Government Hospital for Thai people, free in hometown only???

[bbi1]

I've had a Thai person tell me that apparently the free medical care from a Government Hospital for Thai people can only be used in the hometown of where that Thai person has registered. If they travel to another province and have an accident or needs treatment, they need to return back to their hometown to get free treatment or if they don't, they will have to pay for treatment in a Government Hospital of whichever province they are at.

 

Same with if they get treated in their hometown then need to continue treatment in another province, they will need to pay for the rest of the treatment in their non-hometown province.

 

To me that sounded really strange. Is this really true? Also, does anyone know where a Thai person can call to confirm if this is true or not?

[robblok]

They only get treatment at the hospital they are registered, however if they are referred by that hospital to an other hospital the treatment is still free. 

Edited February 16, 2018 by robblok

[Sheryl]

It is semi true.

 

In a true, life-or-death  emergency wherein it is not possible to transfer them elsewhere they may receive care at any government hospital...though that hospital will want to transfer them to their home area once they have stabilized. Anyone in that situation who is asked to pay should immediately call the NHSO office and complain - but only if it was really an emergency that made returning home impossible. Call center 1330.

 

Otherwise, they must receive care at the hospital which is designated for the area where they are listed in a tabian ban (house registration book) or any other facility that this hospital refers them to. Such referral is generally given only if the care needed is not available at the home hospital and will not be to any hospital of choice, but rather to the designated nearest referral site in the public health system. That said, I have known cases where hospitals have been a bit flexible on it if the patient or family specifically requested a different location due to where he/she worked. This varies by hospital, some are much more accomodating than others, and it also varies with what the condition was.

 

The system operates on a capitation basis not a fee for service basis - hospitals receive a flat amount annually for each person living in their catchment area. They do not receive anything  specific to the amount or cost of treatment provided. If people could freely go to any hospital, any place, certain hospitals would have a large funding excess and others would be rapidly bankrupted, not to mention overrun in terms of manpower and space. It would be complete chaos, hence the rules. This is not an unusual approach and many national health systems operate on a somewhat similar basis.

 

What makes it problematic is that many, many Thais live somewhere other than where they are listed in a tabian ban, sometimes hundreds or kilometers away. It is possible to change tabian ban listing but it is a hassle and many do not bother. This in turn leads to problems when health care is required, as they then have to travel to their home province. Which in turn much increases the time needed to take off from work, especially if the distance is far, as people will want to stay put back home until their condition is completely resolved.

 

 

 

 

[lovelomsak]

My wife developed a bad respiratory problem. We are registered in Lomsak but live closer to Lomkow (sp)  Hospital. She went there for treatment and has to go back every 3 months. I pay for every visit  plus meds. every time. I ask her why she does not go to Lomsak for free. She gave me an answer that I could not make sense of so gave up.

  So yes it seems go where you are registered or pay.

[bbi1]

57 minutes ago, Sheryl said:

Otherwise, they must receive care at the hospital which is designated for the area where they are listed in a tabian ban (house registration book) or any other facility that this hospital refers them to. Such referral is generally given only if the care needed is not available at the home hospital and will not be to any hospital of choice, but rather to the designated nearest referral site in the public health system. That said, I have known cases where hospitals have been a bit flexible on it if the patient or family specifically requested a different location due to where he/she worked. This varies by hospital, some are much more accomodating than others, and it also varies with what the condition was.

My gf got a bad dog bite recently and went to her hometown hospital. She's got a few upcoming job interviews in my province in the next 2 weeks. She will still require a few more vaccines for the dog bite over the next few weeks, but needs to go for these job interviews in my province. Do you think there is a possibility for the hometown hospital to refer a hospital in my province to provide her the vaccines and give the injections free of charge? Otherwise maybe she needs to collect the vaccines from her hometown hospital, and bring them here, but then there's the issue of refrigeration of the vaccines of an 8 hour bus trip or via a flight.

[Sheryl]

3 hours ago, lovelomsak said:

My wife developed a bad respiratory problem. We are registered in Lomsak but live closer to Lomkow (sp)  Hospital. She went there for treatment and has to go back every 3 months. I pay for every visit  plus meds. every time. I ask her why she does not go to Lomsak for free. She gave me an answer that I could not make sense of so gave up.

  So yes it seems go where you are registered or pay.

Is she listed in a tabian ban for where you now live? And is that in Lom Sak district? If so, then it might just happen to be the case that you fall within the administrative catchment area of Lomsak even though Lomkow is closer. Each hospital has a defined geographical catchment area, usually matching to the boundaries of an administrative district. It is quite possible, if you live towards the outer boundary of a district, to fall under the catchement of one hospital but actually be closer to another.

 

If not then solution is to change her tabian ban registration to where you actually live.

 

Neighbors will know what hospital covers your village.

