geriatrickid

jayjay0,

You are missing the point: New therapies and treatments should be undertaken under specific circumstances with an emphasis upon oversight and review. When people start applying these treatments and therapies outside the structure that allows for checks and balances, they sabotage and disrupt legitimate research and imperil the lives of those that could benefit from the innovations. Stem cell treatments are still being researched and must be left to those facilities and personnel best equipped and trained to test the therapy.

Plenty of for profit facilities throughout the world undertake innovative treatments, but they act within the context of bonafide R&D activity. The teaching hospitals affiliated with Mahidol & Chula are able to do such research, but they didn't. Why do you think that is? My gut feeling tells me is that the proposed treatment would not have passed review. Allowing unapproved, unregulated treatments willy nilly damages the integrity and reliability of the health care system and brings shame to countries . remember the rip off cancer treatments that mexico was famous for back in the '70's? It damaged Mexico/s medical tourism niche when sanctions were imposed. If Thailand doesn't get out in front of this, it could face serious sanctions that impact the money transferred from the WHO and various governments (USA, Canada, Germany, Japan) along with funds from the Gates & Clinton foundations for research and health care projects. That's the part of the story, people must appreciate. There are conditions attached to funding and some of those strings require a rigid enforcement of a code of ethics. Honest, ethical scientists may suffer because of this.

I enjoyed reading your post - well-informed, knowledgeable and raised some interesting points. Do you know if the JCI standards, in particular, the EOC section can be assessed anywhere (in English) as I am intersted in seeing what Thai hospitals seeking accreditation are expected to comply with or if these are customized further for individual countries like Thailand? Best bet to get a copy of these standards?

Thanks,

CB

Some of the information is available in the annual report (in English). (Downlaod from their website) There is nothing wrong with the JCI, and the goals are admirable. However, they charge for their services so their programs and rating criteria are not public. They also list all of their verified hospitals.

Nothing like reporting events after the fact. Is the sudden interest because of a complaint to Medical Council? This article was published 4 months ago based upon activity that is almost a year old. Get your umbrellas ready boys and girls, the sh*t is going to hit the fan. My understanding is that there is an allegation of a breach of ethics.

There is a another thread running in respect to the attempt to make Phuket a medical tourism thread. In that thread I have pointed out and emphasized the approach to bioethics in Asia. Here we see a clear example of a questionable activity. The Medical Council of Thailand must act and hold a thorough investigation. If the physicians involved have violated treatment ethics as I believe they have, then they must be sanctioned. However, I will be very surprised if that happens.

Before anyone jumps over the two authors of the study, please note they only removed the kidney from the deceased patient and reported their findings. They did not kill the patient. These are two reputable pathologists and have distinguished careers, so please, no bashing.

Ok, so here's the abstract;

Angiomyeloproliferative Lesions Following Autologous Stem Cell Therapy

Duangpen Thirabanjasak^*, Kavirach Tantiwongseand Paul Scott Thorner^*Departments of *Pathology and Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Pathology, Hospital for Sick Children, Toronto, Canada; and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada Received for publication November 16, 2009. Accepted for publication March 28, 2010.

Some reports suggest that autologous hematopoietic stem celltransplantation holds potential for treatment of renal diseasessuch as lupus nephritis, but the safety of delivering variousstem cell types (hematopoietic, mesenchymal, and endothelialprecursors) is not well established. Here, we report a caseof lupus nephritis treated by direct renal injection of autologousstem cells recovered from peripheral blood. The patient developedmasses at the sites of injection and hematuria. We suspectedtransitional cell carcinoma but nephrectomy revealed that themasses were angiomyeloproliferative lesions. We believe thatthis previously undescribed pathologic entity is stem cell–derivedor –induced. The biologic potential, including the neoplasticpotential, of this lesion is unknown. This case illustratesthat the development of angiomyeloproliferative lesions is apossible complication of stem cell therapy.

In plain English'

They found that the patient had not benefited at all from the treatment. In all likelihood, the treatment killed the patient.

What the nation did not report;

The authors conclude that their findings should serve as a warning to clinical investigators that the development of blood vessel and bone marrow masses may be a possible complication of stem cell therapy. And they said more work was needed to identify why the masses formed, and how this could be avoided.

