Healthcare on a Shoestring for the Elderly who have no insurance

[JLCrab]

I presume that for less than 3% of subscribers will health insurance work out to be a good deal. It's just that you never know when you will be part of that class for whom having health insurance was a real good deal and your claims greatly exceed your paid-in premiums.

 

... and one major event can -- as Ms. Sheryl often writes -- wipe out one's self insured reserves even of several million baht and then you are left with zero reserves.

[tonray]

Health Insurance is really not insuring your health. Aside from preventative services which for most people are not taken advantage of, you will get sick whether you have insurance or not. What health insurance does is insure the viability of your assets which you have accumulated thru a life of hard work. If you have not saved anything in your life that you want to preserve either for your own enjoyment or for heirs, then insurance is not necessary. It will however, make sickness more bearable in that the worry that comes with major illness will be lessened, and maybe prolong your life to enjoy aforementioned assets. Again, no assets..no reason to worry about the future.

[Sheryl]

Except that health insurance also insures access to health care.

 

I've seen plenty of expats in Thailand with no assets get into serious trouble for lack of health insurance -- because they could not access the care they needed.

 

[cheeryble]

I don't disagree with the pro-insurers above......but it gets complicated.

 

Can i ask some example questions?

 

1. Age nearly 69, can I start a policy and how much. (and how will it rise with age?)

 

2. Enlarged prostate, moderate urinary problems and modestly high PSA (above 4).......does that cancel all prostate conditions in future or not?

 

3. Is high cholesterol (think mine might be called very high, don't have it handy) a pre existing cardiovascular problem which cuts that off the insured conditions?

(Or is there a cut off number? ....and if so does the HDL/LDL combo come into it?)

 

Out of interest I wonder if I personally could get treated on the NHS despite being out of the UK a long time.......wondering if I could give the (true, and documented) excuse of severe agoraphobia and anxiety (previously......improving a lot now) stopping me flying. I still do not use planes. Though obviously if it was for something big and serious I could use medication to get to NHS it was best for my health to be avoided in the past.

Edited October 25, 2017 by cheeryble

[NancyL]

1 hour ago, Sheryl said:

Except that health insurance also insures access to health care.

 

I've seen plenty of expats in Thailand with no assets get into serious trouble for lack of health insurance -- because they could not access the care they needed.

 

I've known quite a few who have died from conditions that would have been treated if they had funds available -- prostate cancer, heart conditions, even skin cancer.  What is amazing to me are the ones who could go back to their home countries and get care, for example U.S. veterans who could access the VA system, yet they refuse because they want to stay in Thailand.  

 

People with limited funds rarely get routine medical checks so problems aren't caught until the symptoms become to extreme to ignore.  This is one of the big frustrations of the folks who are Cancer Connect - Chiang Mai.  So many of the folks who contact them for advice and assistance have cancers that could have been "cured" or at least managed if they had been caught earlier through routine screening, but instead they are contacting Cancer Connect for information about how to manage "end of life" care in Chiang Mai.

[cheeryble]

18 minutes ago, NancyL said:

I've known quite a few who have died from conditions that would have been treated if they had funds available -- prostate cancer, heart conditions, even skin cancer.  What is amazing to me are the ones who could go back to their home countries and get care, for example U.S. veterans who could access the VA system, yet they refuse because they want to stay in Thailand.  

 

People with limited funds rarely get routine medical checks so problems aren't caught until the symptoms become to extreme to ignore.  This is one of the big frustrations of the folks who are Cancer Connect - Chiang Mai.  So many of the folks who contact them for advice and assistance have cancers that could have been "cured" or at least managed if they had been caught earlier through routine screening, but instead they are contacting Cancer Connect for information about how to manage "end of life" care in Chiang Mai.

I can kind of understand some older people not wanting to chase around the world, but to do what they can here and accept what kismet brings them. Their home towns and countries will now be a different place, their friends maybe gone on upstairs or elsewhere or just too long ago.....and it's a damn long trip to America not to mention the expenses, the benefit of treatment would have to be in the "laey san" range to be worthwhile.

I can always remember my BIL in England saying "it doesn't matter what happens, I've had my three score years and ten."

That was 16 years ago he's still fit as a fiddle :)

 

Edited October 25, 2017 by cheeryble

[JLCrab]

My answer to the above query is probably: No. Health insurance presumes that a covered person will be paying premiums for multiple years with a low probability of any significant claims. Not that someone will be reasonably likely to submit a claim about the same time the policy starts.

