery at significantly lower cost? Because I assume that they think, hey, it's basically the same thing as the U.S. where I'm just

not paying for the USA market. But right out of the starting gate, that's wrong, right? How is plastic surgery abroad different? So even if you trust the doctors to do their job properly, and we're going to get into that part of things later, they are not even dealing with the same raw materials. Here's a really good example. There are 20 FDA approved injectable fillers. In other countries, it can be as high as 190. And you know what? Maybe all those fillers are fine. I genuinely have no idea. Maybe they are. But what I do know is that 170 of them are illegal to stick in your body in the United States. I've seen other comments about this with fillers specifically because I was doing that dick episode several months ago. And there is stuff that's like better for that, but it's

too expensive to get FDA approved, even though it might be better. But the other issue that a doctor here told me about Dr. Pash at upsized clinic.com, one of the things that he told me was like, hey, we just don't also have long-term data on this. And so the FDA does not like stuff like that. Like, they don't want to find out that, oh, yeah, this filler was better. But it turns out you can get necrotic tissue after about 10 years and you're going to have to have your wiener whacked off. Like, that's not, I probably shouldn't say whacked off.

Cut off. That's not good. Anyway, so for whatever reason, at least some of these fillers are illegal ostensibly because of safety reasons or a lack of long-term data or whatever. Sure. And like, whatever, maybe in 20 years we'll have 190 legal fillers in the United States. And then there's going to be 400 used abroad. But yes, I get your point.

American facilities, in addition to government oversight, are regularly inspected by private accreditation bodies, such as the American Association for accreditation of ambulatory surgery facilities. That's the quadruple ASF. I guess they're branded. They're taking liberties there, but okay. Yeah, they're currently branded as Quad A. They require 100% compliance with very strict standards for staff, equipment, operating procedures, things like that. I don't know what the bar is for the regulatory body, but I would bet money, sight unseen, that theirs are much higher.

So it's a quick and easy way to filter out who the hack jobs are in the United States. Do they have this accreditation? Yes or no. abroad, it's far more common to just go shopping for somebody who gives you the green light. We talked about the, you know, the pharmacies earlier. Stateside, when you get a procedure of any kind, you're not just paying for the actual procedure. You're paying for your little share of a $50,000 per year compliance officer who makes sure that they get that accreditation by seeing that instruments aren't washed in leftover dishwater.

before they cut you open with them. Yeah. For a guy who hates regulations, bro, you're making a pretty strong case for regulations right now. Well, the thing is, people just assume that there's the same kind of regulatory rigor abroad as there is in the states. And I'm totally fine with people using whatever medical care they want, but they also need to be aware of what they're getting into. Yeah. Another aspect that people don't understand is the externalization of risk. So you go to a sketchy American doctor and you get a BBL. That sucks.

But hey, guess what? He's legally and ethically responsible. There's going to be consequences for this guy. Right. There are going to be dire consequences for this guy. He's going to jail if he screws this up. Yeah. He's losing his license at best.

So nearly three quarters of all medical tourists are not even getting proper follow-up after their procedure, which makes the chances of something going wrong much greater. Part of the reason for the follow-up is, remember, we talked about, you know, catching stage zero cancer before it becomes, yes. Yeah. Catching these little problems that if they go untreated become very, very big problems. You know, that's interesting. You mentioned that because I, as I said on the old Wiener episode several months ago,

again, Dr. Pash over there at upsizeclinic.com, I should probably verify that URL. But whatever, the dick doctor, I wanted to, like, sort of do a Louis Theroux and get like something checked for myself or have the procedure myself. I didn't have the procedure, obviously, but he filled this little tiny dent because I was like looking for a reason to have a needle stuck in my penis, just so I could talk about it on the show. You're welcome, everybody. But even then he was like, hey, FYI, even if I put like this half-cc into this little like thumbprint on your wiener, like you have to come back in a week and or do a somewhat awkward face time so that I can make damn sure. And he made me come in. Like he was like, I want to feel that wiener in my hands,

you know, like, he's like, I want to make sure that it's not inflamed, that there's not the weird stuff happening with the tissue around it. And I was thinking to myself, when we were doing the notes for this episode, I was like, wait a minute. What happens if the person who did the original whatever it is to you is in Thailand and you're back in Bristol, you just don't get to do that. Like, and if you go to wherever and you get a BBL, like a really serious one, and you get a gnarly infection, you are not flying back to your medical tourism destination to get

it treated, you're going to the emergency room and you're in the UK or in the U.S. or whatever. Yeah, which honestly makes me kind of mad because you and I are paying for that. Yeah, I wondered about that. Right. If they can't afford it, it's going to be Medicare, Medicaid, whatever, or it's just insurance companies go, well, we got to raise rates because all this medical tourism and people are coming back with infections and like, we got a, we had to pay for that. So everybody else's insurance for getting hit by a car is going up by $100. Yes. Yeah. A recent study found that the average cost for a U.S. hospital for a botched surgery done abroad, it's that specific, ranges from $26,000 to $154,000.