Writing in the same journal, Andras Nagy, of Toronto's Mount Sinai Hospital, and Susan Quaggin, of the University of Toronto, said caution was needed over stem cell therapies - especially if they were being offered by unregulated private clinics. Premature enthusiasm and protocols that are not fully vetted are dangerous and result in negative publicity for the field of stem cell research, and more importantly, may result in disastrous outcomes with no benefit to the patient. Although there is promise, a large gap still exists between scientific knowledge and clinical translation for safe and effective stem cell-based therapies.

Does anyone think that the private hospital undertook an ethical review prior to undertaking the treatment? Where did they harvest the stem cells from?

Who knows? Nothing is public.

And why does the Thai Medical Council need a kick in its pants from researchers in Canada to respond?

What do people do with their other bedmates? A "good" friend of mine had this girlfriend who had a dog that insisted, his place was between the 2 of them.

What happens if there is a cat in the picture? When one's legs are used as pillows or if someone decides he prefers to sleep horizontally when you are positioned vertically, it doesn't leave much room for stuff.

Some people snore. I have it from a reliable source that the snoring compels the bedmate to seek shelter elsewhere. (She also said, that if she gets arrested for smothering the guy, no one will convict based upon years of suffering. Meanwhile she talks in her sleep, like sleeping with a crazy lady. Probably discussing ways to murder the poor guy. )

What difference does it make anyway? Some people's bedmates are wearing pajamas + sweater + bathrobe. As if no has heard, the "You make this room like an icebox, this is Thailand, not North Pole. Just because you look like Santa Claus does not mean I have to live like him"

Hey, want to know a fun fact? The more sexual encounters one has, the more likely one is going to be a carrier of various STIs and other beasties like warts. Just what every woman wants to hear; "Yo lady, I just got done screwing with 9,999 women of various backgrounds and you will be number 10,000. As a recognition of this event, I am giving you a nice wart, some herpes and a chance to say you fornicated with a guy with psychological problems." Just what every lady wants.

If the intent is for the house to be occupied, many of best candidates in terms of trustworthiness are not going to be available during the day because they will hold down jobs. In Thailand, that leaves the next best ideal candidate: A widow or older woman. A 60 year old lady isn't going to be inviting her boyfriends over and she most likely is going to be puttering around the house, not down at the local bar.

- The dreaded discussions of Sin Sod. (Cringeworthy)

- The murder conspiracy threads. (Aluminum pie plate hats optional.)

- Driving skills. (We know, we know.)

- Fat guys in their stained singlets accompanied by ugly bargirls. (Barfilicious)

- People posting in the health section promoting miracle cures. (Enemas seem to be very popular with some people)

- Threads ridiculing Issan people. (Get over it.)

- Threads from goodhearted people asking if anyone can take in a stray critter that are met with abuse.

So what's an interesting thread? Well, I can't believe that I'm the only person that knows of a dog that ran off with a bra. How come no one else's cat insists on sitting on a pillow staring, thereby preventing amorous relationships between a couple?

I am always surprised at the cop bashers here. For the resources they have, they do a fair job and all police I have come across in 4 decades or more here have been polite and seem to be trying to do their job. I would really like to know what perfect society these cop bashers came from that they are comparing Thailand to. There are good cops and bad ones everywhere in the world from my own experience and reading. Just what real inside knowledge do these bashers have ? Anyone here who has a real personal bad experience of Thai police - as opposed to hear-say is welcome to describe that.

The cop bashers and the Thai bashers one and the same, no doubt they did the same in their homelands; I, as you have only encountered politeness from the Thai police and have never been asked for 'tea money' despite being stopped numerous times for varying checks. If cracking down on drug venues is a bad thing and a waste of resources...well.. words fail me!!

Cop bashers and Thai bashers one and the same? No. They did the same in their homelands? No.

If you have not seen the police coruption then either you do not get out much, are not employed in Thailand, do not own assets or are in denial. Which is it?

Is the Government of Canada inventing the allegations? The Government of Australia? The EU? Various agencies and government bodies have all cited endemic police corruption. Need some documentation? There's plenty of it. One of the nice reference articles comes courtesy of the briefing paper from Canada's Immigration and Refugee Board legal research division, which authored an opinion to be used by multiple departments and which cites approx. 20 different sources in its opinion: Immigration and Refugee Board of Canada, Thailand: Police corruption particularly in the state of Udon Than, 18 December 2007, THA102694.E, available at: http://www.unhcr.org.../47d6547dc.html Read it before you dismiss the concern in respect to police corruption. You can find similar documentation in Australia and the EU.

