US Alzheimer's patient: Goodbye Thailand - it was nice knowing you

[watcharacters]

7 hours ago, suzannegoh said:

So basically you need to completely drain your savings on mefical care or hide it away in a trust before the government would pay for it.

 

 

The government is fairly well attuned to people trying to go this route.

 

 

[donnacha]

50 minutes ago, TallGuyJohninBKK said:

In the past, the mother could have been/was covered by an income affidavit, because she/they could count the income they had coming in before it went to pay for her nursing care.

No, she was only "covered" in the sense that the income affidavits allowed her, and everyone else, to lie about the amount of money available to them. She was able to claim she had sufficient income available to her in addition to her fixed care costs.

In fact, she never had any additional income and would not have been covered in the event of a major medical emergency.

This is the heart of their dispute: that they should be able to count the money that is already spoken for as satisfying the requirement to have money to pay for unexpected medical expenses. To the disappointment of some, Thai immigration are sticking to the old-fashioned principle that you cannot spend the same money twice.

[BradinAsia]

6 hours ago, donnacha said:

 

Yes, that would solidly solve the problem they claim Thailand is "forcing" upon them. They could even forego the 800K and pay just 20K per year to an agent. Problem solved for less than the cost of their flights to the Philippines.

What they have chosen to do instead has solved their real problem: they want to remain living in Thailand but they do not want to continue paying 85K per month for specialist care. Leaving mum in the Philippines saves them almost $2K per month.

Hopefully it won't make much difference to the old girl, and they no doubt have many other important things they can spent the money on. It just lacks class for them to play the victim card and pretend that this was not 100% their own decision. 

 

 

All in all, a quite ludicrous post. When you look at all the complexity and cost of living long-term in Thailand, even WITHOUT adding in medical expenses, using a word like "forced" is quite reasonable in this case.

 

 

[BradinAsia]

7 hours ago, donnacha said:

There was no "ruling". Money you have to pay for necessary care simply does not count as income.

The reason for the 800K bank deposit, or equivalent verified income, is to ensure that Thailand, a developing nation, does not get stuck paying for the considerable end-of-life costs of elderly people from rich countries.

Remember, for most people, the medical costs of their final month will be more than their medical costs for the entire life before that.

The 86K per month being spent on this unfortunate lady provided her with the special care that Alzheimer's requires. It does not cover the considerable cost of cardiac and other expensive operations that people often need as their body finally breaks down.

Sadly, this lies waiting for most of us at the end and, under current medical ethics, caregivers are obliged to do all they can to save your life unless you give very specific instructions that they must not.

Medical costs are lower in Thailand than America, but they are not nothing. $25K is actually a fairly low estimate. Just one cardiac operation would eat up most of that. You might need several. Emergency repatriation back to your home country could cost ten times that.

So, they are making sure you have that money stashed away, for your own emergency use. All poor countries should do this but, unlike Thailand, the Philippines are not in a strong enough position to insist upon it.

By leaving her in the Philippines, she is essentially getting that desperately poor country to pay her mother's end-of-life care. The care provided in a government hospital won't be great, healthcare in the Philippines is significantly worse than Thailand, but it will certainly drain resources away from sick Filipinos.

 

 

You obviously don't know much about the Philippines.

[BradinAsia]

7 hours ago, TonyR101 said:

I have absolutely no sympathy whatever with this family.

The solution to the problem is simple - 

Place the 800,000 Baht in a Thai Bank savings account. Take mother home to Nakorn to live you. Spend $1000 of the current $3,000/month cost on keeping mother in the loving care of a Thai maid. Use the other $2,000/month to repay capital/loan costs on the 800,000 and in twelve months time the family has kept both mother and Thai Immigration happy, and as a bonus has amassed an 800,000 Baht nest egg in a Thai bank. 

 

I have absolutely no sympathy for someone who has become a flaming authority on this forum in only 21 posts.

[natway09]

They really are milking this for all the wrong reasons.

Take her home & let the US look after or simply take out a loan to cover the requirement.

After all you are self stated as being "successful business people"

Be careful also how much you  rattle the sabre as may find yourselves refused entry on your

return for being "disruptive people"

[donnacha]

3 minutes ago, BradinAsia said:

You obviously don't know much about the Philippines.