[cheeryble]

5 minutes ago, JLCrab said:

My answer to the above query is probably: No. Health insurance presumes that a covered person will be paying premiums for multiple years with a low probability of any significant claims. Not that someone will be reasonably likely to submit a claim about the same time the policy starts.

Thanks.

Would still be interested if anyone has answers for those questions......even if I personally can't get insurance. 

Edited October 25, 2017 by cheeryble

[cheeryble]

Funny enough i just clicked an ad on Thaivisa on this page. Healthcare International.

Sceptical me could guess they're a kind of broker but who knows.

Unfortunately the button for "PLANS" didn't work 

 

"Membership is open to virtually everyone, provided they join before the age of 75, and we are committed to keeping any restrictions linked to past or pre-existing medical conditions to an absolute minimum. We also welcome applications for health cover from people aged 75 onwards, when will just need to ask a few additional medical questions."

[JLCrab]

Even if an insurer says that they will accept Health care applications up to age 80, each individual policy goes through an underwriting process and there is no way to tell whether they will accept any given person's application ... And they often will often not tell you why if your application is rejected.

 

I applied to 4 separate insurers that would offer international coverage including USA and received 4 rejections with no specific reason given other than I did not meet their underwriting criteria.

[Sheryl]

2 hours ago, cheeryble said:

I don't disagree with the pro-insurers above......but it gets complicated.

 

Can i ask some example questions?

 

1. Age nearly 69, can I start a policy and how much. (and how will it rise with age?)

 

2. Enlarged prostate, moderate urinary problems and modestly high PSA (above 4).......does that cancel all prostate conditions in future or not?

 

3. Is high cholesterol (think mine might be called very high, don't have it handy) a pre existing cardiovascular problem which cuts that off the insured conditions?

(Or is there a cut off number? ....and if so does the HDL/LDL combo come into it?)

 

Out of interest I wonder if I personally could get treated on the NHS despite being out of the UK a long time.......wondering if I could give the (true, and documented) excuse of severe agoraphobia and anxiety (previously......improving a lot now) stopping me flying. I still do not use planes. Though obviously if it was for something big and serious I could use medication to get to NHS it was best for my health to be avoided in the past.

1. There are insurers who will issue a new policy at age 69, yes. Examples: Cigna,  AXA, Globality, ALC, A+ Asia. Rates rise with age - some insurers yearly and some in 5 year increments.  To give you a rough idea - specifics will vary- here is one plan that I happen to have rates on hand for. It is  for inpatient only and without any deductible, can lower premiums by taking a deductible.

 

65 - 69 years   134,831

70 - 74 years   163,352

75 - 79 years  198,749

 

 

2.  and 3. will depend on the insurer. If you have enlarged prostate that is certainly a pre-existing condition so I would expect BPH to  be excluded but whether or not all prostate conditions would be is another matter. Insurers also vary in how they handle elevated cholesterol in someone without known cardiac disease.  The only way you will know is to compete an application and see what they come back with.

[DogNo1]

cheeryble:  Why not get a complete checkup and get a doctor's opinion on your risk of developing prostate cancer or coronary artery disease?  Some prostate cancers are very slow growing and just need to be watched carefully.  High cholesterol does not necessarily cause heart disease.  You could get a stress-ultrasound and see what shape your heart is in.  If you have some blockages, stenting is a possibility.  It is best done early on.  Also, elsewhere on the forum the option of having your medical procedures done in India is discussed.  Perhaps if you can predict what the cost might be if worse came to worst, you can calculate whether you need insurance or can pay on your own.  I personally have both Japanese National Health Insurance and Medicare but if I have a serious medical problem I doubt that I would want to fly out of Thailand.  Fortunately, If I must have stenting, bypass surgery or some other procedure done on an emergency basis, my Japanese insurance will reimburse me for what it would have cost in Japan which means that I would stand to recover about one-third of what I would have to pay at a private Thai hospital. At my age (75,) buying insurance to cover me in Thailand is not feasible, especially since I already have cancer and cardiovascular disease as pre-exisiting conditions.

