How is the standard of medical care so high?

[HLover]

1 hour ago, Moonlover said:

We can all quote, either indirectly or from direct experience, good treatment and bad treatment anywhere in the world.

 

As a direct follow on @Isaanbiker's experience I can report some excellent surgery carried out on my double fracture (tibia and fibula) in Udon Thani, which also included plate insertion. (still there 4 years on)

 

There were some shortcomings in other aspects of the treatment, (the physiotherapy was rubbish, I knew more than she did) but the surgery was 1st class.

 

In short, it's impossible to judge a country's medical service from one isolated incident.

Well said.

[cmarshall]

Here is another way to understand Thailand's performance in medicine compared to other similar countries.  

 

In the World Health Organization's ranking of the quality of health care by country here is Thailand and its neighbor's:

 

46  Barbados

47  Thailand

48 Czech Republic

 

http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/

 

(We have to bear in mind that what we expats mean by quality of care is not just the same as the WHO, who is more interested in dimensions like access for the population and other factors.)

 

Now what is the GDP (PPP) per capita of those countries in USD:

 

46 Barbados               16,839

47 Thailand                 19,476

48 Czech Republic       37,371 

 

https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(PPP)_per_capita

 

Then, let's add the health care costs as a percentage of GDP, to see that Thailand can afford:

 

                                  gdp per cap             health costs/GDP

46 Barbados               16,839                      6.96%

47 Thailand                 19,476                      4.02%

48 Czech Republic       37,371                      7.15%

 

https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS

 

So, Thailand does indeed appear to be outperforming at least a couple of comparable countries, with a health care system that is either better or more efficient or both. 

 

I think the credit goes substantially to the bureaucracy who persuaded Thaksin to implement the 30 baht universal health care system and who defended it successfully when the military government attempted to dismantle it.  Thai people are also much inclined to contribute to hospitals, even government hospitals.  

 

 

 

 

[scubascuba3]

Here is another way to understand Thailand's performance in medicine compared to other similar countries.  
 
In the World Health Organization's ranking of the quality of health care by country here is Thailand and its neighbor's:
 
46  Barbados
47  Thailand
48 Czech Republic
 
http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/
 
(We have to bear in mind that what we expats mean by quality of care is not just the same as the WHO, who is more interested in dimensions like access for the population and other factors.)
 
Now what is the GDP (PPP) per capita of those countries in USD:
 
46 Barbados               16,839
47 Thailand                 19,476
48 Czech Republic       37,371 
 
https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(PPP)_per_capita
 
Then, let's add the health care costs as a percentage of GDP, to see that Thailand can afford:
 
                                  gdp per cap             health costs/GDP
46 Barbados               16,839                      6.96%
47 Thailand                 19,476                      4.02%
48 Czech Republic       37,371                      7.15%
 
https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS
 
So, Thailand does indeed appear to be outperforming at least a couple of comparable countries, with a health care system that is either better or more efficient or both. 
 
I think the credit goes substantially to the bureaucracy who persuaded Thaksin to implement the 30 baht universal health care system and who defended it successfully when the military government attempted to dismantle it.  Thai people are also much inclined to contribute to hospitals, even government hospitals.  
 
 
 
 

i wonder why the difference between your info and that below, quite a big difference.

[BestB]

I do not know about the data, but have had surgeries in Australia and in Thailand and Thailand wins hands down from start to finish, from preparation for surgery, to actual surgery to recovery and after care.

 

One best example i can offer is what happened with my first surgery in Thailand. It was a shoulder surgery. not my first shoulder surgery, but my first in Thailand.

 

1. Back in Oz, you stripped naked on the table tied up like Jesus Christ and feeling not only anxious but also very uncomfortable with your private parts on  display

Thailand, towel or something over private parts, not tied up(while awake at least),totally relaxed while anesthesiologist having a casual chat and all over sudden i wake up in recovery room.