You obviously lack the capacity to construct actual arguments and, instead, puke out one sentence insults that add nothing to the discussion.

It appears you have repeated this procedure 1,038 times on this forum. Well done.

 

[Skallywag]

3 hours ago, donnacha said:

Like this woman, it is far more likely that we will spend a decade or more requiring expensive care and, probably, a few operations costing tens of thousands of dollars per pop.

Not if you have a proper health care directive (living will).  As "un" compassionate as it sounds, there is no logic in keeping someone alive who has no memory and cannot take care of herself, himself.  Dementia and Alzheimers I have no experience with, but am sure there is a point of no return.  (or did I just type that?)

We should have the right to die without putting financial burdens on our friends and relatives

[BradinAsia]

4 hours ago, donnacha said:

Thailand has been a good host to them, and to all of us.
 

 

Really??? An amazing statement. Amazingly weird.

 

[donnacha]

2 minutes ago, Skallywag said:

Not if you have a proper health care directive (living will).  As "un" compassionate as it sounds, there is no logic in keeping someone alive who has no memory and cannot take care of herself, himself.  Dementia and Alzheimers I have no experience with, but am sure there is a point of no return.

The catch is that you have to be of sound mind to request even a DNR (do not resuscitate) and that only becomes relevant if you have the type of condition in which keeping you alive would require extraordinary means.

If you are deteriorating mentally, the process could easily last a decade or more before you reach the stage at which the simple withholding of treatment could end your life, and you would probably have missed the chance to request it while you could still be considered the be of sound mind.

I suppose most people have the capacity to kill themselves once they are very ill, most illnesses don't debilitate you in way that would make you physically incapable of suicide, but it appears that few choose to do so.

 

[TallGuyJohninBKK]

20 minutes ago, donnacha said:

No, she was only "covered" in the sense that the income affidavits allowed her, and everyone else, to lie about the amount of money available to them. She was able to claim she had sufficient income available to her in addition to her fixed care costs.

In fact, she never had any additional income and would not have been covered in the event of a major medical emergency.

This is the heart of their dispute: that they should be able to count the money that is already spoken for as satisfying the requirement to have money to pay for unexpected medical expenses. To the disappointment of some, Thai immigration are sticking to the old-fashioned principle that you cannot spend the same money twice.

 

 Under the former system of income affidavits, there was no requirement official or unofficial that any of the reported income had to be available to spend in Thailand, or even that it ever had to be brought into Thailand. And that wasn't involving lying or cheating. That was following the rules as they existed.

 

Under the former system, I could truthfully report my income via the affidavit, and then spent the entirety of it back in my home country if I wanted to taking care of family members or otherwise. And that would have been fully complying with the rules as they existed then. 

 

Sadly, that's no longer the case under the current "monthly import 65K into Thailand" rule or the now more restrictive 800K Thai bank deposit with the added requirement to keep at least 400K on deposit yearround.

 

[donnacha]

2 minutes ago, BradinAsia said:

Really??? An amazing statement. Amazingly weird.

It is becoming increasingly apparent how you achieved your high post count.

Bugger off. I have met mosquitoes with more interesting things to say. 
 

[donnacha]

Just now, TallGuyJohninBKK said:

 Under the former system of income affidavits, there was no requirement official or unofficial that any of the reported income had to be available to spend in Thailand, or even that it ever had to be brought into Thailand. And that wasn't involving lying or cheating. That was following the rules as they existed.

I think what caught out most people is that, because the embassies were in no way verifying the claimed income, they simply claimed income they did not have, either to bring into Thailand or to spend elsewhere. In those cases, yes, the people were lying. The people who didn't need to lie did not face the same problem when the letters system ended, they had the money anyway, with or without the letters.

Many of those lying were lulled into a false sense that this would continue indefinitely but it was doomed to end at some point, if only because the Thai were eventually going to figure out that, if a significant minority of retirees were running into trouble over medical costs, it meant they did not actually have the money they claimed to. Ironically, given this whole thread, that is what the crackdown stemmed from: unpaid hospital bills.
 

[BradinAsia]

31 minutes ago, donnacha said:

You obviously lack the capacity to construct actual arguments and, instead, puke out one sentence insults that add nothing to the discussion.