[cheeryble]

On October 25, 2017 at 3:55 PM, Sheryl said:

1. There are insurers who will issue a new policy at age 69, yes. Examples: Cigna,  AXA, Globality, ALC, A+ Asia. Rates rise with age - some insurers yearly and some in 5 year increments.  To give you a rough idea - specifics will vary- here is one plan that I happen to have rates on hand for. It is  for inpatient only and without any deductible, can lower premiums by taking a deductible.

 

65 - 69 years   134,831

70 - 74 years   163,352

75 - 79 years  198,749

 

 

2.  and 3. will depend on the insurer. If you have enlarged prostate that is certainly a pre-existing condition so I would expect BPH to  be excluded but whether or not all prostate conditions would be is another matter. Insurers also vary in how they handle elevated cholesterol in someone without known cardiac disease.  The only way you will know is to compete an application and see what they come back with.

Thanks v much for the specific figures Sheryl.

For me at near 69 it would mean almost exactly 2 million baht premiums to take me to 80.

That would pay for several heart bypasses

OTOH I know cancer treatments can go up towards the 1 or 2 million alone thanks to pharma costs which I haven't seen Pres Trump doing anything about as promised and didn't hear much about when he tried......well others tried.....to change the ACA.

For me the problem would come if i had a series of events going into the multiple millions and even then I may get away with pulling my belt in. But if things go averagely well I will be able to pay and still have resources which can give me income.

Hmmm.....

[cheeryble]

On October 25, 2017 at 6:05 PM, DogNo1 said:

cheeryble:  Why not get a complete checkup and get a doctor's opinion on your risk of developing prostate cancer or coronary artery disease?  Some prostate cancers are very slow growing and just need to be watched carefully.  High cholesterol does not necessarily cause heart disease.  You could get a stress-ultrasound and see what shape your heart is in.  If you have some blockages, stenting is a possibility.  It is best done early on.  Also, elsewhere on the forum the option of having your medical procedures done in India is discussed.  Perhaps if you can predict what the cost might be if worse came to worst, you can calculate whether you need insurance or can pay on your own.  I personally have both Japanese National Health Insurance and Medicare but if I have a serious medical problem I doubt that I would want to fly out of Thailand.  Fortunately, If I must have stenting, bypass surgery or some other procedure done on an emergency basis, my Japanese insurance will reimburse me for what it would have cost in Japan which means that I would stand to recover about one-third of what I would have to pay at a private Thai hospital. At my age (75,) buying insurance to cover me in Thailand is not feasible, especially since I already have cancer and cardiovascular disease as pre-exisiting conditions.

Hi Number One Dog (I thought that was me!)

 

Don't worry I will go in yearly and I'm under the urologist etc.......last time he didn't even bother to get me in every three month and seems to think a years OK.

As for cardio I've had a brief chat about statins which I turned down at the time.

As I can cycle up Doi Suthep and can still hike and run or whatever daily I'll take my chances.

Funny enough last time HDL s were so high (about 100?) the v high LDLs were cancelled out.

Good luck with your conditions!

[Sheryl]

5 hours ago, cheeryble said:

Thanks v much for the specific figures Sheryl.

For me at near 69 it would mean almost exactly 2 million baht premiums to take me to 80.

That would pay for several heart bypasses

OTOH I know cancer treatments can go up towards the 1 or 2 million alone thanks to pharma costs which I haven't seen Pres Trump doing anything about as promised and didn't hear much about when he tried......well others tried.....to change the ACA.

For me the problem would come if i had a series of events going into the multiple millions and even then I may get away with pulling my belt in. But if things go averagely well I will be able to pay and still have resources which can give me income.

Hmmm.....

 

As I explained those are the premiums without any deductible or copay. You can reduce substantially - by as much as half - by accepting deductible and copay.

 

You can -- and people do -- run up a bill of 2 million in just a single hospitalization. Even 4-5 million if private hospital.  

 

o self-insure adequately one needs a minimum of 2 million baht (5 if want to use private hospitals) readily accessible and a plan for what to do once it is spent.  You have a 2 million baht insurance claim, after that you are still insured. You self-insure and spend 2 million baht and it is gone.

[DogNo1]

Good point Sheryl but if you have a hospitalization whose cause is the worsening of a pre-existing condition, your insurance won't pay, right?  Accidents and a new disease might be covered but I wonder if insurance is still worth it when I would have to self-insure for cancer and heart problems.  I would be able to buy cancer insurance in Japan since my cancer was cured more than five years ago.  I wonder if that's true of insurance available in Thailand.