I find it particularly offensive and insulting to have someone deny that one of the reasons there is no respect for the rule of law in Thailand is that IMO the police are rotten to the core. Look at the ownership of many of the beer bars and clubs. Why do many police officers have ownership stakes? Do you understand the concept of conflict of interest? I can assure you that if a police officer in my homeland was sitting in a bar that pimped out people and was visibly inebriated yet still consuming whiskey while prominently wearing his badge and sidearm, I would be equally offended and disgusted. You can make all the excuses you want, but that's representative of police ethics in Thailand. There is no oversight of the police authority. The PM and lead police general admitted as much earlier this week. The civilian oversight committees are rigged and stacked with police cronies.

There is something inherently wrong with your moral compass if you are not concerned by police officers purchasing their ranks and positions as is currently the case. There is something very wrong with your understanding of integrity when you do not see the destruction and damage the police corruption causes. Why did 61 people burn to death at the Santika club? How is it the club could operate in an area where there were not supposed to be clubs? Why didn't the police act to stop the sale of liquor in a venue that was not licensed? On and on it goes.

I have respect for police officers that are professional and that have integrity. Honest Thai police officers are prevented from doing their jobs properly because of the disease of corruption that plagues the system in Thailand. It's time to disband the police department and rebuild. It's time to reintroduce the concept of justice into the entire justice system. Police corruption is an impediment to the advancement of Thai society and those that want it to stop, are not Thai bashers.

Well it just goes to show that some of the cops are doing there job. Not a popular belief in TV Farong Land.:jap:

Or maybe these people couldn't buy their way out of the charges?

Why this big fuss? I wonder what's it all about. Reporting tourists is standard 'law' for hotels in most western countries. It's nothing new.

Huh? Did something change in the UK, USA, Australia, Netherlands etc.? When I register, I leave a credit card imprint. Some hotels in NYC will sometimes take a photocopy of an id card, but that's only to identify you in the event of death or suicide etc. I stay in enough hotels in Europe and North America to know if my whereabouts are being reported to immigration. They scan my passport when I enter the country. that's it.

I have a suggestion for Thai immigration. Attach those tracking monitor ankle straps to the tourists, especially those heading to Pattaya. Post their activity on a google map. This way I can see if Lord Wallce Fitzhiggns- Whipplesnout is heading to Boyztown, or if Rev. Joachim Shickelshnitz is off to save souls at Miss Weewee's house of barely legal refugee girls shaking their silicon implants.

Ok, me bad. :jap:

Crock of sh*t. Remember the last crackdown promise?

Here's a hint;

1. Deputy Police Commissioner General Jongrak Juthanon said: 'We found it did not confirm to standards.'

Stumped?

(No peeking at the answer below or I'll have a kathoey slap your posterior, and they slap hard, lemme tell you.)

2. It was licensed to operate as a noodle shop and was supposed to close at midnight, plus it was located in an area of Bangkok that in 2003 had been zoned as a no entertainment zone.

3. Allegedly only 1 fire extinguisher was on the premises.

Despite the horrific loss of 61 lives, and a business operating illegally for some time, not one official or police officer was charged with dereliction of duty or corruption.

Remember the Santika. This is why I say this is crap. Let the interior minister act to enforce the fire code first.

edit 3/4 of my post vanished

When I was an undergrad and we had to hand in the compounds for analysis that we created in organic chem lab class, we used to adulterate the stuff. Toss in some powders, mix it up. The big eared low paid east european lab tutor wasn't going to know any better. Little did we realize Svetlana had seen our kind for several years and was quick with a 0 grade and the comment "You no make with the f**king around, you get zero". Well, it's time Svetlana did the same to the officials that fudge their data. A big fat zero for you guys.

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

No, it is not negativity and rubbish. What exactly are the major procedures done under the banner of medical tourism in Thailand? My understanding of the situation is that they are for the most part elective cosmetic procedures. Of course one cannot discuss this properly because the participants will not release the information. I wonder why?

There is a big difference between the provision of critical care under the "normal" operations of a hospital and catering to medical tourists. The big ticket procedures on behalf of westerners are few and far between. It is in large part driven by costs. Once one factors in the ancilliary and associated charges of flying to Thailand for most procedures, the savings, if any does not justify the hassle of travel or the added risks.