It appears you have repeated this procedure 1,038 times on this forum. Well done.
 

 

If you take an objective look at your last 10 posts (mostly rambling nonsense) you would have to

conclude that you're the one who lacks "the capacity to construct an actual argument."

 

Good luck living in your own little bubble.

 

 

[sunnyboy2018]

23 hours ago, RandolphGB said:

They can't / don't want to submit the required deposit for the visa. The logical step then is to leave. Am I missing something?

why dont they use and agent?

[Dave67]

On 5/28/2019 at 10:22 AM, Kasane said:

The patient needs to be on Medicaid. She paid all her life for Medicare, now that she is ill US don't want to care for its citizen who is now terminally ill. Reminds me of unscrupulous insurance companies who drop coverage when the patient really needs them. 

Tell me about it. I won't name them but they took my money with a questionnaire and when I was in ICU in Vietnam, where I was working at the time, they asked me for medical records from the UK which I didn't have with me. Luckily the company I had been for 3 weeks covered it for me. At the moment I am working in the UK so i don't need insurance  but I will never use them again when I go back to Thailand

[Ctkong]

6 hours ago, hotchilli said:

Yes I was thinking the same, I would have thought the Thai immigration would have excepted this as her income paid to the care home... now Thailand has lost a revenue as she leaves for Manila..

Short term thinking again!

Thai immigration is part of the Thai police force so thinking about economic ramifications is not part of their job. Their job is only the enforcement of existing policies.  One department fowling up the other departments’ planning as usual. 

[Letseng]

3 hours ago, terje johnsen said:

in europe the pensions is around 75-85k and here in norway its 90k if you never have worked in your life. the americans allways say its better over there so i asume if this old lady have worked she have a pension above 65k. i think there is more to this story that is untold.why thaivisa not interview imigrasion offisials about this to then i think the story have another side to it.

  4 hours ago, Jingthing said:

Why would you assume her pension was at least 65K? Based on what evidence? The average US social security check is about 45K. 

"in europe the pensions is around 75-85k"

All depends where in Europe you come from and how many years you contributed. Many have a lot less.

 

[SheungWan]

7 hours ago, wwest5829 said:

An earlier article cited that Thai Immigration refused to acknowledge the monthly healthcare cost of 86, 000 baht as meeting the income requirement. That seems to have played into the decision. We all know that a ruling like this can vary between different locations, even within one office. Sad...

Probably because the money didn't come in as monthly 65,000 baht equivalent from abroad. That's a general ruling, yes?

[Thaidream]

1 hour ago, donnacha said:

I cannot see how anyone can argue against the clear, simple, undeniable morality of this.

Now that you have stopped preaching = I will  provide an answer.  Thanks for at least admitting I am well intentioned

 

1 hour ago, donnacha said:

 

but your  rhetoric is somewhat condescending rather than accepting that someone else may actually have  an idea that could work.

 

If you paid any attention to what I wrote- you will notice at this juncture I did not dismiss insurance- I clearly stated that each long stay foreigner buy into the Thai Social Security Fund. While I stated a cost that could be increased or decreased past on numbers.  The pool of money available is  going to be large. This in essence solves all the diatribe on having insurance in Thailand and not being able to get it.

 

However- such an illness as Alzheimer's or other long term care will need to have  the patient or family pay an added charge to effect this care.  Thailand appears to want to take in foreigners for long term care or they would not have accepted the patient in question.  The cost is reasonable and there is no such thing as this person or any other foreigner becoming a ward of  the State.

 

There is also a plan to charge foreigners coming as tourists a $10 surcharge and that will solve any issues in this group.

 

In one of your earlier posts- you asked for someone to give an idea to solve some of these issues.  I gave you an idea on how to do it and how it would solve both the Thai Government issuers and the individual issue.  It appears you have dismissed this out of hand by going backward to the idea that everyone must have some type of insurance before coming to Thailand.

 

As you can see- my idea is everyone can buy into insurance after they arrive in Thailand.  I am not an actuary and not privy to exact numbers in Thailand but simple Math shows there would be a huge pool of money and probably enough to put the Thai Government Health System in the black as opposed to its current deficit.

