Chiang Mai Ram Hospital - Far Too Expensive

[p1p]

The Chiang Mai Ram has become far, far too expensive - and reports are suggesting they are even padding their bills in less than ethical manners. A friend recently had a bill for oxygen alone reduced from 45,000 Baht to just 5,000 when he questioned it and refused to pay. The patient in question, a family member, had died. So he told the hospital to keep the body and he walked out. Only after that did they admit to a "mistake" and seek to rectify it.

In addition to this story, I have heard many other cases of overcharging, especially in the area of drugs. Another friend was recently charged over 30,000 for drugs after a brief hospital stay. Checking the price from other hospitals and pharmacies outside, he found the same "name brand" medicines for under 11,000 and generic equivalents for only 2,500.

They are also fond of prescribing expensive and unnescessary tests. Another friend recently went in for a check up after experiencing some mild chest pain. The first thing they tried to do was put him in their new full body scanner, a 20,000+ cost. He refused and phoned with his doctors overseas, who told him to request an EKG first. That was clear and he was treated with simple antiacid, which he purchased from an outside pharmacy.

There are yet other cases of the Ram overcharging local Farangs because they believed they were from overseas, then reducing prices when they discovered they were expatriates.

I can not help but feel it is time to call for a Farang ban of the Ram hospital until they start showing a few more ethics in their charging policies.

[ThaiPauly]

Don't get me started on the Chiang Mai Ram Hospital

I went in for a very minor ailment and nearly lost my life because of their incompetence

[Ta22]

Got no idea where is chiangmai ram .. is that the one near KSK - central ?

anyway my mother was sick a while ago and went to see a doctor near the KSK beside the tokyo hotel ,

the doctor fee is 300 baht ,

but after giving her some panadol . and some painkiller - i think is ibuprofen 200mg . she was bill 3,400 baht ..

so when i check i think 300 for doctor fee and time and 100 baht for some thing and the rest is drug price .

she was cure .. after looking at the bill in stunt whahhahahahahhahahahah

the next time round she went there - i requested to buy the drug outside . giving excuse that i am leaving chiangmai and can get cheaper drug in my country whahhahha

[likite]

Chiang mai ram is a hospital that I would avoid if at all possible (from personal experience). Not because of treatment costs, although from the OP's and ThaiPauly's comments that would enough, but the substandard levels of care and customer service, which have been discussed on other threads here.

In respect of drug prices I suspect a few hospitals do exactly the same and overcharge for drugs. This was I think the case with the private hospital on Suthep Road when my wife had complications after an operation. I couldn't prove it but the cost of the drugs were IMHO way over the top.

[Ajarn]

I have been going to Ram for awhile. In my experience, I haven't been overcharged at all, and, lately, my care has been excellent. One must consider the doctor, for everything revolves around them. If you have a good doctor, then I would say that you are safe from malpractice and most overcharging, in my own experience

[Ta22]

Seem like is a trend to overcharge - sick needy people - whahah

well . go see the doctor . and request to buy your drug else where . there is like so many drug store out there . that is willing to sell you almost anything if you can give them the name whhahaha opps .. i mean if you give them a doctor 's paperwork whahahahhahah

[thomo]

Odd timing of this thread. I've probably been to a hospital 3 times in my life but was gonna pop back there for something minor over the next few days. I had to go there for something minor about 6 months ago and thought it was a really good set up - it cost me about THB2000 {would have cost about €300 in my country of origin} but may go somewhere else now.

Anybody have any good hospital recommendations?

[ThaiPauly]

I have been going to Ram for awhile. In my experience, I haven't been overcharged at all, and, lately, my care has been excellent. One must consider the doctor, for everything revolves around them. If you have a good doctor, then I would say that you are safe from malpractice and most overcharging, in my own experience

Many Doctors indeed Ajarn....but how many aneatheatists?

[richard10365]

I had surgery there. The surgery went ok but the after care kinda sucks. I was scheduled for followups every month and just decided they weren't worth the 1000+ baht I was spending for 5 minuites with a doctor. I just stopped going.

The prices are pretty high. I took my bill apart and noticed some irregularities. I added everything up and noticed I over paid.

My insurance covers 75% of the bill. I was responsible for 25%. The hospital computed my 25% from the total cost and not the adjusted cost after my insurance paid.

After I explained their error, I got a refund.

When my son is sick here in Chiang Mai, I take him to Lanna Hospital. It seems more reasonable.

[Ulysses G.]