I fully acknowledge that Bummie is able to deliver quality care. However, the issue is one of elective procedures which is what the core basis of medical tourism is. People do not fly to Thailand from the UK, Australia, USA etc. for chemo or cardiac care. Why would they when they can get the care for less cost in their home countires? Yes, even in the USA. If one is on medicare or medicaid in the USA, the treatments are available. Those that fall outside that program or do not have private health care are not going to be able to afford the options in Thailand. Western critical care cardiac patients cannot just fly in to Thailand and stick around for 1-3 months. They would die in flight if they did because people with advanced coronary disease just don't do well under such conditions.

No one would doubt or argue that some hospitals can and do provide excellent care in Thailand. However, one is confusing that situation with elective critical care procedures. Add in all the costs associated with the hospital stay and recuperation and the costs exceeed that of what one pays outside of Thailand for the big procedures. Here's an example;

Cataract surgery at Bummie (just the surgery) costs between C$2,200 and $3,600. If one chooses to go the private route in Canada, and avoid the 6 month waiting period, the cost is approx. C$2,500. How about hip replacement surgery? Let's take Louie from Omaha. He can have it done at the local state hospital for free or $10,000. at worst case. If he goes truly private, he has to pay $30,000. If he is old enough, he probably has medicaid or medicare, or he may have private health care coverage. Let's assume Louie is part of the working poor without coverage, so he needs to pay $30,000. Well, he can consider Costa Rica or Mexico where the list prices are between $7,000 and $15,000. Or he can go to exotic India for the flight and treatment special of $10,000. Curry is inclusive. Now compare to Bumrungrad at $15,000. for the procedure, exclusive of travel costs. Where exactly are the savings?

The issue that you miss is that of medical ethics. It is an entire thread in and of itself. Asian hospitals do not have the same code of ethics as do western based hospitals. If I want to harvest some organs for transplant in the EU I better be able to identify the donor and circumstances of the harvest. Do you think that happens in China or India? If I want to run a clinical trial in Canada, I better be able to explain myself to the Ethics Review Board. What's the process of review in Thailand?

Do you know what the JCI does? It is still trying to get some hospitals to follow basic procedures that are a way of life in Australia, the EU etc. Look at it's last initiative, all intended to address major problems in developing world hospitals;

1. Look-alike, sound-alike medication names

2. Patient identification

3. Communication during patient hand-overs

4. Performance of correct procedure at correct body site

5. Control of concentrated electrolyte solutions

6. Assuring medication accuracy at transitions in care

7. Avoiding catheter and tubing misconnections

8. Single use of injection devices

9. Improved hand hygiene to prevent health care-associated infection

When the starting point is impressing upon hospital staff that they cannot reuse disposables, there's plenty of room for improvement.(BTW that was one of the issues highlighted in the elective eye surgery fiasco last year.)

I said it before and I will say it again, medical tourism has a massive ethics issue because it attracts patients shopping for procedures that medical practioners often refuse to do in their home countries because the patients are not good candidates. If a patient has serious medical problem and would benefit from a visit to a foreign location, that patient is most likely unable to travel in the first place.

Many Thai hospitals, even those not certified by JCI are able to provide excellent critical care treatment. That is not the issue. The question that has not been dealt with is whether or not some of the procedures are appropriate. It is not restricted to Thailand. Gastric bypass surgery is a big fad in North America. There is a reason why many of the practioners also operate in places like Mexico. The Mexican clinics cater to the higher risk candidates declined by the US and Canadian surgeons. The likelihood of being held accountable in Mexico is less likely when a high risk procedure goes wrong. Several of the surgeons that do the procedures in Canada and the USA also fly down to Mexico to perform the surgeries where they can double their incomes.

Where Thailand could have an advantage are for those procedures that require extended recovery or rehabilitation. The cost driver is labour. Unfortunately, even with a markup of 100% of the provision of labour, the profit margins are not there so a Thai healthcare system is not going to be interested. As well, there is a shortage of qualified physiotherapists and rehabilitation nurses (like everywhere else). Not a lucrative part of the health service field I guess.

Nice teeth...not!!!

Let the bitching commense....oh, it already has, nothing new there then.

OP posted in good humour but as always ends up in 'handbags at dawn', lighten up guys...please! Life really is too short you know?