 

The long term solution for Thailand and the World is to stop the unbridled  exponential cost of Healthcare.  Hence, my comment and belief that healthcare is a basic human right and not a commodity to be sold to the highest bidder.

 

  The solution is there. and it involves getting rid of greedy insurance companies and forcing down the price of medical care and drugs.  No one is saying medical personnel do not deserve a good salary to provide care or that  research on life saving drugs  do not incur a cost.

 

The United States is the only industralized country that operates on for profit medicine and it is the costliest in the World.  However  it's days are number because Medicare For All is coming and in this next Presidential election this issue will be the most talked about issue there is.

 

All of Europe; Japan; Australia and others recognize Healthcare is a human right as their coverage is for all.  Thailand, unfortunately, has tried to adopt the American model which is failing and will fail in Thailand.

 

On the positive side Thailand does have Government Hospitals which are adequate for care and also the 30 Baht system for the very poor.  The doctors who staff the Government Hospitals are many of the same that work in the private sector.

 

To quote your directly- I cannot see how anyone can argue against the clear, simple, undeniable morality of this.

 

  However it appears you morality is more based on money and my morality is based on basic human rights  Your morality is exclusive and mine is inclusive and therein lies the difference.

 

 

 

[connda]

5 hours ago, malibukid said:

why won't the American people wake up and vote for change?  look what they got in 2016????

What?  Medicare for all?  ????

[suzannegoh]

7 minutes ago, connda said:

What?  Medicare for all?  ????

If "Medicare for All" is just an expansion of the program to include younger people then it would not solve the problem.  Most Alzheimer's patients in the US are older than 65 years old and hence already have Medicare.

[Thaidream]

8 minutes ago, suzannegoh said:

f "Medicare for All" is just an expansion of the program to include younger people then it would not solve the problem.  Most Alzheimer's patients in the US are older than 65 years old and hence already have Medicare.

Every American who works has Medicare tax deducted from their salary.   

 

 

 

What Medicare for all will do is for the first 5 years lower the age gradually to obtain actual care from 65 to 55 and then it will cover everyone from birth to death.  Medical Insurance companies would be eliminated.

 

Many questions about the actual nuts and bolts.  How much will it cost and will it truly be universal- coverage extending overseas. 

 

What it will do is eliminate insurance; get the lawyers out of medicine and force Big Pharma to lower drug costs as well as get rid of For Profit Medicine.

 

If this passes- it will eventually affect medical care in Thailand as  Thailand will see the obvious savings that can be had by adopting a similar system.

[donnacha]

55 minutes ago, Thaidream said:

However it appears you morality is more based on money and my morality is based on basic human rights  Your morality is exclusive and mine is inclusive and therein lies the difference.

What you wrote may well be inclusive, but it did not include anything I could understand.

Some morality must be based on money, because it is immoral to force others to pay for your needs.

As guests in a poorer country, we use money to cover our healthcare needs. Healthcare of generally good quality is available at a good price in Thailand. We buy, they get paid, everyone is happy. Worldwide communistic reforms would probably not be an improvement.

The Thais are happy to allow us to stay as long as we do not freeload. A lot of freeloading was happening, so, to prevent that, they now require foreign retirees to prove that they have money. Understandably, they do not want their under-resourced public health system to be swamped by an aging population of foreign retirees who have spent all their money on Chang and hookers rather than health insurance.

Some expats have interpreted the reasonable requirement that they have actual money to be part of an anti-Western campaign by the government. The poorest farangs have already loudly announced their imminent departure to Cambodia or the Philippines. The rest of us are just slightly stunned that they ever thought they had a future in Thailand without any money. No money, no antibiotics.

 

Edited May 29, 2019 by donnacha

[suzannegoh]

1 minute ago, Thaidream said:

Every American who works has Medicare tax deducted from their salary.   

 

 

 

What Medicare for all will do is for the first 5 years lower the age gradually to obtain actual care from 65 to 55 and then it will cover everyone from birth to death.  Medical Insurance companies would be eliminated.

 

Many questions about the actual nuts and bolts.  How much will it cost and will it truly be universal- coverage extending overseas. 

 

What it will do is eliminate insurance; get the lawyers out of medicine and force Big Pharma to lower drug costs as well as get rid of For Profit Medicine.