I will boycott Ram until I have a need for good quality medical care and then I will run over there with my tail between my legs as fast as I can go!

[pichai]

I went for my annual check up with my wife and we found that the prices Ram charged were acceptable. Recently, I had food poisoning and flu n cough on 2 occasions I went back again the prices were also acceptable. I don't see Ram overcharged at all.

[ThaiPauly]

CMR's prices are not expensive compared to BK prices however.

I spent 24 hours in Samitevej last week and was charged 11,500 Baht for medication!

That is outrageous...its not as if I was in intensive care or anything. They took all the medicine I use daily away from me and said it was "Policy" to use their own drugs (although they forgot to mention that these were 1000 times more expensive than I pay for them at a Pharmacy).

It used to be that Thailand was reasonably priced for hospital care, not anymore, perhaps they are feeling the pinch of new government regulations and are getting less customers and need to charge more to compensate?

[DrFisher]

I hate to say it but Chiang Mai Ram is the best hospital in the city and if I have a major problem it's where I want to go. I have government insurance but they will only send me to Lana hospital and well, the ER isn't even clean!!! Being from the USA and having worked in a hospital most of my life I can tell you that Thai hospitals are no different than American hospitals when it comes to billing or over billing. As a physician I would very much advise against a boycott in an emergency situation but Lana hospital is reasonable for testing and has a clean facility for this purpose. Anytime you are in a country that has for profit medicine and little or no social medicine you are going to run into this problem, it's just a fact of capitalist country.

[Austhaied]

We had the same (over charged) experience about 6 months ago. And all 3 of my children were in and out many times with the same ailments, only to be told to take dozens and dozens of pills again and again, total rubbish. We have since changed to Maharat Nakhorn Chiangmai (13th floor)on Suthep Rd, they have a special clinic that acts as a private ward, ie; no long waits.. Excellent service at a very reasonable price.. Of course my Thai wife takes them there, i stay in the lobby downstairs, just in case the dual price vice comes into play.. I am not sure of the level of English spoken there..

[chuchok]

I hate to say it but Chiang Mai Ram is the best hospital in the city and if I have a major problem it's where I want to go. I have government insurance but they will only send me to Lana hospital and well, the ER isn't even clean!!! Being from the USA and having worked in a hospital most of my life I can tell you that Thai hospitals are no different than American hospitals when it comes to billing or over billing. As a physician I would very much advise against a boycott in an emergency situation but Lana hospital is reasonable for testing and has a clean facility for this purpose. Anytime you are in a country that has for profit medicine and little or no social medicine you are going to run into this problem, it's just a fact of capitalist country.

There is reason for that.They are too expensive at Ram.

Edited February 19, 2007 by chuchok

[davidgtr]

Funnily enough I had to go to Ram last Saturday night with some broken bones.

Id fallen off my bike near Hongsa in Northern Laos Friday afternoon & made a mess of my shoulder. There are almost non-existent medical facilities (no x-rays, but I knew it was broken anyway) in Hongsa & the Lao advice was to go Xayaboury 4 hrs & 96 kms south-east. Now having a bit of accident experience I knew that I could make it to Chiang Mai by pick-up, & I did get to Cnx 42 hrs later at 9.30 pm Saturday night. My plan then was to test out my pain limit & last until Sunday morning & then make it to the good bone Dr Sudhee at his clinic & start the patch up process. However by 11pm I decided I needed another jab of Tramadol & off I went to Ram. The service there was ok, but it no jab without an X-ray to confirm, which was fair enough. Anyway the xray showed 4 fractures of my humerus, which got me the necessary jab. The Dr then told me needed to operate on me immediately that night to pin my shoulder & humerus. Greedy little bastard I thought could not wait until I was even checked in. He then got a shock when I said a straight NO; I'm off to Dr Sudhee's clinic tomorow morning. I’m going home now, just give me the bill & make sure your medical report is detailed & correct.

The next morning as I painfully crawled out of the g/f's car Sudhee arrived & says hello David, not back again. Yep sure was came the reply. Sudhee is a wonderful man & human being. But he was not at all impressed with the Dr at Ram suggesting I needed an emergency op - he only wanted to make some fast money were his own words! Plus the op would have been dangerous at this early stage with so much swelling, and Sudhee believes there is only 1 Dr in Chiang Mai who can do the op, & it is not even him. Also I was not even given any anti-inflammatory pills, which should have been 2nd after the Tramadol jab.