[Sheryl]

It depends entirely on your policy.  You fill out the application form truthfully and see what they come back with.

 

Some insurers will cover pre-existing conditions if there have been no recurrences in a certain period of time; some will cover "acute exacerbations" of ongoing pre-exisitng conditions; some will exclude everything remotely related to a prior condition; some will refuse to insure altogether. Some will insure with an exclusion but lift the exclusion after a period of time. etc etc

 

In my experience international insurers are more sophisticated in their understanding of medical history and more likely to insure if a prior condition is clearly now resolved or stable, while some Thai-based insurers tend to make pretty  far-fetched assumptions (e.g. person with history of colds must have asthma, anyone who ever had heartburn must have a hiatal hernia etc etc) - some more so than others.  Note that "insurance available in Thailand" and "Insurance that covers expats living in Thailand" are not the same thing.  You do not have to buy a policy issued in Thailand to be covered in Thailand.

 

The only way to find out is to apply. You do not pay anything until they reply with policy terms so can decline at that point if what they offer seems not worth it.

 

I would suggest starting with Cigna Global Silver plan and seeing what they come back with. Note that there are deductible and copay options which will reduce premiums.

 

 

 

 

 

[cheeryble]

15 minutes ago, Sheryl said:

 

I would suggest starting with Cigna Global Silver plan and seeing what they come back with. Note that there are deductible and copay options which will reduce premiums.

 

 

"LIKE" is not enough for your posts Sheryl 

Edited October 29, 2017 by cheeryble

[DogNo1]

Many thanks, Sheryl.  I will give the Cigna application a try.

[nausea]

On the theme of healthcare on a shoestring, cheap as chips prices at Siriraj Hospital Bangkok from two of my recent visits. This is going through the public health system, which, for me, is an experience reminiscent of the UK NHS. I've no idea if they do private work.

 

Physio: 15 mins hydrocollator (fancy name for hot towels 555) 60bt, 15 mins electrical stimulation 60bt, 15 mins short wave diathermy 70bt - total one session 190bt.

 

Consultation: doctor (40bt) plus prescription (metaformin 500mg 120 tab., atenolol 50mg 60 tab., aspirin 81mg 60 tab.) -  total 240bt.

 

And not quite so cheap, cos of the drug costs, from a previous visit:

 

Consultation: doctor (40bt.) plus prescription (myonal 50mg 60 tab., duoccetz paracetamol 325mg+tramadol 37.5 mg 60 tab.) - total 1,155bt.

 

Also from Siriraj a couple of years ago:

 

Basic hearing aid (Oticon BTE 13 SP) c.15,000bt; not exactly cheap, but a lot cheaper than you'd get it privately I would imagine.

 

I've also had experience at Siriraj as an inpatient. I was on a public ward for 3 weeks a couple of years ago, with a very bad viral infection and a subsequent loss of hearing. Had a ton of diagnostic procedures including a spinal tap, steroids on a drip, three steroid injections directly into the inner ear. I remember fretting about the cost and insisting on a weekly bill. I was always pleasantly surprised when it arrived, my last one was circa 10,000bt. My highest was I think (not sure now) about 30,000bt. The biggest cost was the high end steroids I was put on for a while. My experience of the private sector (I was transferred to Siriraj from a private hospital after they ran out of options) makes me think those bills were pretty reasonable.

 

And more recently at the dental surgery of the local public hospital:

 

Dental work is ongoing (my mouth was a disaster area) but the extensive dental work so far has been very cheap, a few hundred baht, apart from the cost of a frontal palladium crown, which was circa 3000bt. There was a cheaper metal version offered in the 2000bt range. By contrast, I had a crown done privately a few years ago that cost 20,000 bt total.

 

 

[Sheryl]

Sisrarj has a private hospital as well but costs there are of course much higher.

 

There is no question but that public hospitals cost substantially less than private ones, usually anywhere from 1/3 - 1/5 as much.

 

Even so do not be lulled into false security by the bills you have had thus far. It is quite possible to run up a 1-2 million baht tab in a government hospital if specialized surgery and prolonged ICU care is needed.

[cheeryble]

52 minutes ago, nausea said:

On the theme of healthcare on a shoestring, cheap as chips prices at Siriraj Hospital Bangkok from two of my recent visits. This is going through the public health system, which, for me, is an experience reminiscent of the UK NHS. I've no idea if they do private work.

