FAQ
How many Bhutanese are sent abroad for medical treatment?
About 1,301 patients a year are referred abroad for treatment Bhutan cannot provide at home, at a state cost of roughly USD 6 million — about Nu 501 million — a year. Care inside Bhutan is free and primary care is strong, but the specialist tier is thin, with near-zero cardiologists, oncologists, and other consultants, so the most complex cases are sent to India and beyond at public expense. It is free healthcare with a depth-of-care ceiling.
The referral system is a feature, not a failure: when a case exceeds domestic capacity, the state pays to treat the patient abroad rather than let care lapse. But 1,301 referrals a year, costing about Nu 501 million, is also a precise measure of the gap between what Bhutan’s free system promises and what it can deliver at the top end.
That gap widens as the disease burden shifts toward chronic conditions that demand exactly the specialists Bhutan has fewest of — the structural squeeze set out in Paradox #37.