He's English. Not his fault.

Here we go again. More pie in the sky wishful thinking. Do these people read medical journals or track the patients that enter Thailand?

Here's some discussion points;

- China and India also are promoting themselves as centers of medical tourism. They draw some of the most profitable procedures and you know what those are don't you? Does anyone want to join me in a chorus of where or where have all the organs gone?

- What exactly are Thailand's "International Standards"? Just who enforces those standards? When is the last time any hospital or health professional faced sanctions for a botched procedure? Oh, that's right, there are no cock ups in Thailand's health system. Thailand isn't like other countries...... Sure there was the eye surgery fiasco last year, and what pray tell was the outcome?

- US citizens can find more cost efffective medical centers in Mexico, Panama and even Canada. Yes. that's right. Canada has a very lucrative eye care business that charges a fraction of the US costs for cataract and other corrective surgery and the procedures are less costly than in Thailand. Factor in the travel costs and Canadians can find more affordable cosmetic procedures in the USA, Cuba and even India. Surprised?

- If you were a wealthy asian, and you were unable to obtain care, why would you pick Thailand, when Singapore and Malaysia have excellent facilities? But then, if you had the money, you surely wouldn't be going to Thailand. You'd get it done in your homeland. So you know what that means, don't you, Thailand has to offer the procedures at a lower cost to attract these patients. The most significant input in healthcare that can be shoved down is labour costs, and I regret to say, that top quality surgeons that perform standardized procedures in Thailand do not charge fees that are as small as people think. Check out the fees that surgeons are paid under the the UK NHS, or Canada's provincial health care plans. They are often close to the rates Thai surgeons charge. Surprised? How about this. If you are an American and have a decent health plan, the rate paid by the insurer is going to be significantly less than the "rack" rate at a hospital. Surprised again? Think of the hotel industry. There are volume discounts and there are rack rates. There are are other ways to cut costs. Want to hear about the surgical scalpel blades sourced from India? 1/2 the cost of the German blades. Trouble is that the the blades kept breaking off in the patients. The North American hospitals that made the mistake of purchasing those blades went after the suppliers. Guess what happened? The Indian supplier went to vapors. The North American hospital systems scrapped the blades and ate the costs. What do you think a Thai hospital would do?

Aren't the majority of procedures performed in Thailand on foreigners are elective cosmetic activities?. Often surgeons have declined to perform the surgery in the patient's homeland. Do Thai surgeons explain procedures to their patients? Do the chop shop folks ever talk a patient out of an elective surgery? The much promoted gender reassignment surgeries undertaken have been criticized by some observers because the patients were not suitable for the surgery. In order to have a sex reassignment in the EU, Canada, Australia etc., the patient must complete the pre counseling and be thoroughly screened. Patients can avoid this by running off to Thailand. These are the ones that usually return to their countries and have serious psychological problems.

Oh sure, some will say, I can't wait for the heart bypass surgery in Canada because there is a 2-4 month waiting period. Know what? If the patient's condition was critical the patient would go to the head of the line and more importantly, that patient would most likely die if he or she attempted a 12 hour plane ride. So, I reckon, the case isn't that critical if the patient makes it to Thailand. Selling health care services is now like selling life insurance. Quick, you better have this stent in before you drop dead. Quick, go to XYZ hospital and do it now, before it is too late.

I am not slamming Thailand's medical system because it's private care facilities can and do provide excellent care on a daily basis and they treat enough foreigners in times of emergencies to warrant respect. However, there is a big difference between those that practice medicine as a profession and those that work in chop shops. Don't believe me? If you have a relationship with your health care provider, ask him or her for their opinion.

Medical tourism is a sham. It doesn't matter what country provides it. The procedures where low labour costs are a factor such as in palliative care, or rehabilitation therapy would be ideal for Thailand. However, these are not as profitable as putting in some new boobs or sucking out some blubber. What people forget is that there are complications from liposuction and you just can't get on a plane an fly home a week later without the serious risk of something going pop. Even basic facelifts carry inherent risks. Air travel, jet lag and a change in suroundings have an impact upon the healing process. In plain language, the patients that do best are those that benefit from having a support network and sufficient time to recuperate. Most procedures that medical tourism wants to attract require a healing and recovery window of time, that the typical foreign patient does not have. What about a follow up? What does the patient do if 3 months down the road there are complications?