 

Physio: 15 mins hydrocollator (fancy name for hot towels 555) 60bt, 15 mins electrical stimulation 60bt, 15 mins short wave diathermy 70bt - total one session 190bt.

 

Consultation: doctor (40bt) plus prescription (metaformin 500mg 120 tab., atenolol 50mg 60 tab., aspirin 81mg 60 tab.) -  total 240bt.

 

And not quite so cheap, cos of the drug costs, from a previous visit:

 

Consultation: doctor (40bt.) plus prescription (myonal 50mg 60 tab., duoccetz paracetamol 325mg+tramadol 37.5 mg 60 tab.) - total 1,155bt.

 

Also from Siriraj a couple of years ago:

 

Basic hearing aid (Oticon BTE 13 SP) c.15,000bt; not exactly cheap, but a lot cheaper than you'd get it privately I would imagine.

 

I've also had experience at Siriraj as an inpatient. I was on a public ward for 3 weeks a couple of years ago, with a very bad viral infection and a subsequent loss of hearing. Had a ton of diagnostic procedures including a spinal tap, steroids on a drip, three steroid injections directly into the inner ear. I remember fretting about the cost and insisting on a weekly bill. I was always pleasantly surprised when it arrived, my last one was circa 10,000bt. My highest was I think (not sure now) about 30,000bt. The biggest cost was the high end steroids I was put on for a while. My experience of the private sector (I was transferred to Siriraj from a private hospital after they ran out of options) makes me think those bills were pretty reasonable.

 

And more recently at the dental surgery of the local public hospital:

 

Dental work is ongoing (my mouth was a disaster area) but the extensive dental work so far has been very cheap, a few hundred baht, apart from the cost of a frontal palladium crown, which was circa 3000bt. There was a cheaper metal version offered in the 2000bt range. By contrast, I had a crown done privately a few years ago that cost 20,000 bt total.

 

 

Thanks for the information Nausea

 

I'm not sure how the public and private divides.

It sounds like you went properly public.......but you did pay even if very reasonable prices.

The big public hospital in CM, Maharat, has a private entry system too, and that is certainly not cheap like your prices, nor is the public dental hospital up the road which is actually very modern and is a bit cheaper than normal. 

I wonder how one goes into the "public lane" for the regular hospital.

 

I'm due for some dental work and couldn't care if it's done in a fancy clinic or a public hospital. Crowns are starting at 8000 now for regular, normally more and of course there are three in a bridge, you did very well.

[cheeryble]

9 minutes ago, Sheryl said:

Sisrarj has a private hospital as well but costs there are of course much higher.

 

There is no question but that public hospitals cost substantially less than private ones, usually anywhere from 1/3 - 1/5 as much.

 

Even so do not be lulled into false security by the bills you have had thus far. It is quite possible to run up a 1-2 million baht tab in a government hospital if specialized surgery and prolonged ICU care is needed.

Thanks for the warning in your last sentence Sheryl.

 

How does one enter say Maharat through the public system......just turn up and they check if you know youre going public? In fact I live out of town.......would I have to be referred from my small local hospital?

Edited November 2, 2017 by cheeryble

[Sheryl]

No, since you are not covered under the "30 baht" system you do not need any sort of referral. Just turn up but need to do so very early morning. You will need to first get a hospital registration card if you do not already have one. Then there is usually a central area where people line up for a queue number and they tend to start this as early as 7 AM.  By 9 AM you risk being told to come back the next day (I am basing this on usual for government hospital, I don't have specifics on Maharaj).

Expect very long  waits, bring lots of reading material and patience. Also expect to have to run a gauntlet of medical students/interns before accessing a specialist if that is what you need, and this process may take more than one day. It is not at all unusual in a government hospital to be told you have to come back another day after you have waited many hours.... I once helped a Cambodian lady get open heart surgery at a large government hospital and it took us a full week, 8 hours each day, to finally meet the actual cardiac surgical team, following which there was a month long wait list to get an echocardiagram...you get the picture. But ultimately she got what she needed, and ti was worth it as no way could her family possibly have come up with what it would have cost privately.

 

Once in the system and getting treated in a specific clinic, the follow up visits are easier and you can go direct to the relevant place, but even then not unusual to have an appointment (which will not be for a fixed time) and show up only to find out that the doctor(s) have all been called away for a seminar or the like.  So be prepared for all this and consider if it is really worth it given that you live some distance away.