2. Australia, Recovery room, wake up alone, totally lost, disoriented and no one around for what feels like hours

Thailand. Wake up with 2 nurses holding your head up, very soft and gently move you up, telling you where you and and who you are. Before you know it, 4 nurses are there, making you comfortable, giving you coffee and whatever else you need

3. The most important one. Australia, Wake up in pain and stay in pain for 3 days needed pain killer injection every 4-6 hours. not really eating because of pain and medication, hardly able to walk to the toilet, let alone outside

Thailand. Wake up with no pain at all, i mean none,Hungry and ready to eat 3 main meals, 30 mins later taking a walk outside to have a smoke. Why? Because doctor injected Novocaine in to a nerve somewhere in the neck, total numbness,ie can not feel any pain at all, do not need pain medication. Novocaine worn off 2-3 days later, by which time pain is mild.

 

Never ever in my life and all my surgeries back in Australia have i had something that smart and yet simple to block out the pain.

 

4. After care. Australia, to call out nurse can take 10-40 mins, they are rough and rude at times.

Thailand, 2-5 mins to call nurse and for her to arrive, soft spoken, sweet and gentle.

 

Point of my rant, Thailand in my opinion should be in top 10, sure as hell beats Australia

[cmarshall]

1 hour ago, scubascuba3 said:

i wonder why the difference between your info and that below, quite a big difference.

"PPP" means "Purchasing Power Parity," i.e. calculates GDP per capita according to what money can buy, rather than at the currency exchange rate.  For instance, if we compare nominal GDP (total, not per capita) between the People's Republic of China and the US, the US is the larger economy.  However, if we compare GDP PPP between the two countries, China's economy is larger by about 25%.  Economists usually take GDP PPP to be the more meaningful basis for comparison.

 

The number you cited for Thailand's GDP per capita is nominal, not PPP.

[luk AJ]

I had eye lens replacement (multi focus) and at a different eye clinic they peeled of the retina and filtered eye liquid.
Further I had triple coronary bypass some complications but I am still alive. I am confident if you thoroughly select a specialist your chances are as good as home. Big difference even a coronary bypass can be performed within one week after diagnose. Where else in the world is this possible? Also service is 10 times better in Bangkok.


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[cmarshall]

36 minutes ago, FredGallaher said:

 

BTW US healthcare is expensive, but is considered the world leader. I don't trust a lot of studies because I know they can be designed to show anything the author wants.

US healthcare is certainly not the world leader.  In the WHO ranking it is # 37 and France is #1.  This is the kind of mindless repetition of what is essentially propaganda that we are used to hearing from the US healthcare industry.  Reminds me of old Soviet films that were filled with claims that Soviet healthcare was the best in the world.  

[Nyezhov]

10 minutes ago, cmarshall said:

US healthcare is certainly not the world leader.  In the WHO ranking it is # 37 and France is #1.  This is the kind of mindless repetition of what is essentially propaganda that we are used to hearing from the US healthcare industry.  Reminds me of old Soviet films that were filled with claims that Soviet healthcare was the best in the world.  

Who? Oh, the WHO. UN. Gotcha.

 

12 hours ago, BestB said:

Wake up with 2 nurses holding your head up, very soft and gently move you up, telling you where you and and who you are. Before you know it, 4 nurses are there, making you comfortable, giving you coffee and whatever else you need

Thats part of the pleasant hospital stay I had. Those nurses hovering over you with those tight white uniforms and the hats and bowsnoods.....then they put a mask on and all you can see are those eyes (usually with a lazy one) just staring at you as they whisper throatily "You cannot move, OK?". Yes darling could you mop my brow again?

 

Makes me want to put a straw in the San Saeb and take a sip so as to get a quick stay with those beauties.

[Sheryl]

Any discussion of healthcare in Thailand needs to clearly differentiate between private care and the public health system. The overwhelming majority of Thais get care from the latter whereas medical "tourists" and resident expats more often use the former. Though with rising costs more and more resident expats are starting to use public hospitals, especially now that most offer "after hours" special clinics where senior doctors can be directly consulted (a big drawback to the public channel is that care is delivered by medical students, interns and residents albeit under supervision.)

