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Price controls will hurt medical hub goal, private hospitals warn


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Price controls will hurt medical hub goal, private hospitals warn

By THE NATION

 

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ASSOCIATION SAYS MOVE WOULD TAKE AWAY |THE CHOICE OF AN ALTERNATIVE FROM PATIENTS
 

PRIVATE HOSPITALS are now trying to thwart moves to control their prices of medicines and services.

 

Speaking via the Private Hospitals Association of Thailand, their representatives told a press conference yesterday that the move would only hurt the country’s medical-hub status and take away people’s right to choose, he said.

 

“First of all, the prices of medicines have long been controlled by law,” the association’s president, Dr Pongpat Patanavanich, said. 

 

The price of medicine found on the medical bill in private hospitals was so much higher than that at pharmacies and state hospitals because these prices contained hidden costs not shouldered by other operators. 

 

Pongpat dismissed claims that without medical-price controls at private hospitals, people risked falling into medical bankruptcies. 

“All Thais can access free treatment through one of the country’s major healthcare schemes,” he pointed out.

 

These schemes are the universal healthcare scheme covering most Thais, the social security scheme covering about 10 million people working in registered businesses, and the medical benefit scheme for civil servants and their family members. 

 

“This means private medical facilities are in the market as alternatives,” Pongpat said. 

 

He also said that in life-threatening emergency cases, patients in Thailand could attend a private facility and receive free medical treatment for 72 hours. 

 

Beyond that time “this means if a patient chooses to go to a private hospital, he or she must be prepared [to pay too],” he said.

 

Pongpat emphasised that medical price control would affect Thailand’s goal to become an international medical hub. At present, about 4.23 million foreigners seek medical services in Thailand every year. In 2016, medical businesses generated more than Bt234 billion in income. 

 

“Thailand is now in fact well set to become an international hub, particularly in the CLMV [Cambodia, Laos, Myanmar and Vietnam] region,” he said.

 

Pongpat said his association was worried about the Commerce Ministry’s efforts to control medical prices at private hospitals. 

“Unlike state hospitals, we directly and fully shoulder the cost of operations,” he said. 

 

Foundation for Consumers’ secretary-general Saree Ongsomwang has lately expressed full support for a medical price control plan. 

 

“The risk of medical bankruptcy is there. Some patients go to private hospitals with symptoms they think fall into the category of life-threatening emergency cases and are told later that their cases are not considered life threatening by medical standards,” Saree explained. 

 

She said it should be possible for authorities to specify how high the charges for medicine could go at private hospitals.

 

“Those prices can be higher than pharmacies. But there should be a ceiling,” she said. 

 

Saree said efforts to control private hospitals’ medical prices would reduce brain drain in the state sector. 

 

“If we don’t do anything, more and more medical specialists will move to private hospitals. In the end, state hospitals may be left with general practice doctors,” she said. 

 

Yupadee Sirisinsuk, a board member of the foundation, said she had heard that several players had been trying to block authorities’ efforts to control medical prices. 

 

Source: http://www.nationmultimedia.com/detail/national/30362244

 
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-- © Copyright The Nation 2019-01-15
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1 hour ago, webfact said:

contained hidden costs not shouldered by other operators. 

oh u mean GREED

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2 hours ago, webfact said:

“All Thais can access free treatment through one of the country’s major healthcare schemes,” he pointed out.

total deflection; what he said is not the immediate issue; private hospitals exist for one thing , profit, and overcharging is greed

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Reminds me of 2 years ago when i had an infection to my leg.

I wanted to go to a government hospital, where treatment would have been maybe a few thousand baht, but armed guards from a private hospital came over and shuffed me in a black van. They drove me to a private hospital where I was forced to undergo treatment. I really didn't want to go there, but what can you do when they put a gun to your head?

 

Oh wait, that never happened.

Nobody is forced to go to a private hospital.

All patients there come voluntary, even though the prices are high.

 

If private hospitals are too expensive and people cannot afford going there, why are they so busy?