Why doesn't the MoH track and publish Adverse Events?

(I leave dental procedures out of the discussion, because those are an entirely different matter.)

Boy, do articles like this tick me off. They reduce an honourable profession to that of mutton vendors at a market.

My guess is that if someone looked at statistics Bkk is much safer than London or any big city in the U.S. Pollution is part of a big city. The dregs of society live in the big cities all over the world - white collar criminals, drug pushers, drug addicts, prostitutes, etc. I would like someone to begin listing any big city in Europe or the Americas - more than 1 million pop. - that is not polluted from industry & that any safer than the streets of Bkk. Mexico City? L.A.? New York City? Detroit? London? Add some names & we can discuss it. Want to look at pure trash look at the big cities in Africa, Central & South America? Are they safe? Are they not polluted? Is it not dangerous to walk the streets at night? I don't like Bkk mainly b/c of the pollution in the air & the traffic but any big city has the same problems? Think about rat holes like New Delhi, Calcutta or any other city in India? Or the filth in Pakistan? Or the unbearable cold in Moscow or the filth in the cities of China like Shanghai & Beijing or any Asian country for that matter?

There are plenty of world class cities that are liveable and that come out on top. Copenhagen. most of Canada's major cities like Vancouver, Toronto, Montreal, and even Amsterdam. Dublin for all its heartache still does better. Barcelona is another gem. Huffington Post was running a list compiled from Lonely Planet as the happiest places and places like Hidakwa, Japan; and whole regions popped up. It's all about planning and a population's resolve to make the urban center a real community. NYC, London, and Shanghai are basically city states and are in a different league from Bangkok, so perhaps it is unfair to compare them. Size doesn't a city make. Bangkok is in the same league as Delhi, Lahore, Dhaka and Bangkok comes out on top, but look at what it competes against.

There is zero administrative cost associated with an increase in VAT. Whether it is 7% or 10%, the same collection procedures are undertaken. VAT is an efficient tax because it captures tax at the point of transaction. Much more difficult to undertake VAT non compliance than personal income tax non compliance.

The takeaway lesson for the police? No screwing around when it comes to a crime involving a large influential business. If  a hiso has a problem, it's best to not try and  use the problem as a money making opportunity. Stick to extorting the poor and those that do not have powerful positions in society.

Some in fact consider the horrendous traffic and the adrenalin-rush of riding through the polluted streets and sois on the back of a motorcycle taxi or in a tuk-tuk as an attractive part of their Bangkok adventure

:cheesy:

Too bad they cannot substantiate that claim. Anyone that comes from a city with greenspace, cleanliness, room to move and decent air loathes Bangkok.

Bangkok is as representative of Thailand as is London to England. England has some beautiful places and people but one wouldn't know it from parts of London. Same applies to Bangkok. Thailand has so much better to offer than stinky Bangkok.

Decision delayed - Abhisit chalks up another diplomatic victory. When will people learn that this guy is a real player.

What? It is a delay because the Thai government said it was working on demarcation of the border first, not because of political genius. THere has been no endorsement of the Thai position. The Thai position is that if it can agree to a border the Temple issue will go away. Also look at the revised Thai position: it is no longer an outright claim but a proposal to co-manage. That to me is a retreat. My understanding is that Minister Suwit Khunkitti threw the diplomatic version of a hissy fit and said the Thais would withdraw from UNESCO, that they were being discriminated against, blah blah blah. The extension was expected and is basically giving the Thais enough rope to hang themselves.

You see....substandard literacy doesn't mean a thing.

Really? I don't think you make a valid point. You neglect to mention that the people you cite achieved their success in countries that allowed for opportunity. Everything in Thailand is predicated on having a piece of paper first. One cannot get a job as a bank teller without a university diploma.

Albert Einstein was a graduate of Zurich's polytechnic, Rockefeller graduated cum laude from Ivy League Dartmouth, Jefferson was in a different era where skillsets were different and Churchill received the benefits of an advanced military service education etc. etc. There is no comparison or relationship between the achievements of the aforementioned people and illiterate 3rd graders in Thailand. I can assure you that all of the westerners you cite were not illiterate in their equivalent point in time with the Thai 3rd graders. The reality is that the Thai educational system has not evolved. It is still run much as it was 50 years ago. The world has changed, but Thailand's education system has not kept up with the changes. It is as simple as that.