[Sophon]

3 hours ago, bbi1 said:

My gf got a bad dog bite recently and went to her hometown hospital. She's got a few upcoming job interviews in my province in the next 2 weeks. She will still require a few more vaccines for the dog bite over the next few weeks, but needs to go for these job interviews in my province. Do you think there is a possibility for the hometown hospital to refer a hospital in my province to provide her the vaccines and give the injections free of charge? Otherwise maybe she needs to collect the vaccines from her hometown hospital, and bring them here, but then there's the issue of refrigeration of the vaccines of an 8 hour bus trip or via a flight.

Rabies vaccinations are very cheap, so in your situation I would just go to the local hospital and pay for the shots. I was bitten in Bangkok a few years ago and got post exposure rabies and tetanus shots at the local government health centre for 50 baht and 20 baht respectively.

 

The immune globulin is relatively more expensive, but your GF should already have had that on the day she was bitten.

 

Sophon

Edited February 16, 2018 by Sophon

[Sheryl]

2 hours ago, bbi1 said:

My gf got a bad dog bite recently and went to her hometown hospital. She's got a few upcoming job interviews in my province in the next 2 weeks. She will still require a few more vaccines for the dog bite over the next few weeks, but needs to go for these job interviews in my province. Do you think there is a possibility for the hometown hospital to refer a hospital in my province to provide her the vaccines and give the injections free of charge? Otherwise maybe she needs to collect the vaccines from her hometown hospital, and bring them here, but then there's the issue of refrigeration of the vaccines of an 8 hour bus trip or via a flight.

No, not a chance IMO. But getting them to give her the vaccine to take with her is possible if they are willing and most of the cost is the vaccine itself, the fee for a nurse to inject it is nominal.

 

Not hard to keep cool on a bus, especially given how high they tend to keep the a/c assuming you mean one of the private inter-provincial bus services. The vaccine vials are small. Pack in a portable ice cooler. (but protect it from direct contact with the ice - it should not be frozen). Although the recommended storage tempo is 2 - 8 C, the vaccine has been shown to keep its potency for up to 30 days in temperatures as high as >30C.

 

If she gets job and it looks like she will be staying in  your province long term she should change her tabian ban registration accordingly.

[bbi1]

34 minutes ago, Sophon said:

Rabies vaccinations are very cheap, so in your situation I would just go to the local hospital and pay for the shots. I was bitten in Bangkok a few years ago and got post exposure rabies and tetanus shots at the local government health centre for 50 baht and 20 baht respectively.

 

The immune globulin is relatively more expensive, but your GF should already have had that on the day she was bitten.

 

Sophon

Ok thanks for the info. So the immune globulin is only given once on the first visit to the hospital? It's only the rabies & tetanus shots that are given 4 or 5 times all up over a few weeks?

[bbi1]

35 minutes ago, Sheryl said:

No, not a chance IMO. But getting them to give her the vaccine to take with her is possible if they are willing and most of the cost is the vaccine itself, the fee for a nurse to inject it is nominal.

 

Not hard to keep cool on a bus, especially given how high they tend to keep the a/c assuming you mean one of the private inter-provincial bus services. The vaccine vials are small. Pack in a portable ice cooler. (but protect it from direct contact with the ice - it should not be frozen). Although the recommended storage tempo is 2 - 8 C, the vaccine has been shown to keep its potency for up to 30 days in temperatures as high as >30C.

 

If she gets job and it looks like she will be staying in  your province long term she should change her tabian ban registration accordingly.

Ok thanks for the info :)

[Sheryl]

Ok thanks for the info. So the immune globulin is only given once on the first visit to the hospital? It's only the rabies & tetanus shots that are given 4 or 5 times all up over a few weeks?

Only the rabies vaccine usually since most people will have had full tetanus series as children and need only booster.

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[phitsanulokjohn]

16 hours ago, Sheryl said:

It is semi true.

 

In a true, life-or-death  emergency wherein it is not possible to transfer them elsewhere they may receive care at any government hospital...though that hospital will want to transfer them to their home area once they have stabilized. Anyone in that situation who is asked to pay should immediately call the NHSO office and complain - but only if it was really an emergency that made returning home impossible. Call center 1330.

 

Otherwise, they must receive care at the hospital which is designated for the area where they are listed in a tabian ban (house registration book) or any other facility that this hospital refers them to. Such referral is generally given only if the care needed is not available at the home hospital and will not be to any hospital of choice, but rather to the designated nearest referral site in the public health system. That said, I have known cases where hospitals have been a bit flexible on it if the patient or family specifically requested a different location due to where he/she worked. This varies by hospital, some are much more accomodating than others, and it also varies with what the condition was.

 

The system operates on a capitation basis not a fee for service basis - hospitals receive a flat amount annually for each person living in their catchment area. They do not receive anything  specific to the amount or cost of treatment provided. If people could freely go to any hospital, any place, certain hospitals would have a large funding excess and others would be rapidly bankrupted, not to mention overrun in terms of manpower and space. It would be complete chaos, hence the rules. This is not an unusual approach and many national health systems operate on a somewhat similar basis.