So yeah you need to watch it at Ram hospital.

And if you ever need an orthopedic surgeon, only deal with Dr Sudhee first. Plus you don’t always have stay in the hospital, the docs just like to keep you there & make easy money. Right now I have a shattered left shoulder humerus & I don’t see any need to lock myself up in Ram. If & when I need an op I will go in the day of the op & hopefully be out again in 36 hrs, then use Sudhee at his clinic.

[p1p]

David - Sorry to hear of the accident, but glad you got back home in one piece. (Please feel free to give me a call if there is anything I can do to help.)

Yes, Dr. Sudhee is by far and away the best. I have to go see him again soon because my rebuilt knee (from the UK) seems to be falling apart again. Trying to lose some weight first though. Don't want another of his lectures.

Back to Ram. One of my children's teachers was recently given some stomach medication, They tried to charge him 250 Baht per pill. He refused to accept the pills and went around the corner to a pharmacy, 75 Baht per pill or 10 Baht for the generic equivalent.

[ProThaiExpat]

I am two weeks outpatient of Ram, in there for 10 days. Two surgeries, second one to see why I kept bleeding at the surgery site.

Orthopedist charged 17,000 Baht for internal fixation of displaced fracture of femur near femural head. Anethists charge 3500. Operating room about same. Second exploratory surgery was charged at 2000K for surgeon, operating room and anethisit were the same as first surgery. Standard room was 1k a day but I payed extra for electric adjustable bed.

Every meal, always cold and almost unedible were charged at 150 Baht. Nurses services were charged extra on a daily basis. I had my meals brought in and KFC delivered. Dieticians prevented me from ordering what I wanted from hospital kitchen due to my high chloesterol condition, so I just told the food order taker to disregard the dieticiians orders and they did.

Every conceibable supply was charged including the number of swabs, etc.

When I left, they gave me a bag of leftover meds and injectables that were charged to my room and in excess of what was needed. Credit was given on my bill at one half the charged cost for the items I took home.

Bills were delivered to my room on Mon, Wed & Friday and a breakdown of any category was provided willingly.

No question they make their profit on the meds. Tylenol was 53 baht per tablet. They charged me 500 baht a day for an injection of a clear liquid that was supposed to supress bleeding, it didn't work and I am sure nurses services covered the administration of the injection and were billed separately.

I received three units of whole blood, very reasonable charge, because the blood was donated.

Most spoke enough English but the rotational change of staff was so great that they didn't know which limb was broken when they moved me.

I believe in being active in my own care so was able to avoid the inevitable thoughtless treatment by the lowest denominator in the skill chain. When I questioned catheter removal time, someone forgot and profuse apologies came forth.

My orthopedist was very caring and spoke good English, Dr. Aurunpong -----------. He was on night duty the night I went in by ambulance. They had no ambulance available when I called, so used the governent hospital ambulance near the house. The busy ambulance brought in a patient from Hangdong that didn't make it, so it seemed by the frantic heart pounding they were giving him to no avail.

They do have a ritzy Heart Ambulance on display outside Emergency and three or four other ones parked around, so really don't know why they couldn't send one.

Overall, the treatment and care were satisfactory. The whole bill was 136K, fair once the med cost was accepted. Clearly that part of the bill was agregious. Certainly many supplies could have been charged for and not received, but no way to determine the accuracy of what is used in the operating room. Another thread reports a skull fx case billed at 80K for seven days, half in ICU.

Followup visit was free. Xrays were inexpensive, lab test were what they usually charge outpatients, perhaps a little on the high side.

They would only accept Visa card for payment. I was so glad to get out of there that I was in no mood to strart a dispute about their outrageous med charges, which I am sure they count on. Hospital pharmacy med charges are high throughout the world as they must have pharmacists on duty 24 hours a day and carry a much larger inventory of drugs than regular pharmacys.

I am happy Ram is in Chiang Mai and those who don't like it for whatever reason are free to exercise their right to go elsewhere.

By the way, I kept my own meds in the drawer next to my bed and continuted by hpertention, gout and chloesterol medicines as before admission. Their pain meds were too expensive for my taste so I had mine brought from home, and my doctor had no problem with that, once he saw what was in it.