That's incorrect. 3G is anything but outdated.

4G standards are not finalized yet and only deployed experimentally in small zones, notably in Sweden.

You can't "skip" 3G because it is not meant to be replaced by 4G. Similarly, 3G did not replace 2G in the countries where it is deployed. Those are complementing network: 2G (gsm) is still used for calls and sms while 3G is used for internet. 4G will, for example bring the possibility of HD video streaming while roaming.

3G is shamefully late in Thailand but not too late. And the bright side is that once they finally obtain the 3G licenses (this is a licensing issue, not a technological or financial one) , operators will directly deploy the latest 3G revisions (usually called 3.5 and 3.9G and LTE) which will quickly make up for the delay.

Whoah, Even an IT challenged guy like me reads the news and looks at IT developments, just so I can learn about even more complex devices and systems that I can't figure out. From what I see, 4G is available in selected markets in the USA. Canada's major wireless companies are redeveloping to 4G capabilities, China reports that it has a network and it is even available in Tashkent. Yes, Sweden and Norway have a working network, but one can do wonders in a small area. When one gets to large geographic land masses like the USA/Canada and the use of 4G, that does suggest that change is on the way. The regulators and companies in Canada/USA started working on the scheme 2 years ago, so I don't think it is unreasonable to say that it takes time to implement advancements like 4G.

Thailand demonstrates a retarded growth in all things related to advanced technology and science. I use the word retarded in its purest sense. By the time the 4G system is ready to go in Thailand, it will have been surpassed by 5G, which South Korea is already planning for. That;'s the thing about technology. You have be in the game to keep up and Thailand isn't even sitting on the bench. Maybe, Thailand should forget about 4G for the time being and instead address its basic telecommunications and ISP weaknesses first. In terms of bang for the baht, I don't know what the advantages to Thai society will be of having a wireless 4G capability, when businesses can't even obtain reliable internet service.

IMO, the Dengue infection data available to the public is misleading. The system of reporting and the compilation of infections is spotty at best. What one sees in Thailand is that only the most serious cases are counted.People can be infected but asymptomatic. It's not intentional, but the reporting of the disease is passive, i.e. it is done by hospitals and designated treatment facilities on a voluntary basis. If Somchai Wiggins toughs it out and doesn't seek treatment, no one knows. Poverty acts as a barrier for those that are ill as they cannot afford medical care. As such, the incidence of Dengue Fever is significantly higher than reported in the popular press. However, insect borne diseases are part of life in the tropics just as head lice is part of the urban experience in the USA and EU.

People travel to Puerto Rico every year and don't give DF a second thought, and yet DF infections occur there. In the USA, there are serious neuronvasive infections of West Nile Virus, also carried by mosquitos and yet people still flock to California, Alabama and Arizona where the cases are diagnosed. Would you avoid visiting California for fear of contracting WNV? If so, then you should avoid Thailand nd its DF. However, if you are prepared to follow the advice of other posters (long sleeves & pants at certain times of the day and insect repellent) you will be ok. Life is full of danger. If we stayed indoors, we'd all probably die from boredom and heart disease. Don't let the DF keep you from visiting.

The OP is about the sale of insurance through a bank branch. Think about it for a minute. Is the bank manager qualified act as an insurance intermediary? This is why several jurisdictions forbid "bancassurance". It was a concept that originated in Europe and although it made sense at the time, regulators realized there were serious deficiencies and conflicts of interests and itroduced regulations that do not exist in Thailand. As well, the banks themselves have realized that the commissions earned through branch sales by tellers wasn't worth the errors and omissions that were generated. That is why many of the countries that permit it now require trained staff to sell the products and the banks themselves restrict themselves to no brainers like mortgage and life insurance related products.

Bank managers are there to manage a branch. Unless they have specific training and an education in the products they are selling, one shouldn't purchase financial services like insurance or mutal funds from these people.

It's wonderful that Police General Vasit and the Prime Minister made mention of the PAMC.

Now what are they going to do about getting it work? How about the introduction of the regulation that says no appointments by the police the PAMC is supposed to supervise. Also, how about a rule that forbids conflicts of interest, you know like owning a bar or a criminal record.

Because no one in Thailand have the license to umport M-67, other than the army. This is a known fact.

Come on. You can buy anything on the black market here.

Unfortunately, integrity, honesty and good government is not for sale.