 

If this passes- it will eventually affect medical care in Thailand as  Thailand will see the obvious savings that can be had by adopting a similar system.

But only Medicaid, and not Medicare, covers long-term care of Alzheimer patients in convalescence homes.  So expanding Medicare to include everyone would do nothing to help Alzheimer patients.

[Jingthing]

What you wrote may well be inclusive, but it did not include anything I could understand.

Some morality must be based on money, because it is immoral to force others to pay for your needs.

As guests in a poorer country, we use money to cover our healthcare needs. Healthcare of generally good quality is available at a good price in Thailand. We buy, they get paid, everyone is happy. Worldwide communistic reforms would probably not be an improvement.

The Thais are happy to allow us to stay as long as we do not freeload. A lot of freeloading was happening, so, to prevent that, they now require foreign retirees to prove that they have money. Understandably, they do not want their under-resourced public health system to be swamped by an aging population of foreign retirees who have spent all their money on Chang and hookers rather than health insurance.

Some expats have interpreted the reasonable requirement that they have actual money to be part of an anti-Western campaign by the government. The poorest farangs have already loudly announced their imminent departure to Cambodia or the Philippines. The rest of us are just slightly stunned that they ever thought they had a future in Thailand without any money. No money, no antibiotics.

 

You're slightly stunned are ye?
Egads.
There is actually no direct relationship between the level visa financial requirements and the actual cost of living for a particular individual. The actual costs may be much lower or much higher.
So Thailand is like Monaco now?
Only the rich and famous may enter?

Sent from my Lenovo A7020a48 using Thailand Forum - Thaivisa mobile app

[Thaidream]

3 minutes ago, donnacha said:

Some expats have interpreted the reasonable requirement that they have actual money to be part of an anti-Western campaign by the government. The poorest farangs have already loudly announced their imminent departure to Cambodia or the Philippines. The rest of us are just slightly stunned that they ever thought they had a future in Thailand without any money. No money, no antibiotics

Sorry, but you just regurgitated something we already know.  At the present time, one has to follow the immigration law to stay in Thailand.  That is one issue and I have no problem doing it  , although the bureaucracy created is rather  disingenuous

 

The thread has evolved into an idea as how long stayers can  manage medical care- aging or not and also the morality behind For Profit Medicine.  I am not advocating not paying for one's medical care; nor saying do not purchase insurance although it is truly unaffordable for the coverage presented.

 

I presented an argument and a plan to  cover the medical conundrum that many face and potentially solve the funding issue of Thai State Hospitals.

 

I then went further and  set out a principle of Healthcare being a Human Right and a long term way in which Medical Insurance becomes obsolete.

 

It is hardly a Communist philosophy. How do you think the Japanese Healthcare system operates; the NHS in the UK; the Australian system etc.  These countries realize that  Healthcare is indeed a human right because they provide it for their citizens.

 

Why does a Government exist if it provides no real service to it's citizens welfare.?   America is in a transition and will eventually realize what every other industrialized country has and it will need to provide universal healthcare.

 

You are completely wrong on the point that some morality must be based on money.  The very concept of morality is based on fairness; equity and never an exclusion .

 

The immorality of  for profit healthcare is the abomination that must be eliminated and the Insurance industry  .  Both For Profit medicine and insurance have brainwashed a large portion of the World, including yourself, that it actually cares about fairness and equity and morality but it cares only for money.

 

In fact it wants you to die quickly so the system doesn't have to support you and pay out money/  

 

 What could be more immoral than that?

 

[donnacha]

3 minutes ago, Thaidream said:

What could be more immoral than that?

Forcing other humans to render services to you without paying for them.

[Benmart]

The usual nasty posters spewing venom and negativity. I wish the lady and her family well. As for the hate filled controllers on TVF, I wish them well...well far from me.

[metempsychotic]

what a nasty bunch o' fox you lot are.

As for accusations its a publicity stunt, good for them, it should be public knowledge.

and inferring that they are dumping her? It seems to me they are doing all they can, thank heaven my folks both died  living life under their own terms and independent.

I never had to make the nursing home decision or pick them or me,  nor be saddled by the burden of knowing they were far away and feel like i was neglecting them.

All over the west people abandon their parents even before they require such a high level of care.