 

What makes it problematic is that many, many Thais live somewhere other than where they are listed in a tabian ban, sometimes hundreds or kilometers away. It is possible to change tabian ban listing but it is a hassle and many do not bother. This in turn leads to problems when health care is required, as they then have to travel to their home province. Which in turn much increases the time needed to take off from work, especially if the distance is far, as people will want to stay put back home until their condition is completely resolved.

 

 

 

 

Well explained Post Sheryl.

[Jeffrey346]

I am registered and use Khon Kaen University Hospital. It's a Gov hospital and my treatment is free.

People come from all over the NE and their treatment is free as long as they have preregistered.  

[Jack Mountain]

What Sheryl says. My gf got her appendix removed at Sirikit, Sattahip although she's coming and registered in Kham Peng Phet. And indeed they declared it an emergency. Had to pay the investigating costs (about 1500 Baht) but when they concluded that it couldn't wait it was further for free. She got the operation 3 hours later. 

[sjbrownderby]

I am registered at a number or hospitals but only one is local to where I live. For each hospital the registration process and documentary requirements were slightly different. When I registered at the Suranaree University Hospital in Korat I had only to show my Thai ID card to register and that is all I need should I require treatment at any time. I understand that at some hospitals I may have to pay for medication but at my local hospital in Khonburi (Nakhon Ratchasima province) I do not. Most hospitals will issue an ID card after registration and Fort Suranaree Military Hospital in Korat issued a photo card ID. So, it seems that every government hospital has a slightly different way of doing things so what may apply to one hospital may not apply to another. I should say that I am entitled to the same healthcare as Thai Government employees by virtue of my wife being a teacher. 

 

[sandyf]

On 2/17/2018 at 12:45 PM, sjbrownderby said:

I am registered at a number or hospitals but only one is local to where I live. For each hospital the registration process and documentary requirements were slightly different. When I registered at the Suranaree University Hospital in Korat I had only to show my Thai ID card to register and that is all I need should I require treatment at any time. I understand that at some hospitals I may have to pay for medication but at my local hospital in Khonburi (Nakhon Ratchasima province) I do not. Most hospitals will issue an ID card after registration and Fort Suranaree Military Hospital in Korat issued a photo card ID. So, it seems that every government hospital has a slightly different way of doing things so what may apply to one hospital may not apply to another. I should say that I am entitled to the same healthcare as Thai Government employees by virtue of my wife being a teacher. 

 

I have been to a few hospitals and clinics and would agree that they all seem to do there own thing.

I went to the hospital in Bang Saen a few days ago and I registered there with my ID card. There everyone pays 200 baht to see the doctor, probably explains why there was very little queue, I got ticket No 12 and by the time I had left I doubt another half dozen had turned up.

Doctor said they would do another X ray and ECG and make appointment for cardiologist next week, charges were reasonable, 300 for X ray and 200 for ECG, same as the cancer hospital a couple of weeks ago.

[sanuk711]

On 2/17/2018 at 8:59 AM, Jeffrey346 said:

I am registered and use Khon Kaen University Hospital. It's a Gov hospital and my treatment is free.

People come from all over the NE and their treatment is free as long as they have preregistered.  

I have been registered there for some years Jeffery-- but its never been free for me--(the heart hospital you mean?) Its not expensive, but I have to attend every 12---16 weeks for a check.EKG sometimes scan etc.

I think even Thais have to pay for medication -& the doctor part isn't expensive. I am also registered in Udon Thani, been having Physiotherapy + heat treatment on shoulder there weekly,  ----cost per session with the Physio 170 Baht

[Jeffrey346]

16 hours ago, sanuk711 said:

I have been registered there for some years Jeffery-- but its never been free for me--(the heart hospital you mean?) Its not expensive, but I have to attend every 12---16 weeks for a check.EKG sometimes scan etc.

I think even Thais have to pay for medication -& the doctor part isn't expensive. I am also registered in Udon Thani, been having Physiotherapy + heat treatment on shoulder there weekly,  ----cost per session with the Physio 170 Baht

Sorry I should have explained that my wife is a Gov't employee and I am covered on her plan. 

Yes, I am referring to the heart hospital. I pay the same B250 copay as Thais do.  Doctors and meds are included. I am on a new heart med and the cost is in excess of B16,000 a month.

[sanuk711]

1 hour ago, Jeffrey346 said:

I pay the same B250 copay as Thais do.  Doctors and meds are included. I am on a new heart med and the cost is in excess of B16,000 a month.

Your on a winner Jeffrey---the meds are always the most expensive part of (long term) treatment---yes its a good hospital, excellent doctors most who have worked overseas so can speak English well.

[Jeffrey346]

10 minutes ago, sanuk711 said:

Your on a winner Jeffrey---the meds are always the most expensive part of (long term) treatment---yes its a good hospital, excellent doctors most who have worked overseas so can speak English well.

Agreed. I use Dr Burabha.. He spends a lot of time with me.. no short cuts..