So the patients save $5,000. But the U.S. healthcare system, which is your tax dollars and your premiums, just paid six figures to save their life because they wanted to save a few bucks on a BBL. Yeah, great. So you get a bootleg butt strapped on and the American public has to pay the equivalent of a small suburban house in 1997 to make sure that you don't croak as a result. Great. Okay. Stay tuned for the housing crisis episode and we'll explain why you can't get a house for $150,000 anymore. Right. No. Maybe in Compton you can rent a room in a house for that. You can get a condo for that much these days. Yeah. Okay. So even in the best case scenario, the chances of complications are high because,

after you get the procedure done, you're going to go sit on a plane for 10 hours, and that causes a condition known as deep vein thrombosis or DVT. You know, I've actually heard about this, and I just remember it's like, oh, if your flight is over X number of hours, you should, like, do airplane aisle yoga. Yeah. So that the blood doesn't pool something, something in your feet. I don't know. It's one of those silent killers that you can't, you can't really see it until it's

too late and then you're in deep doo-doo. So I think the short version is you get a blood clot usually in your leg because of the way that you're seated or just from being seated, which then breaks up and then goes to your heart and stops it from beating kind of. So your body treats surgery as a major injury and starts clotting much more easily, like crazy in some people. And then you go sit on a plane in the sky in an economy plus seat for, if you're lucky, for 14 hours to get home. and the recovery time, as far as I know, for most surgeries, before you're safe to fly, cabin pressure, dehydration, sitting for 10, 14 hours, whatever. It's like a month or more, right? And most of these medical holiday places, they've got you out the door in like a week or less. Yeah, five to seven days is pretty typical. I've actually never seen the television series botched,

but... Oh, you're missing out. In the course of researching this, I learned that how soon after. did you fly is the question the doctors ask everyone who walks in the door. Yeah, I frankly, I'm slightly amazed that you of all people have never seen that show. It's a funny, guilty pleasure to watch. Like if you're in a hotel and you've got cable, which I haven't had since like childhood, it's up there with Dr. Pimple Popper and 90-day fiancé where you're like, oh, botches on for the next seven hours. Just turn it on while we exist in this hotel room and we'll like glance at the TV every seven minutes. It's more of my wife's thing. I'm

I'm a bar rescue guy. That guy was on my show. What is his name again? The bar rescue guy that he just like screams at people. I don't know his name. I just like I've worked in bars and stuff. So I love when he goes into some place that's functionally identical to a place I used to work and screams at people for problems that would have bothered me when I was working there. John Taffer.

John Taffer. That's right. Yeah, yeah, yeah. Yeah. He was on the show and he's, I was like, oh, he's a pretty nice guy. And then I was, but as I was watching bar rescue, I was like, oh, I see. He is a like, he's basically a Gordon. Ramsey on the show. He's just like screaming at people. Gordon Ramsey for bars. Right. Exactly.

Another reminder, by the way, that I need to come hang with your wife at some point and watch trash-ass TV. Inane reruns of Bravo shows where people almost kill themselves for, you know, bigger whatever's on their body. I'll make sure to have popcorn and bar fags ready for the both you. Thank you. I appreciate that. Anyway, yeah, traveling too soon can double or even quadruple your chances of getting thrombosis. Right. And the thing is, don't get thrombosis just by not flying. I feel like there's a whole set of medical apparatus that legit clinics have on hand so that you don't die because you went to get your boobs lifted someplace. Yeah, they also have prescription drugs and will recommend that you extend your stay

if they think it's medically necessary. A lot of people need more than just rest in hydration after they had a major procedure like breast implants or tummy talk or whatever. How common are problems when it comes to medical tourism? Because I don't know. I don't hear about this, but I also don't know anybody who does this other than the hair transplant guy that I mentioned before. We don't really know because there's a survivorship bias involved here. I see. So survivorship bias is generally when people focus on success cases over failure cases, which is exactly what I'm doing with this hair transplant guy because he was fine. It was like, oh, that's great. If I ever need this, I'm totally going to do that. So you're essentially saying that people are going, hey, I know

that this guy did this and everything was fine. Literally what I just said, basically, hey, this guy did it and he was fine. So I'm almost certain to be fine. I'm guessing the CDC or whoever tracks this stuff, FDA, they don't get a notification every time somebody flies to the Philippines to get a facelift or something.

Yeah, my old man used to drive drunk, like, constantly. And lo and behold, he's still walking around alive. It does not make drunk driving a good idea. Right. There's no rigorous official tracking of this. We do have a little data. A large-scale population study found that roughly 5% of medical tourists report significant complications upon returning to the U.S.