Instead of introducing price controls for private hospitals, why not improve government hospitals?

If government hospitals can offer similar service for a lower price, nobody would go to a private hospital anymore.

 

 

By the way: I want a Porsche but cannot pay for one. Will the government introduce price controls on the new 911?

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1 hour ago, YetAnother said:

total deflection; what he said is not the immediate issue; private hospitals exist for one thing , profit, and overcharging is greed

Then don't go there.

Problem solved.

 

(and don't go to a movie theatre, mall, restaurant, shop, farm, etc cause they all exist for that same thing)

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Private Hospitals are just money-making machines ... The price for their medicine is more than double what you would pay elsewhere .

They do not care if you are in good health , they want you sick ! Like this they can sell treatments and even operations that you do not really need .

I once was hospitalized for a broken foot in one of CM's ' World Class ' private hospitals , I came out with a bad skin infection due to not clean beds ...!

The DR. told me there are 2 ways for my foot , traditional thai style , ( just cement it , no operation ) , or complicated and risky operation where they fix the broken bones with screws , risk of infection very high ... I took the ' traditional ' way , but it did still cost me about 60000 THB . Another day I had my prostata checked , was ok , just a little bigger , the nurse who checket it , said ... the doctor who talked to me said that I need an operation - BS , lying ...! Years later I am fine , no problems ... if I had taken that operation , I could probably not say this ...

 

 

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If I required what could be an expensive procedure at a private hospital, I would want to informed beforehand as to the total likely cost.. Parameters with min/max cost per procedure and daily charges, as a guide.. Instead of being charged a huge unexpected bill on discharge, and then having to be re-admitted because of a sudden cardiac issue because of your bill shock..

 

Many hospitals have certain procedure costs online so at least you can shop around first.. Not helpful in an emergency situation, but a price list guide would be good starter, instead of a one million plus Bht bill shock..

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I can understand making profits on medicines, but aren't drugstores making profits too. So why does a hospital need to sell medicines at up to four times the drug store price? I could accept a 50 percent mark up because, as they said, they have more overheads, but 100 to 300 percent markup on drugstore prices. That is daylight robbery. And W-T-F has this got to do with "medical-hub"? 

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If Thailand is already getting over 4 million patients from overseas, the goal of becoming an international medical hub has already been achieved. So no concerns there. If prices are controlled, even more patients will want to come from overseas, making it an even bigger and better hub.

 

Private hospitals have a captive market for drugs which is a huge advantage over pharmacies that charge less. So what are their hidden costs that justify charging more? They remain hidden because he declined to elaborate. Normally they say they have to stock exotic drugs with lower turnover but they can still sell them and at higher margins than the common drugs. There was once a move to force hospitals to allow patients to fill prescriptions outside the hospital but that had been dropped this time for some reason.

 

The argument that Thais can just forget access to private healthcare, unless they billionaires, apart from being unfair, doesn’t wash because the government schemes cannot cope. Private hospitals pricing middle class Thais out forces more people into government healthcare putting even more strain on it. Therefore government must act to control prices in order to protect its own schemes.

 

Basically Thai hospitals earn a bottom line net profit margin that is twice as high as private hospitals in developed markets and continue raise prices faster than inflation to protect and enhance their margins. The inevitable result of this will be that their will eventually become uncompetitive and will kill their medical hub. Many Thai doctors are quite incompetent relative to developed countries and recommend unnecessary treatment in an unethical way. Accountability is way below international standards. Super wealthy Thais already know this and go to the US, Europe or Australia for major operations.  In time foreign patients will start figuring this out too and go elsewhere. Meanwhile hospitals in neighboring countries will improve. Now is a good time to reform and regulate Thai private hospitals before they kill the golden goose.

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Every business has to make a profits, so get over it !

 

And as another poster said, if you cannot afford the Private Hospitals use the government Hospitals - just what is wrong with so many complainers ?

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10 minutes ago, Arkady said:

If Thailand is already getting over 4 million patients from overseas, the goal of becoming an international medical hub has already been achieved. So no concerns there. If prices are controlled, even more patients will want to come from overseas, making it an even bigger and better hub.