My doctor is considered only part-time by the staff as he is not listed on their web page. He teaches at CMU and is on staff at their hospital. The ten orthopedists that are listed with picture on the Ram web page are not impressive in any regard, although, they may be very good, I have no idea. Perhaps I was lucky. On the other hand, my femur fx was torsion caused and my ortho payed little or not attention to the obvious, to me, muscle strain and sprain in my upper leg that has given me the most pain and discomfort. He just focused on the bone and the subsequent bleeding. In the West, it is acknowledged that muscle sprain and strain are far more injurious and difficult to treat sucessfully than a fx. A hospital Internist was also called in to consult by my Ortho due to my age, and meds going in, he came to seee me allmost eveyday and his bill was quite reasonable.

I am confident that you can do a lot worse in Chiang Mai than Ram. If you contemplate going to Ram for the first time, expect to pay more for meds. Otherwise the physician charges are reasonable and if you don't think so, the physician may well reduce his charge.

I went outpatient there last year and the dermatologist said their charges were less than BKK. When he charged me more than the advertised prices by Yanhee Hospital and I showed him so, he reduced his charges.

It is certainly a "for profit" institution and during thier slow periods, patients probably pay more so they can meet payroll, etc.

Good luck to those who find alternative hospitals and would like to hear about them as knowledge is power and options are freedom.

[richard10365]

If you use your insurance to pay the bill, make sure if you have a percentage to pay, they calculate it correctly. Reading through all these stories of hospital care at CM Ram makes me think there is something going on there illegal. Even with my own experience, had I not checked my bill, I would have paid almost 4000 baht extra. If every foreigner gets charged like that you can imagine how much money they are making on the side.

I had Doc Anupong too. His surgery was good but his after care left me feeling a bit cold. Kinda like on every 5 minuet visit with him was to punch his ticket so he could get paid. I had more appointments scheduled, but I stopped going. I didn't feel like paying 1000+ baht/month to let him tell me I would be better eventually.

[JimGant]

They would only accept Visa card for payment.

PTE, Was this a Visa card from a US bank? If so, was the charge strictly in baht -- and did you have to remind them not to convert to dollars? (I ask because some hospitals in Bangkok are using the dynamic currency conversion scheme, whereby instant conversion winds up costing you 5-6% more -- and they're not giving the option of baht only, as is supposedly required.)

Richard, I seem to remember you're retired military. So, is the insurance you used Tricare? If so, did the hospital bill Tricare for you -- and you only had to pay your 25% co-share?

Thanx.

[PeaceBlondie]

I only used CMR once, and that must be where I got the infection that nobody in Thailand could cure until I went to Maharaj Hospital and the doctor took it out physically, by surgery. Great guy. I use Maharaj (13th floor special clinic, as mentioned earlier) almost exclusively. The care in that same building, after surgery, was as good as I got at CMRam, and probably much cheaper. In fact, I only went to CMRam when I couldn't get in the emergency operating room at Maharaj.

[richard10365]

They would only accept Visa card for payment.

Richard, I seem to remember you're retired military. So, is the insurance you used Tricare? If so, did the hospital bill Tricare for you -- and you only had to pay your 25% co-share?

Thanx.

Jim,

I did use Tricare. The Tricare office at JUSMAGTHAI helped me with all the paperwork. Since I stayed in the hospital for 16 days, they sent a promise note to CM Ram that they would pay the 75% of my hospital bill. I had to pay 25% upon my release.

I also had a simple personal accident and injury plan as well from a Thai insurance company which cost around 3000 baht. After the accident they paid me the 25% that I paid the hospital plus they gave me 1000 baht for every day in the hospital.

Full coverage on my little 125cc Honda Wave also helped with the bill. The hospital deducted that right away. That was worth 15,000 baht.

In the end, I made about 16,000 baht thanks for the personal accident and injury policy. I had to use 7000 baht of that to fix the motorcycle.

It was a good way to learn about insurance in Thailand but I wouldn't wish that educational experience on my worst enemy. It was way to painful.

[ProThaiExpat]

JinGant: Having been through the offshore and onshore game and read the threads about Brumrungard etc. so I did try to get Ram cashier to charge my Visa Debit at Schwab in dollars in hopes of ensuring an onshore conversion rate.

They said no. Had to be in baht. Anyway, Visa has a published rate which I consider favorable and the net debit on my Schwab account in dollars was equivalent to the onshore converstion rate for the week I used the card. I was quite pleased with that.

I expect to be bring money into Thailand this year and am going to try to time a Visa Debit transaction at the bank with a Swift Wire Transfer for the same day and amount to see how they compare. Will report when I get that comparison.