Of those who experience problems, 67% required medical care back in the United States. Wow. Data from the British Association of Aesthetic Plastic Surgeons, or BAPS. Yes, that's really what they're called. BAPS. They showed a 94% increase in patients needing hospital treatment after oversees. surgery over a three-year period. Okay, but complications, that's kind of vague, right? Is that not just like, hey, this is a little bit red? And it's like, oh, okay, here's some ointment and a bandage.

Like, that could be required medical care back in the United States after a surgery. Yes, absolutely. That would be included in complications. Vagness is doing a bit of work here, and we should address that. In Columbia, for example, which is a popular destination for medical tourism, some high-end clinics report a 6.2% complication rate, which is actually comparable to benchmarks for U.S. board certified clinics and physicians. I see. The issue is what are the complications, and that's where we need to get more specific, but there's not a ton of data. Yeah, like one is, hey, this is a little swollen. The other one is you're going to potentially die from this if you don't go to the ER right now or whatever. Like, you're a little red here. You need some, you need a

cortisone shot versus like, whoa, that's necrotic tissue. We have to amputate this. Yeah, we have to cut that off. So in the United States, you might get a staff infection. In medical tourism, we see non-tobacteria, also known as Ntm. I love that whenever I have to pronounce something difficult, I put on my radio news reporter voice. Yeah. Otherwise, nobody will understand what the hell you said, so we do appreciate that. Yeah. These are waterborne. BORN bacteria found in tap water used to clean instruments at lower end clinics. If your recovery plan involves a beach, a cocktail, and zero legal recourse, maybe balance that out with something sensible, like supporting the sponsors that support this show.

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We've got a subreddit for the show if you want to discuss how terrible I am with other show fans. Actually, that's only 10% of the threads. Join us over on the Jordan Harbinger subreddit. Now, back to Skeptical Sunday. to the compliance officer in the United States who does not allow people to just rinse things off in the break room sink and then put them back on the tray for the next person. Oh my God. Wipe it on a napkin and it's good to go. So these are, in addition to being gross, incredibly hard to treat. They require months of heavy duty antibiotics and those can cause permanent kidney or hearing damage. Oh my gosh. So it's not just like eat a bowl full of pills

for a month and you're fine. No, it sounds like IV stuff at that point. Ivy anti-bator. Oh, my God, dude. I didn't realize. You know, I have heard of hearing damage and, of course, kidney damage from antibiotics, but that's really gnarly.

So this, again, as I mentioned, it goes back to regulations and compliance. American hospitals are insanely regulated and thus incredibly clean. There's also a massive bureaucracy just filled with people who, frankly, would probably love to ruin a hospital's day by finding violations.

Oh, yeah. This stereotype of Latin. law enforcement being essentially freelance has been confirmed by absolutely everybody I know who lives there and has lived there. And I remember, and again, this is anecdotal, but I'm talking about a lot of show fans right in about this stuff too. But when I was in Panama and Mexico, first of all, I remember in Mexico, I had to pay the cops to let me go for something I didn't do. Surprise, surprise. And in Panama, when I worked to the U.S. Embassy there, they would pull you over. And the joke was, oh, they must be hungry. It must be lunchtime. Because they'd be like, you read.

a stop sign. And you're like, there's no stop sign here. And they'd be like, I need $10 for that violation. And the running joke with everybody who lived there was just say, it was lunchtime. They were hungry and they didn't have any money. And $10 was the price for a decent lunch. And I knew guys that were doing like serious stuff over there because I was working with the narco folks at the U.S. Embassy. As you go up the food chain, the corruption is worse and more expensive. You know, it's not a $10 bribe. It's a trip to Vegas or whatever. Yeah. So, yeah. Yeah. I've known multiple people who lived in. of the least corrupt countries in South America, and they confirm that, like, you got a problem

with your passport or your visa? Well, if you got a hundred bucks, you don't have a problem anymore. Yeah, exactly. Obligatory, okay, fine, it happens in America, too, but we're talking about, like, hospital compliance, medical compliance is, like, is crazy here. It's just, mostly we complain about the opposite thing. Like, wait, this thing was left open and in the air in a sterile room for more than a few minutes, and now you have to throw it in the garbage and open something else. Like, that's ridiculous. And it's like, well, there's a 0.01% chance that something floated and landed on it. And we're going to do a heart surgery on a vulnerable person. So like, yeah, we're going to waste a thousand dollars worth of shit because they might die if we don't. It's like,

all right, that's probably the best practice. Yeah, I know exactly one person who's ever bribed American cops. That's a story for another podcast, I assume. Yeah. So there's also the issue where people stack surgeries. We addressed this a little earlier. You fly to Thailand. You get procedure because it's cheap and you go, hey, let's get a bunch while we're there. Let's get everything done in one trip and that I don't have to pay for another flight. So your tummy talk, your breast implant, your lipo, your BBL, your veneers, your Botox, the whole deal. Yeah, because you're like, I'm already in pain and I'm going to already be taking codeine. I might as well just like get it all knocked out. Yeah. Well, in the United States, surgeons won't do that for the most part because of the risk of pulmonary