 

Private hospitals have a captive market for drugs which is a huge advantage over pharmacies that charge less. So what are their hidden costs that justify charging more? They remain hidden because he declined to elaborate. Normally they say they have to stock exotic drugs with lower turnover but they can still sell them and at higher margins than the common drugs. There was once a move to force hospitals to allow patients to fill prescriptions outside the hospital but that had been dropped this time for some reason.

 

The argument that Thais can just forget access to private healthcare, unless they billionaires, apart from being unfair, doesn’t wash because the government schemes cannot cope. Private hospitals pricing middle class Thais out forces more people into government healthcare putting even more strain on it. Therefore government must act to control prices in order to protect its own schemes.

 

Basically Thai hospitals earn a bottom line net profit margin that is twice as high as private hospitals in developed markets and continue raise prices faster than inflation to protect and enhance their margins. The inevitable result of this will be that their will eventually become uncompetitive and will kill their medical hub. Many Thai doctors are quite incompetent relative to developed countries and recommend unnecessary treatment in an ethical way. Accountability is way below international standards. In time foreign patients will start figuring this out and go elsewhere. Meanwhile hospitals in neighboring countries will improve. Now is a good time to reform and regulate Thai private hospitals before they kill the golden goose.

"If Thailand is already getting over 4 million patients from overseas, the goal of becoming an international medical hub has already been achieved. So no concerns there. If prices are controlled, even more patients will want to come from overseas, making it an even bigger and better hub."

 

Agree entirely.

 

"Many Thai doctors are quite incompetent relative to developed countries and recommend unnecessary treatment in an ethical way."

 

Agree that this is mostly the case, but I have had good experiences with 2 Thai doctors (in private hospitals).

 

The first time was when I wanted various, unusual, blood tests.  The doctor was completely honest and explained that they're not available here - and we ended up chatting for quite a while about his son, who is being trained in England, and his life there 🙂.

 

The second time was when I broke my wrist for the third time (......) but this time it was badly out of place.  He too was entirely honest and explained that I had 2 options:-

1) Have an extremely expensive operation to put 'pins' in the wrist - which was likely to not be entirely successful as my bones are so thin, or

2) Have it manually manipulated back into 'place'.  It would be extremely painful (despite the provision of a small amount of morphine etc. IIRC), and I would still end up with a plaster cast for a while - but he made it clear that this was his recommendation.

Obviously he was thinking about what was best for me, and not hospital profits!

 

Incidentally, he wasn't wrong when telling me that manual manipulation back into place would be extremely painful, despite the morphine etc. ☹️.  If it happens again, I'll insist on being fully anaesthetised (and obviously pay for this) before the break is manually manipulated back into place!

 

 

 

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33 minutes ago, Arkady said:

The argument that Thais can just forget access to private healthcare, unless they billionaires, apart from being unfair, doesn’t wash because the government schemes cannot cope. Private hospitals pricing middle class Thais out forces more people into government healthcare putting even more strain on it. Therefore government must act to control prices in order to protect its own schemes.

Hope you don't mind me just quoting you this paragraph.

 

1. Unfair? Is it unfair that you can get better service/products with money? Can you explain how that works, as it sounds terribly communist. I can get a decent car for 500K, but for an imported luxury car i pay 7 times that price. Is that unfair? A Thai pays next to nothing for medical treatment in a government hospital, or they can go to a luxury hospital with a private room, no waiting lists, and 1st class treatment for 100-1000x that price. I can agree that access to healthcare is a necessity, and something the government should provide, but I disagree that access to LUXURY healthcare is a necessity.

 

2. So because the government is <deleted> up its own scheme, they should not fix their own scheme but instead start controlling private enterprises? Sounds terribly communist again. Reminds me of countries that introduced price controls in every facet of life, all the way down to products in the supermarket. Not too much later the supermarkets were empty and the population was hungry. How about the politicians and directors stop skimming off 20-30% of the healthcare budget and clean up their own act?