 

The government health care system here IMO works pretty well but suffers from the same problems that most government health care systems do: overcrowding, underfinancing, big disparity in quality between urban and rural locations with remote rural areas in particular suffering.  I spend quite a lot of time in government hospitals, assisting neighbors and friends getting care, and on the whole am favorably impressed -- not with creature comforts, of course, but with overall allocation of resources (treating the most critical first, prioritizing the most important things at the expense of the lesser ones) and the adherence to well thought out treatment protocols. That said, I have had to go to bat once or twice to deal with incompetence on the part of interns. I also had to do that, very regularly, when a nurse in a US teaching hospital.

 

Private health care in Thailand is a very mixed bag and cannot really be called a "system" . The key thing to understand -- aside from the obvious one that it is a profit making business - is that there is little regulation of it and that doctors are usually independent contractors at the  hospital (often at many hospitals) with complete latitude to practice as they see fit. This can be good or bad depending on the doctor and the situation.  It definitely saves time and is more amenable to giving patients what they want (which may or may not be what they need)  but unless you have carefully researched and chosen the doctor there is no guarantee that treatment will follow usual medical standards. In addition, it is highly specialized/fragmented and does not revolve around GPs as care coordinators/gate keepers. That is great if you need a specialist and know what type you need, not so good if you have no idea what your problem is.  I use and help people use private facilities a lot but always after careful research in selection of the doctor.

 

 

[The Deerhunter]

On 10/6/2019 at 8:56 PM, IraqRon said:

after stays in private and govt. hospitals I would agree wholeheartedly.  Just because some charge a great deal more than others doesn't ensure the care is better.  I shake my head when some posters say that they chose Tland because the care is "so great".  

 

As an limited example, a good friend who wanted lasik surgery did research and found that the bkk hospital so revered by some on here were the best, great equipment etc. for this, however the job was botched and his eyes were so damaged that he killed himself in misery over the pain.

He later, before suicide. found that the machine used had not been calibrated in years and filed a complaint for this to no avail.  So sad as he was a very upbeat positive person before this.

 

 

 

I used to believe in quality Thai medical treatment too but after living in LOS for nearly 6 years and originally planning to end my days here eventually, I wised up.   Been "back home" now for 3 months and plan to stay here.

Mis-diagnosis  (several times) on myself and my Thai wife in Thailand.  Attempts or success in over treating for obviously financial reasons on several occasions.  Surgery that had to be repeated because the surgeon never bothered to finish the job when she discovered it was more than she intended to do.  That procedure repeated 12 months later in N.Z. and 13 years later no problems.  

A botched simple Gyno procedure at "Bangkok's most famous" hospital.  That procedure, also repeated in N.Z. because it was not done correctly.   

There are successes and good stories but like airline service, times change.  We have had some good experiences with medical care in LOS but far in the minority.    Sorry to say this but I too was under the misapprehension of quality medical care but have well changed my mind.  

[Sheryl]

In the US interns do most of the inpatient care, but are supervised by a Hospitalist physician. The Hospitalist is quite often a foreign trained but follows established protocols. I have interacted with them and some are very good, but others are difficult to understand. The interns do the bulk of the work.
It is rare to see your physician during a hospital stay unless you are in a specialized care unit. ie cardiology, oncology, etc.
 

True only in major teaching hospitals.

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[BestB]

8 hours ago, The Deerhunter said:

I used to believe in quality Thai medical treatment too but after living in LOS for nearly 6 years and originally planning to end my days here eventually, I wised up.   Been "back home" now for 3 months and plan to stay here.

Mis-diagnosis  (several times) on myself and my Thai wife in Thailand.  Attempts or success in over treating for obviously financial reasons on several occasions.  Surgery that had to be repeated because the surgeon never bothered to finish the job when she discovered it was more than she intended to do.  That procedure repeated 12 months later in N.Z. and 13 years later no problems.  