embolism and surgical shock, it skyrockets when you start stacking these. Okay. But abroad, it's like, No, it's the mommy makeover package. You get six different procedures done. Right. And to people like me who don't think deeply about this until right this moment, it totally makes sense. Like, I got all four of my wisdom teeth removed at the same time. Why wouldn't I also get my butt and my boobs and my lips and my double eyelid surgery

and my whatever else implant at the same time? Because I'm already going to be on pain meds watching Netflix and sleeping all day. Like, get her done. But no, you're saying the body might kill you as a response to all of these. invasive injuries, which like, duh, of course that's going to happen. So other than thrombosis and the dangerous mycobacteria, what are some common complications for medical tourists? And if this is going to get really gross, maybe heads up, y'all, it might get really gross. It's going to get reasonably gross. Okay. Infections and wound dehiscence. What is that? Yeah, so infections

people get. Wound dehins is when your wounds don't close, they leak. bro. I've never even heard that word, dehiscence, but man, is that disgusting? So like just a festering open sore that just... Yes. Come on, man. Oof. Yeah, it's extremely gross. It's also half of all hospital visits for medical tourists after they get back home. So what type of complications? Weeping open wounds that don't close. Lastly, there's hematomas, which is a form of internal bleeding that is going to require another surgery to open it up and drain the blood. Damn, that is all pretty serious. This is not, hey, I have an inflamed incision around the edges. I took three days of antibiotics to clear up a potential infection or like, I don't know,

put some ice on it or like you said, a cortisone shot. I mean, that's really gross. That's really, really gnarly. You don't want a wound that leaks. I mean, that's, there's a bit of survivor bias involved in this because when someone flies to Bulgaria, we'll pay. on the post-Soviet world since we've been picking on the third world the whole, the whole episode. And you get major plastic surgery and nothing goes wrong. We have no idea. But yes, the takeaway from this is that if you do have complications, they are going to be a big deal, if not life-threatening. Yeah. Look, TMI, but hey, what else is new? I might as well keep talking about my wang. I had a vasectomy last year or maybe, no, it was even more than last

is a couple years ago. And that, very rare, but it got infected. And I had a speaking gig, and I could barely walk. Thankfully, the gig was in Hawaii, and I told the event hotel and organizer what happened. And they basically gave me, like, the craziest deal ever to stay at the hotel for a week and recover. And it was kind of awesome because I had medical care for something that was relatively minor.

But I cannot imagine having that kind of issue someplace else and having to deal with it. I mean, this was like a massive swelling in where the sun don't shine. And I went to the ER in Maui. And I'm actually still paying that off because it was like $4,000, but I was in no danger of, you know, dying from it because I had real medical care. I know it was serious. And even Kaiser Permanente was like, hey, you probably think we're lying, but this never happens. And the doctor was like, dude, I'm 65 and I've been doing this for my whole career.

And I've seen like a handful of this. And I was like, well, maybe stop sneezing on the scalpel or whatever. He's just like, no, you just got like terrible luck. This is just straight up bad luck. Buy a lottery ticket, man. Exactly, exactly. So how many people actually die from complications from surgery? Do we know?

The CDC reported 93 U.S. citizens dying following cosmetic surgery in the Dominican Republic. Again, that's specific to the Dominican Republic and U.S. citizens. And specific to cosmetic surgery, too. So that's a lot sounding from just that narrow place with a narrow niche. And it was just in terms. 2009. Yeah. Deaths are increasing in the DR.

From 2009 to 2018, the average was about four deaths per year. Between 2019 and 2022, that jumped to 13 deaths per year. With a peak of 17 deaths in 2020, almost all of these were women with a mean age of 41, and the leading cause was embolisms. Jeez. I'm guessing that that trend of people dying is not that. medical care quality in the DR's going down, but that people are going there for more dangerous stuff, like BBLs, probably.

Probably, yeah. So that's really terrible. I wish we had better stats to compare to the U.S., because I'd love to get an apples to apples here. It's very, very difficult to get apples to apples because you have to compare the exact same surgery because, like, no one is dying from hair transplants. I mean, apologies to the one person out there is like, hey, my brother died from a hair transplant. But, like, for the most part, people are not dying from hair transplants.