 

3. How about the government offers something in between private and public hospitals? Better service, shorter waiting lines, and more choice for patients at a price point below private hospitals? Oh wait, that already exists. Many public hospitals offer this already, here in Phuket they just opened a "mahogony care" clinic right next to the public hospital where you get exactly that. I've been to similar places in Bangkok. That way they offer something there is clearly demand for... and make a profit that goes back into the healthcare system. Win-win I would say. And the higher the prices of private hospitals, the larger this "in-between" market becomes.

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How about this solution:

 

Legally require private hospitals to quote prices for certain standard procedures, and make a government website that compares these prices across the board (simple table with the prices at government hospitals, all private hospitals, etc). Let patients sign a paper stating the price range of the treatment they are getting, possibly including the prices at a government hospital.

 

Do the same for medicine; when the doctor prescribes you a list legally require them to mention both the prices at the hopsital pharmacy and the prices at some state controlled pharmacy (in a public hospital). Then the consumer has the choice to buy it in the private hospital, or go to the nearest public hospital and purchase it there.

 

I am all for choice. Just inform the patients completely and if they want to sit in line at a government hospital to save XXXX baht then its up to them.

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If your business model is gouging foreigners with outrageous pricing then you will not become a medical hub anyway. Besides you need some decent doctors to become a medical hub. 

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4 hours ago, holy cow cm said:

Pharmacy corporations should also be regulated as it all starts from there. The first start of the greed for the investors greed. 

 

Price controls - you think it actually works? Allowing politicians to control and fix prices? Never! Even more so in areas awash with corrupt politicians and civil servants.

 

If they seriously want to tackle pricing issues then look at dismantling protective monopolies and cartels; price fixing and extortionate profiteering (especially by the drug companies who abuse the use of patents by exaggerating their R&D expenses in some cases),

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8 minutes ago, Pedrogaz said:

If your business model is gouging foreigners with outrageous pricing then you will not become a medical hub anyway. Besides you need some decent doctors to become a medical hub. 

 

All the Thai doctors I and my family see are excellent, professional, and very nice to discuss with.

 

Perhaps you're going to the wrong places?

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56 minutes ago, JoePai said:

Every business has to make a profits, so get over it !

 

And as another poster said, if you cannot afford the Private Hospitals use the government Hospitals - just what is wrong with so many complainers ?

Karl Marx would have written : " they are not in the business of providing medical care but in the business of making money"

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13 minutes ago, Pedrogaz said:

If your business model is gouging foreigners with outrageous pricing then you will not become a medical hub anyway. Besides you need some decent doctors to become a medical hub. 

There are a lot of damn good doctors here in Thailand.

Why do you make derogatory remarks about the doctors here?

 

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The cost of healthcare is not a conundrum.  It is due to a number of factors in the supply chain of the service which includes the presumed cost of R&D in the pharmaceutical industry, medical equipment business and investment in training people in the medical field e.g. doctors (6-10yrs),  pharmacists (5-7 yrs), nurses (4-6 years), medical technicians (2-4 years) nurse assistants (6-12months) who in turn expect reasonably good salaries. 

 

Private hospitals unlike Public hospitals will always be more expensive due to lack of subsidies and higher investment costs in order to provide better service (capitalism at its best).

 

Cost control of a part of the supply chain (medicines/commodities) WILL NOT SOLVE the problem.  It may look like a decent effort to solve the disparity in pricing.

 

For me I choose not to overpay for the same service by choosing hospitals like St. Louis (Catholic non profit organization) because many competent doctors from Chula who are not into maximizing their income work there part time or Siriraj Piyamahakarun, which is the private hospital arm of Siriraj hospital which is more expensive but about 20% less then BH, Bumrungrad and I get university hospital competent staff without having to deal with the private hospital policy of maximizing profit. 

 

Its like choosing deluxe class over business class.  I get the same basic treatment without the frills and pay less with the trade-off being longer waiting times.