A botched simple Gyno procedure at "Bangkok's most famous" hospital.  That procedure, also repeated in N.Z. because it was not done correctly.   

There are successes and good stories but like airline service, times change.  We have had some good experiences with medical care in LOS but far in the minority.    Sorry to say this but I too was under the misapprehension of quality medical care but have well changed my mind.  

First and most importantly you must screen and chose your doctor. 
 

For me , if doctor can not speak English , instantly out.

 

i always chose doctors who speak English , have studied or worked overseas and have some accreditation’s post study . 
 

So far I have not been wrong.

 

[cmarshall]

23 hours ago, FredGallaher said:

BS. You need to look at actual medical treatments not a bunch of unrelated stuff thrown in. I don't know about France but places like U, Canda, Australia that have socialized systems rate high as per cost for the patient but wait times can be excessive. Many Canadians travel to the US because they can't access healthcare in a timely manner. 

There are sometimes waits in the US (because of many reasons) but not as bad as Canada. UK has also been said to have long waits. Thailand on the other hand wait times are very short and seem to be well manager. I think it has to do with labor cost. In the US a surgery, recovery or ED nurse usually makes $50+/hr in California (5 years ago). Administration need to be sure schedules are tightly coordinated to control costs. Not as important in Thailand where labor costs are less.

......the old canard about all those Canadians swarming across the border, because they can't wait for treatment.  That has been debunked.  Far more Americans go to Mexico for medical treatment than Canadians coming to the US.  59% of Canadians are satisfied with their healthcare system vs. 25% for Americans.

 

Economists who specialize in health care economics, on the other hand, do care about how much of the population has access.  There are other metrics we might apply.  For instance, what is the rate of household bankruptcies caused by medical costs?  In the US medical costs are the leading cause bankruptcies among families.  In countries like Japan or Canada, no one goes bankrupt because of medical bills.

 

 

Edited October 9, 2019 by Sheryl
personal insults removed by Moderator

[The Deerhunter]

8 hours ago, BestB said:

First and most importantly you must screen and chose your doctor. 
 

For me , if doctor can not speak English , instantly out.

 

i always chose doctors who speak English , have studied or worked overseas and have some accreditation’s post study . 
 

So far I have not been wrong.

 

The woman Doctor Who messed up my wife's operation was trained and qualified in America I spoke perfect English. The plan is good but it's a bit hard to control in a hospital-based medical system. Many parts of Thailand do not have General Practice clinics where you can pick and choose. All hypothetical to me now because I'm home.

[cmarshall]

12 minutes ago, FredGallaher said:

I haven't heard that before. That's what Medicaid covers in US. Your no expert on US healthcare. You seem to be a proponent of the Nanny state where the government takes most of your pay (if you work) and mothers you. I prefer to make my own decisions, Thank you.

Of course there is then no incentive to work because the government nurtures you regardless.

Of course, you haven't heard about the medical causes of bankruptcy in the US, because typical American conservative that you are, you never learn anything that doesn't fit snugly into your preconceptions.  

 

Congratulations on your paleolithic individualism, which no doubt includes disclaiming your Social Security benefits and, indeed, all forms of insurance since why should other premium-payers pay when your house burns down, which you will no doubt rebuild with your own two God-given hands.

[Sheryl]

Posts from a two-party flame fest (you know who you are) have been removed and another post edited to remove personal insults.

 

cease and desist.

 

And stay on topic, which is the quality of health care in Thailand, not the US health care system or politics.

[The Deerhunter]

5 hours ago, FredGallaher said:

Best that you stay home.

Intend to for medical treatment.  Even my Thai wife agrees after her problems including a simple asthma attack diagnosed as auto immune disease at a prestigious private hospital.

[uhuh]

On 10/8/2019 at 9:40 AM, FredGallaher said:

Thailand on the other hand wait times are very short

In the private sector, yes. 

In the public sector,  no.