But lots of people are dying from BBLs. One thing I do know is that you are not supposed to die at age 41 if you're a healthy woman from elective cosmetic surgery. That's terrible. Yes. Mexico is the number one destination for Americans with over one million visitors annually. You absolutely can find high-quality medical facilities in Mexico. But the basement tier clinics can be lethal in 2023, an outbreak of four. fungal meningitis linked to cosmetic surgery clinics in Matamoros, Mexico, killed at least a

dozen Americans and left dozens more with permanent neurological damage, which I think from, if I'm not mistaken, is probably pretty bad. I'm going to guess permanent neurological damage is not just like, yeah, I can't feel my fingertip anymore. It's probably like, oh, I can't walk properly anymore because I have had fungal meningitis. Yeah, or I have like symptoms that are functionally identical to MS or something. Yes, exactly. Health authorities in Mexico report that the mortality rate in their medical tourism sector is roughly four to five deaths per 100,000 procedures. That doesn't sound like much, but it's significantly higher than international benchmarks for elective cosmetic surgery. The best data we have for the U.S. puts it at one to two deaths per 100,000

for elective cosmetic surgeries. So it's like five times as much. Tijuana, big hotspot for medical tourism, that's 20% of all surgical fatalities in Mexico. Oh, wow. And that's primarily cosmetic procedures like tummy tucks. They have a fatality rate of five and 100,000, which again, doesn't sound like much, depending on where you are, where you're going, a couple factors, that could be 10 times the rate it is in the United States.

Ugh, dang. So again, doesn't sound like much when you put it that way, but when I say, hey, do you want to have 10 times the risk of dying? People are like, no, of course not. No, thank you. No. Other thing to remember is that people may be traveling to places

that aren't super safe for reasons other than medical procedures. In 2023, four Americans were kidnapped and two of them were killed while they were traveling to Montemoros for a tummy tuck. This is a very real concern. One of my best friends was kidnapped in Mexico. Well, I mean, I was kidnapped in Mexico 26 years ago. You're who I'm talking about. And also like, my cousin was murdered in Mexico, but he was.

Oh, dang. I did not know that. He was doing sketchy shit. Okay. Well, okay. That's like saying my friend was killed in L.A. Yeah, he was a Crip. Well, okay, not that that makes it okay, but it does increase the likelihood that

you're, you know, if you're buying a brick of cocaine, it can, you're, it's not the same as somebody who's going to the four seasons to drink beers at a bar. What about other places? Well, we mentioned Turkey as a hotspot. The British Foreign Office issued a warning after 28 British nationals died in Turkey following medical procedures since 2019. In 2023, dozens of medical tourists contracted botulism poisoning. No.

Which is a potentially fatal nerve toxin. Yeah. How do you get that? Stomachia. Oh, duh. Of course. Yeah, it's botulism injections. Right.

They went to a weight loss clinic in Istanbul and Izmir. The thing is, again, this is just the tip of the iceberg because there's not much in the way of official records. There's no real rigorous record keeping. We only find out when there's a problem that requires, that scares somebody enough to go to the hospital. I see. Okay. There's a couple things to note as regard fatalities. Most official stats only count deaths that occur within the country that they're going for medical tourism or shortly thereafter. So if you die of a secondary infection six weeks later in a Chicago ICU, that is probably not going to be counted as a medical tourism death stat. Sure. Yeah, if you have like a blood infection, but yeah, you got it because you

got staff from them washing the scalpel in the break room during your whatever BBL. Right, exactly. Yeesh. Okay. Yeah, BBLs are the deadliest cosmetic procedure in human history, according to the aesthetic surgery, education and research foundation, which was a group of surgeons founded specifically out of concerns regarding BBL's. There's a huge risk of fat embolism. That's where fat... They accidentally inject fat into a vein and it travels to your heart.

Oh, gosh. Dang, dude. I've heard that these are super dangerous if you don't really know what you're doing and they're still dangerous even if you do. In fact, I mentioned this at the top of the show. The guy who originated the phrase that we use on the show all the time,

I'm addicted to lip-fail. Let me find it. It's one of our soundbite that we use on the recommendation of the week. I am addicted to lit filler. That guy, so he worked in the UK and he gave this mother of five a BBL using filler. I don't totally get how it works. And he's, and he's not a doctor.

She died. And so he got arrested and he, you know, posted bail. And he was supposed to, in the UK, they call it answer bail, which I guess is just go, you know, to trial after you've, you know, see it to court. And before he could, he got a BBL with the filler and he died getting done. that, which is crazy. Like the, I hate to say karma, because that makes me sound like I'm saying he deserved it or something, but basically it just came full circle, and he passed away. And it was like days after I licensed that, because I had written him. And I was like, hey, can I license this? He's like, yes. I was like, here's the document. And he's like, great. And I was like,

send me the recording. He sends me the recording. And I was like, hey, could you do this, like, edit on this thing? And there was no answer. And I was like, ah, this guy, come on, man. You're just going to take my money and run. It's just a really simple edit. And I never heard from it. then somebody posted on our subreddit and they're like, oh, that guy died. And I was like, oh, okay, I guess I won't expect a response to this, poor guy. Just to have two people die from BBLs associated with the same person, the odds just can't be good. And again, he's not a doctor, but he didn't do it illegally. I guess you just don't need to be a doctor to do this, which is crazy to me. Yeah, I mean, surgery in general, under the best of circumstances can be very, very dangerous.