 

I don't know about Maharaj but in the regional hospital for where I live, really excessive waits  for dental care  - 1-2 month wait to start root canal treatment (even if the person is in agony with a toothache) and then it takes 3 months to complete.  2-3 month wait for  first visit re dental prostheses...you get the idea. 

 

Frankly unless you have really an abundance of time and very, very  little money, usually not worth the hassle and multiple trips to use public channel for simple consultations or other not very expensive things, especially if coming from out of town - you may spend more on travel than it would have cost you to go through Sripat or even a private hospital.  But for those really living close to the wire economically, and living near the hospital with unlimited time at their disposal, it may be worthwhile.

 

I think you can use Sripat for outpatient care and still have any major inpatient care done through public channel, but perhaps Nancy or other CM resident can confirm.

[cheeryble]

38 minutes ago, Sheryl said:

No, since you are not covered under the "30 baht" system you do not need any sort of referral. Just turn up but need to do so very early morning. You will need to first get a hospital registration card if you do not already have one. Then there is usually a central area where people line up for a queue number and they tend to start this as early as 7 AM.  By 9 AM you risk being told to come back the next day (I am basing this on usual for government hospital, I don't have specifics on Maharaj).

Expect very long  waits, bring lots of reading material and patience. Also expect to have to run a gauntlet of medical students/interns before accessing a specialist if that is what you need, and this process may take more than one day. It is not at all unusual in a government hospital to be told you have to come back another day after you have waited many hours.... I once helped a Cambodian lady get open heart surgery at a large government hospital and it took us a full week, 8 hours each day, to finally meet the actual cardiac surgical team, following which there was a month long wait list to get an echocardiagram...you get the picture. But ultimately she got what she needed, and ti was worth it as no way could her family possibly have come up with what it would have cost privately.

 

Once in the system and getting treated in a specific clinic, the follow up visits are easier and you can go direct to the relevant place, but even then not unusual to have an appointment (which will not be for a fixed time) and show up only to find out that the doctor(s) have all been called away for a seminar or the like.  So be prepared for all this and consider if it is really worth it given that you live some distance away.

 

I don't know about Maharaj but in the regional hospital for where I live, really excessive waits  for dental care  - 1-2 month wait to start root canal treatment (even if the person is in agony with a toothache) and then it takes 3 months to complete.  2-3 month wait for  first visit re dental prostheses...you get the idea. 

 

Frankly unless you have really an abundance of time and very, very  little money, usually not worth the hassle and multiple trips to use public channel for simple consultations or other not very expensive things, especially if coming from out of town - you may spend more on travel than it would have cost you to go through Sripat or even a private hospital.  But for those really living close to the wire economically, and living near the hospital with unlimited time at their disposal, it may be worthwhile.

 

I think you can use Sripat for outpatient care and still have any major inpatient care done through public channel, but perhaps Nancy or other CM resident can confirm.

An excellent rundown thankyou v much Sheryl.

I have resources but I enjoy the opportunity for reading and for some conditions and states of non-urgency it may be a reasonable option. The only worry for me would be the ethical dilemna that I'm taking a poorer person's place but in fact I suppose it's all the same docs/surgeons if you go private so they;re gonna be doing your treatment anyway.

Edited November 2, 2017 by cheeryble

[NancyL]

Excellent description of how to access outpatient care at a public hospital, Sheryl.   One thing worth mentioning is that certain outpatient "clinics" are held on certain days of the week.  For example, at Suan Dok (Maharaj Chiang Mai), cardiology is on Wednesdays, HIV on Fridays, etc.  Of course, orthopedics is every day, Monday-Friday.  As long as Thailand continues to have such a personal accident rate, there is high demand for orthopedics.

 

A year ago or so, Suan Dok hospital instituted "dual pricing" in their inpatient room rate for foreigners.  Considering that often a non-urgent inpatient has to wait several days for a diagnostic test like an MRI or CT scan or for a slot in the operating room schedule,  it may be more economical for someone to check-in at Sripat Hospital, where the patients are at the head of the queue for the diagnostic equipment and operating theaters that the two hospitals share. 

 

I've known foreigners (and Thai people for that matter) to be quoted wait times in excess of a year at Suan Dok for non-urgent procedures like a coronary bypass or hip replacement.  They want the foreigners to use a private hospital and the Thai people to go to an amphur hospital like Nakorn Ping hospital.