I found Dr. Anupong very concerned with my care as long as I was in active treatment and his rep was at stake, however, followup care was with far less attention, he eveidently moves on right away. Orthopedic surgeons are just that, well known for their operative skill but bedside manner is not a surgeons strong suit almost anywhere in the world, including on er, the soap opera.

We cannot forget the Thai attitude toward work and the place they put work in their priority list. I found that to be true in the treatment I got in the hospital by the entire staff.

[Pantip]

I have experienced similar occasions where hospitals overcharge or even try to charge for services not provided, it’s not only the Ram Hospital although they seem to be heavier handed than most. The bill should be closely scrutinized just as you do at a restaurant – as for sure - there will be discrepancies. Hospital medication is always more expensive than outside, even in my own home country.

The real worry is being treated for something you haven’t got!!! Never accept a diagnoses without getting a second opinion from a different doctor at a different hospital if at all possible. I know that is almost impossible in an emergency but I always get a second opinion as regards to ongoing treatment. My sister-in-law was diagnosed has having cancer during a routine check up and was booked in the next day for surgery, (no names – no pack drill). She went to another hospital for a second opinion to find that surgery was not recommended as there was no cancer.

Hospitals of differing standards, methods and access to modern diagnostic equipment frequently come up with contradictory analysis.

[Ta22]

funny - how a hospital is a place that is supose to help you . instead is used like some juice machine that will dry you when you are in need .

what had this world become ..

needy people turn to such place for help - and yes the doctor will ease your pain and your sickness .

then cos you had to pay so much you got to go back to work .. and you get sick again whahhahah

this world is sick - not the hospital is the people

[Austhaied]

funny - how a hospital is a place that is supose to help you . instead is used like some juice machine that will dry you when you are in need .

what had this world become ..

needy people turn to such place for help - and yes the doctor will ease your pain and your sickness .

then cos you had to pay so much you got to go back to work .. and you get sick again whahhahah

this world is sick - not the hospital is the people

:D

[JimGant]

so I did try to get Ram cashier to charge my Visa Debit at Schwab in dollars in hopes of ensuring an onshore conversion rate

Be glad Ram *didn't* charge you in dollars, as that would have meant they've signed up for Dynamic Currency Conversion, which to use the new Rimping Supermarket as an example, would have cost you an additional 6.5%!!! As it turned out, you were lucky to be using a Visa Debit card, as their Plus network is using the more favorable onshore exchange rate. (MasterCard/Cirrus, on the other hand, are using the offshore rates, which are very unfavorable these days.)

[altman]

i've been to CMR and Maharaj.

the drug costs at CMR are outragious. and over prescribed. (how do i get the prescription instead of being directed to 'window 7'?)

otherwise, it has been my hospital of choice, but now i think i will try others.

Maharaj was very good, but crowded, even on the 13th floor. (and talk about SLOW elevators!!. i walked up those 13 floors with a bad knee and still beat the elevators!) i would recommend Maharaj except that in my consultation there after a CT scan for a potentially significant growth, i felt that i was treated with indifference and, (what? scorn? racism? something. like i was a second class citizen or was wasting their time, or ... something. maybe just me, but...).

anyway, i would go back to Maharaj, but i think i will try some others as well. Lanna will probably be my next choice.

the really nice thing about CMR is the speed with which one can go in and see a doctor, get x-rays, and get gone. surgery and in house stay i don't know.

BTW. i was told by one clinic that i had to go to a hospital to get a prescription for pain meds. is this true? can clinics not prescribe pain med or did i just bump into one which did not want to?

[p1p]

BTW. i was told by one clinic that i had to go to a hospital to get a prescription for pain meds. is this true? can clinics not prescribe pain med or did i just bump into one which did not want to?

Strong pain medications can now only be prescribed / supplied by places licensed to do so. This is part of the government's crackdown on the illicit drug industry.

These places are mainly hospitals, but some clinics and, very rarely, outside pharmacies are also able to fill prescriptions.

[richard10365]

BTW. i was told by one clinic that i had to go to a hospital to get a prescription for pain meds. is this true? can clinics not prescribe pain med or did i just bump into one which did not want to?

Strong pain medications can now only be prescribed / supplied by places licensed to do so. This is part of the government's crackdown on the illicit drug industry.

These places are mainly hospitals, but some clinics and, very rarely, outside pharmacies are also able to fill prescriptions.

I get 10 pills of Tramadol (local made here in Thailand) for 40 baht over the counter. I think the only thing you can't get is things like morphine.