But it's especially true BBLs, though new techniques have made them much safe. safer. The death rate is now one in 15,000 for newer procedures, which like people are like, whoa, after here and one in 100,000. Right. It's still super dangerous. Holy smokes. But it used to be one in three thousand. Oh my God. Their real time ultrasound guidance has nearly eliminated the risk of death by fat embolism. But like somebody's got to do that. And it's probably not the guy who works at a salon and isn't a doctor. I feel like influencer culture has to play a huge role in this. Somebody on Instagram has the work done abroad. They go online. They say it went fine. Don't worry about it. Then they take a couple picks of their bougie recovery suite and it's

like, you know, sign up through my link. Right. The testimonials by influencers either conceal or distort the danger. Again, the survivor bias, lack of hard statistics makes it very hard for people to properly assess the risks. And when people find out that the $10,000 surgery they wanted forever is $2,000 plus a $1,000 round trip ticket abroad, maybe they're going to do due diligence, but maybe they're so excited to get down to business that they get caught up in the moment. They forget that serious illness, disfigurement, even death are very real possibilities.

If your surgeon sells vape cartridges out of the front office, we need to talk. But first, let's talk about the fine products and services that support this show. We'll be right back. Thank you so much for listening to and supporting the show your support of our sponsors that keeps the lights on around here.

All of the deals discount codes and ways to support the podcast are on the website, searchable and clickable over at Jordan Harbinger.com slash deals. Now for the rest of Skeptical Sunday. We aren't talking about a one in a million freak accident. We're talking about a measurable rising body count of people who thought they were buying a lifestyle upgrade and ended up in a morgue because a broker sold them on a clinic that didn't have proper emergency care on site in many cases. one thing I'm dying to talk about is what role, we mentioned this in the intro, but what role

Oregon harvesting plays in medical tourism? Because, like, I might not be as cynical as you, but I'm definitely cynical enough to think that people are for sure flying to Asia to get kidneys that were harvested from Chinese dissidents and Falun Gong members or something like that. I've actually done multiple shows on this in the past, so I know that that's, like, there's a UN report. This is a real thing. This is not like a weird TikTok conspiracy. Yeah, this isn't like you got drunk and went home with some girl and, woke up in a bathtub full of ice and a note saying my kidneys are gone. This is a very real thing. What's the common denominator of all medical tourism? You want to save money or time. You want

a cheaper procedure or shorter weight or both. If people are willing to do this for a nose job or whiter teeth, they're definitely going to want to cut the line or cheap out when it comes to a life-saving organ transplant. Yeah, let's talk about kidneys. I mean, you already sort of stole my thunder with the guy meets a girl at a bar and wakes up in a tub full of ice. But like, what's the real version of this? Is there one? It's honestly, uh, and very sadly, not as different than that as you might think. In America, the average wait time for a kidney is somewhere between three and five years. Wow. There are Chinese websites in English, Russian, and Japanese, not Mandarin, mind you, that promise people new kidneys in one to four.

weeks. Holy moly. Wait, so from three to five years down to you'll wait a month if we really take our time to find a donor. Yes. And there are definitely regulations that make it harder to get organ transplants in the United States. Yes. But the main driver of the wait list is not that the people at the Health Resources and Services Administration who regulate organ transplants, you know, they're not just like being big socialist meanings who want to deny people life-saving treatment. This is a very basic problem of supply and demand. There are tons of people who need kidneys in proportion to the people who are dying and gifting a usable kidney to the next generation. Okay, but what about the idea, and I know I'm playing devil's advocate because I've done shows on this, but what about the idea

that there are way more people, way more people in China? So maybe they have more dead people's kidneys to give away and more death row inmates because they have more capital crimes or whatever it is. So here's the thing. Biologically, you cannot schedule a deceased donor transplant weeks in advance unless you know exactly when the donor's going to die. Okay. And this is what first tipped off international investigators that something was amiss in the People's Republic of China. Yeah, yeah. I can see how that might raise red flags. Is there any positive evidence that organs are being harvested in China for the purposes of selling them on the international market? Well, as you know, the China Tribunal, which was an independent people's tribunal who released their findings in 2020, concluded that forced organ harvesting had been committed for years throughout China on a significant scale.

Yes, and I can stop playing dumb now, but you can hear more about this on episode 497 with David Kilgore who did. He was a part of that whole UN-China tribunal. It's crazy. Yeah, so China officially claims about 10,000. to 17,000 transplants per year through their voluntary system. However, researchers using bed counts, staffing revenue data estimate the actual number is closer to 60 to 100,000. The evidence points to Fallen Gong practitioners and Uygh Muslims being used as living organ banks.