 

It's all about supply and demand.  Businesses will gouge if you want their products/services: Think premium products like Apple, Dyson, B&O, Supercars , 5 Star hotels etc.  

 

Let your choice do the talking.

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1 hour ago, JoePai said:

Every business has to make a profits, so get over it !

 

And as another poster said, if you cannot afford the Private Hospitals use the government Hospitals - just what is wrong with so many complainers ?

This not just about profits it's about fair pricing Vs price gouging. 

Will the Thais price themselves out of the market?

 

 

 

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57 minutes ago, dick dasterdly said:

"If Thailand is already getting over 4 million patients from overseas, the goal of becoming an international medical hub has already been achieved. So no concerns there. If prices are controlled, even more patients will want to come from overseas, making it an even bigger and better hub."

 

Agree entirely.

 

"Many Thai doctors are quite incompetent relative to developed countries and recommend unnecessary treatment in an ethical way."

 

Agree that this is mostly the case, but I have had good experiences with 2 Thai doctors (in private hospitals).

 

The first time was when I wanted various, unusual, blood tests.  The doctor was completely honest and explained that they're not available here - and we ended up chatting for quite a while about his son, who is being trained in England, and his life there 🙂.

 

The second time was when I broke my wrist for the third time (......) but this time it was badly out of place.  He too was entirely honest and explained that I had 2 options:-

1) Have an extremely expensive operation to put 'pins' in the wrist - which was likely to not be entirely successful as my bones are so thin, or

2) Have it manually manipulated back into 'place'.  It would be extremely painful (despite the provision of a small amount of morphine etc. IIRC), and I would still end up with a plaster cast for a while - but he made it clear that this was his recommendation.

Obviously he was thinking about what was best for me, and not hospital profits!

 

Incidentally, he wasn't wrong when telling me that manual manipulation back into place would be extremely painful, despite the morphine etc. ☹️.  If it happens again, I'll insist on being fully anaesthetised (and obviously pay for this) before the break is manually manipulated back into place!

 

 

 

   Having worked as a medic for a hospital-based ambulance service, I have assisted ER Dr's and Orthopedics perform closed reductions of extremity fractures where a nerve block was used with no pain response from the patient. A nerve block can even be used in some open reductions. I once suffered a spiral oblique distal fracture of my right fibula that required screws and ligament repair. As it was work-related, I had to use the company approved Ortho, who wanted to operate under general anesthesia. Knowing the possibility of complications, I refused and insisted on a spinal block and was conscious and pain-free during the surgery.  

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Private business that invest their own money or raise capital, deserve to make what ever profits they are able to make for their owners/shareholders.

 

They don't have a monopoly and they will live or die based on their service and price.

 

If their service is poor, no one will go. If they are priced to high, no one will go.

 

But trying to limit private enterprise because Government enterprise is so bad will ultimately limit healthcare options for people that want and can afford it.

 

...if you can't afford it, don't go, but don't whine and try to control those that take all the risks.

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1 hour ago, Baerboxer said:

 

All the Thai doctors I and my family see are excellent, professional, and very nice to discuss with.

 

Perhaps you're going to the wrong places?

Possibly a good point.

 

Which hospital do you frequent?

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1 hour ago, colinneil said:

There are a lot of damn good doctors here in Thailand.

Why do you make derogatory remarks about the doctors here?

 

Yes, there are some good doctors here, but in my experience quite a few are aren't very good at all....

 

As always, it depends on personal experience.

 

But this is off topic, as I can't see how  the rapidly increasing private hospital charges enhances Thailand as a 'medical hub'?

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2 hours ago, Oziex1 said:

This not just about profits it's about fair pricing Vs price gouging. 

Will the Thais price themselves out of the market?

 

 

 

Of course not - have you been in a Private Hospitals lately - full of Thais, Cambodians, Laos - all far richer than we are.

 

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The easiest way to save in health costs is to have a healthy lifestyle, the second best to educate yourself in procedures, medicines, etc. If you pay too much, you're stupid.

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