Survivors from re-education camps have testified about receiving frequent medical exams and blood tests that were focused solely on organ health rather than general wellness. Yeah. By the way, Falun Gong is like a meditation. If I say cult people flip out, but it's sort of kind of like that. But I guess as far as cults go, it's like kind of harmless-ish. Imagine that Buddhism has an offshoot and this offshoot decided that they hate the CCP, the Comedies Party of China, and so they're getting persecuted. And like they just arrest these people. And also, apparently their organs are really good because they're vegetarian and they live a healthy lifestyle full of like semi abstinence and meditation and exercise. So you're getting, this is so

gross, but you're getting like a high quality kidney or a high quality liver from the person that gets arrested and murdered for their corneas or whatever it is. And yeah, I mean, if people are coming back from camps and the numbers don't match and they're getting organ health tests rather than general wellness tests, I mean, it just kind of seems like a pretty big tell. And I'm not alone in thinking that because there's a whole UN tribunal that the whole China tribunal kind of came to the conclusion here. It starts getting really yucky when you introduce medical tourism into the mix. In transplant tourism, it really seems like the state views a detainee, which again, it should be highlighted here like what gets you thrown in a prison or given a death sentence in China. Sometimes it's a real

crime. Other times, it's not a crime at all. Well, yeah, it's not a crime in the resumption. of the world, right, to say like, this Xi Jinping guy is a psychopath who's locking us up as part of COVID and this government needs to go. Like, that will get you a death sentence, potentially, in China. Yes. And it seems like they just view them as like spare parts that they can sell to wealthy tourists. And the people engaged in transplant tourism have, at best, decided not to ask too many questions about where these organs are coming from. I mean, I kind of get it. You know, I'm not saying I would do it, although, I don't know, that's a hard thing. Look, you're going to die unless you just don't ask a bunch of questions about where this came from. It's probably not that hard to just ignore your gut when you are literally going to die otherwise. Yeah, and I think that we can be like fair and acknowledging the pressure that these people are under, but that does not absolve them of the ethical implications of what they're doing. You know, both things can be true. Yes. So several countries and some U.S. insurance providers are beginning to refuse coverage for any postoperative care related to

transplants performed in what they de-risk countries to de-incentivize the practice. The American Stop Forced Oregon Harvesting Act moved to sanction individuals and even entire medical systems involved in this trade. Man, sounds like something might have a horror movie, dude. Yeah, it sounds like an Eli Roth movie because it's absolutely grotesque. So, you know, Like we said, if you're dying, you're unable to lead a normal life. Yes, people are going to do whatever they have to do to extend their life or get their life back to normal. Does not wash their hands of what they're doing, which is coming to buy a living person's organ a month before the Chinese government executes them for having the wrong religion. Why is there no international enforcement against organ harvesting or is there?

Well, international law is a gentleman's agreement. Where's the carrot and the stick for international law? That's true. What about the sanctions you mentioned? I mean, we're not going to sanction China because they're selling a few thousand organs per year probably. No, because it's a rich mine of slave labor for cheap consumer electronics in the West. And China can absolutely skirt basic human decency on a lot of fronts because the rest of the world's decided that they would rather deal with them for $800 iPhones than do anything about it. Yeah, that's not going to change.

Whether it's organ harvesting or human rights violations, no, it's not going to change. You know, it's just the thing that we talked about earlier on a larger scale. People who want a kidney decide not to ask too many questions. The world outside of China has likewise decided not to ask too many questions and to ignore what they do know. With that said, Mr. I hate laws, I think it's completely appropriate to have laws and private business practices. that punish people for getting organ transplants in high-risk countries. Yeah, man, this is so tough because I'm trying to think, like, would I do it? What if it was my kid, would I do it?

And I'm like, oh, man, this is like, it's really tough. It's really tough to make that decision. So, okay, say you've decided you want to go abroad for a procedure. Where would you begin risk management? I think risk management is a really important takeaway here because lots of people are going to just say, I don't care, I'm comfortable with the risk. that's their right to do, but it's important that they be armed with the right tools to make an informed decision. So the place to start, what is the CDC website? I suppose that has medical tourism

alerts on it. I mean, I know it does because I just checked it out. All countries are definitely not equal in this regard. So it seems important to choose countries that don't have a frighteningly high rate of complications to the point where the CDC is actually getting involved in telling you not to go there? Yeah, the plastic surgeon associations like the American Society of Plastic Surgeons and the International Society

of Aesthetic Plastic Surgery can have information. You can also dig around for malpractice information, but be forewarned, the lack of regulation means a lack of litigation, which means a lack of information. They're not being

any available evidence for malpractice does not automatically make a surgeon safe. It's just the bare minimum. I see. What are some red flags for people to look out for? In the U.S., board certified plastic surgeons generally don't offer bogos discounts or, you know, any kind of deep discount. Surgery is a medical procedure. It's not a Black Friday door buster. So if you see that kind of language, at the very least, you should be extremely skeptical. This is the type of thing where, like, extremely skilled plastic surgeons do not need to go out with a guy wearing a sandwich board to get customers. They got more than they can deal with. Tossing the sign around outside and

dancing at the headphones in, one of those guys on the corner. Yeah, they don't need that. We talked a lot about infections and complications, some good question. One very good question to ask is if I have a complication, which hospital do you have admitting privileges at? If they say they handle everything in-house, that is a giant screaming red flag. You want a surgeon who can get you into a fully equipped, accredited hospital if things go south. Yeah, you would think so. So if a broker says you can fly home five days after a major procedure like a tummy tuck or a BBL, it sounds like they're prioritizing their bed turnover over your life and recovery. And a safe recovery usually requires at least, at least, at least two to four weeks on the ground before a long haul flight to

mitigate thrombosis risks, and sometimes it's longer than that. You should check for international accreditations like JCI, which is Joint Commission International. We mentioned the International Society of Aesthetic Plastic Surgery. If you can't verify their license on an official government registry, they do not exist. We live in a world where we're told we can hack almost anything. We can hack our productivity and our sleep and our investments. It's incredibly tempting to believe we can hack the high cost of American health care by simply getting on a plane. Yeah, and you might be hacking your wiener off if you do. That's right.

I would be very, very careful. Speaking of life hacks, how about chopping off that extremity? Yeah. Yeah. The global medical market is not a loophole. It is a tradeoff. And you may decide that's fine. That's your decision to make.

But when you see a price tag that's 70% lower than the domestic average, you are not just saving money on some nebulous overall. overhead, you're paying for the removal of the safety net that exists. It's a double-edged sword. The regulations are very, very burdensome in some ways, but they also mean that fewer people die. And you are also trading away your right to legal recourse and your surgeon's accountability for follow-up care and possibly even access to emergency services in the event that

something horrible happens on the operating table. I do not want to have a cardiac arrest on an operating table in Bolivia. No, I don't want to have one anywhere, but if I have one somewhere, I hope it's next to the, whatever, it was the Cleveland Clinic or the Mayo Clinic? Dude, I don't want to have one at the hospital down the street from me. Right, right, right, you know? Yeah, I want only the best guys on the job. All right, as we explored with the grim reality of transplant tourism, there's an extremely

ugly side to medical tourism in general, whether it's a bargain BBL and a strip mall clinic or a scheduled kidney in a black box hospital system, the results are the same. The patient becomes a customer and the body becomes a commodity. Thanks to Nick Pell for helping us lift the bust and the buttocks of our medical knowledge. And thanks to you for listening. Topic suggestions for future episodes of Skeptical Sunday to me, Jordan at Jordan Harbinger.com, advertisers, deals, discounts, ways to support the show, all at Jordan Harbinger.com slash deals. I'm at Jordan Harbinger on Twitter and Instagram where you can also connect with me on LinkedIn. This show is created an association with Podcast One.

My team is Jen Harbinger, Jace Sanderson, Tata Sedlowskis, Robert Fogart, Ian Baird, and Gabriel Mizrahi. Our advice and opinions are our own. And I'm a lawyer, but I'm not your lawyer. Also, we, of course, we try to get these as right as we can. Not everything is gospel, even if it's fact-checked. So consult a qualified professional before applying anything you hear on the show, especially if it's about your health and well-being.

Remember, we rise by lifting others. share the show with those you love, and if you've found the episode useful, please share it with somebody else who could use a good dose of the skepticism and knowledge we doled out today. In the meantime, I hope you apply what you hear on the show so you can live what you learn, and we'll see you next time. You probably don't picture drug cartel operations running through rural America, but that's exactly why they're so hard to stop. Mariana Van Zeller breaks down how these networks hide in plain sight using everyday systems and small town blind spots to stay one step ahead. I've been covering the cartel for many years now. And I sort of wanted to do a story about cartel presence in the U.S.

And once we started researching it, I realized that actually the story should be about all the things that we don't know about control presence in the U.S., including the fact that they're in small town America. So one of our first shoots for that episode was in Georgia. And we started with a murder investigation of this woman who was tortured and they cut off her fingers and then eventually killed her. And she was killed by the cartel, and it was in the middle of nowhere in Georgia. And then we followed the investigation, and she realized that they're everywhere and particularly like to operate in small town America. Less law enforcement, easier to hide the drugs and have their distribution networks.

You know what was so interesting about this story is that in order to get access to the cartel in the U.S., we actually had to go down to Mexico and gain permission and have them say yes. Because a lot of these groups have people that work for them in the U.S., obviously the U.S. is the end goal. where they were sending their drugs. And so eventually he said, okay, we've got you, and it was all set up, and we were supposed to meet them in Minnesota. We get there, and then we waited and waited and waited for days. I'm like, I never showed up.

I want people to see many of these traffickers. Again, we do not condone what they do. It's difficult to even empathize. But the majority of the people that I talk to are people just like you and me that don't have the opportunities or the luck that we have. I try to always do my job as a journalist, which is hold people accountable. If you want to hear how cartels hide in plain sight, check out episode 1302 of The Jordan Harbinger Show.