SURVEY: Health Insurance for foreigners -- Good idea or not?

[StevieAus]

17 hours ago, Pedrogaz said:

As a 67 year old long term resident here with a home, partner, cars etc......paying outrageous taxes on cars but getting nothing back. I would go back to Europe if I hadn't invested so much on this racist country.

The government should allow all longer term (one year plus) resident to access the Thai government healthcare system for a reasonable fee instead of forcing us into the claws of these morally bankrupt private hospitals and insurance companies that charge foreigners much more than Thais.

Anybody can access government hospitals in Thailand.

I have used a well know private hospital in Chiang Mai for ten years or more and their charges are the same for Thais and non Thais.

You need to understand that private hospitals are what the name suggests PRIVATE they are not funded by the government.

[meechai]

15 hours ago, RichardColeman said:

My visa card has a huge available credit that i never use. I think if you can show you have a say $15-20,000 spare on your card then you should not need insurance. I also have enough money in the bank combined with this credit excess to cover $50,000 - so exactly why do i need insurance to cover an amount i already have access to ?

 

 

This always sounds logical & I also for the most part agree for a short term coverage/vacation etc but long term? No...........

It is not viable for a government to allow it nor have the responsibility to police it.

 

After all credit is like musical chairs it is there ...."maybe" when the music stops.

But how would a government consonantly police that & know you have not been left without a chair when your music stops?

[fredscats]

11 hours ago, brucec64 said:

Why should I fund someone else not getting insurance? The point of insurance is that everyone pays and costs are payed from the shared pool. 

Why should I get ins here in Thailand,when I can get fixed up far cheaply somewhere a couple of hours away

[HAPPYNUFF]

My former neighbour, in my home country, was a senior  executive with an international insurance company.  He never had insurance himself, and frequently told me it was  just a scam, that allowed his company to fly him around the world on "conferences".   After he retired, he needed hip replacement surgery, and as I explained in another thread, rather than  go on the "wait list" at a major public hospital, had himself  booked in, and operated on at a small regional public hospital within a matter of weeks.

As for myself, I would, if I could, take out  health insurance, as I had in my home country, which has no age limitations, . However here, because  I have reached  the "use by" date insurers  set, I cannot obtain same,. Therefor I am forced to self insure. and now, I am locked in to staying forever in the land of smiles (?) as  travel insurance is also   not available to me, and  should I  leave Thailand, I would be unable to meet the requirements to return.    As an explanation,  should I  renew my health insurance   back in my home country,  it does not   cover  me  for health problems overseas.

[starky]

11 hours ago, Adumbration said:

What happens if you are in a situation the same a my current one.  I have $50K in my Australian banks, but I cannot currently access it because I cannot receive SMS OTP messages to my phone.  My bank also, without my permission just recently put sms confirmation as a requirement on all my Mastercard transactions.  

They tried that on me I said I work offshore and the rest of the time I am overseas it's near impossible for me to receive sms (which is true) I said you can leave my accounts password only or I will be removing all my money closing my accounts and moving to a bank that respects my wishes as a customer. Problem solved. Have you spoken with your bank?

[brucec64]

3 hours ago, fredscats said:

Why should I get ins here in Thailand,when I can get fixed up far cheaply somewhere a couple of hours away

That's not always an option.  Of course you can fly somewhere for long term care, but you planning on flying somewhere in the middle of a heart attack?

[thonglorjimmy]

17 minutes ago, brucec64 said:

That's not always an option.  Of course you can fly somewhere for long term care, but you planning on flying somewhere in the middle of a heart attack?

An excellent point, I'll have to confess that having been advised by somebody in the insurance industry, when I retired here at the age of 60, that medical insurance wasn't cost effective at my age, if only for the reason that premiums would escalate over the years, and should I ever have a claim then premiums would go through the roof, previous conditions may no longer be covered and I may even become uninsurable.

 

I took the conscious decision, rightly or wrongly, not to seek out medical insurance, to cover any minor ailments from my own funds and return to my home country in the event of anything serious, where I would be covered from day one, or at least join the National Health Service waiting list.

 

That plan went t**s up when I had a heart attack whilst my wife and I were away on a long weekend in Singapore, I'd taken out travel insurance, at the insistance of my wife who joined me at the last minute, the insurers, luckily, reimbursed me the SGD 30,000 I'd paid for my medical issues, and I paid for follow up treatment of a further 200,000 Baht, as I recall, following my return to Bangkok. 
Whilst I was being resuscitated the hospital asked for a SGD 5,000 deposit, which she paid on our credit card, not really knowing how much was available.

 

So the point made by @brucec64 is well made, it's not always possible to travel overseas, or even upcountry, in the case of a medical emergency.
We considered relocating to the UK a while later, where I would be covered by the NHS as would my wife, once she obtained her settlement visa, but as we got nearer to doing so, we had second thoughts and backed off, but as I reach 75 next year we're considering again.

 

I think many of us believe that the Thai Government should introduce an affordable health scheme, but I thing we all accept that it's not going to happen, and in all honesty why would they want to, I can't think of any other countries who have something similar.

 

I think the current scare, valid or not, is a wake up call for many of us.  

[Longwood50]

16 hours ago, 1FinickyOne said:

so, you think this is a good plan - bargaining for medical like you would in a flea market?... call me a dreamer, I would hope for a better plan... 

Do you have a better idea.  Whose to say that irrespective of what the hospital charges that you are getting quality service.  

I see nothing wrong with a patient shopping for services particularly routine services like blood work, x rays, annual physicals, required vaccinations etc. 

This current system where the hospital charges what it wants, the patient does not care because they are insured only leads to more overcharging and higher insurance premiums.  Even the insurance companies really don't care so long as they can pass the cost on to their customers via higher premiums. 

The current system is like having a dinner on the company account.  You don't care what the cost is and you only want the best. 

I see nothing wrong with a patient who needing a procedure shopping with several qualified physicians before selecting one.   The consumer is then making a choice between the perceived quality of the care being received versus the expense and making a value judgement.  

My system of private pay is not without its shortfalls the primary one being that some people will put off medical care because of its costs.  But the alternative of having third party pay does just the opposite.  Its like a medical buffet where the patient selects the most expensive items on the buffet and doesn't care how much they eat.   There is nothing in the world more wasted than something that is "free"  And right now, once the patient reaches their deductible or co-pay they don't care in the least how much the hospital or doctor charges.  

[MyFriend You]

7 hours ago, Andycoops said:

My insurance in Thailand covers me upto 99 years of age.

At what cost may I ask??   I have read many posts in the past 12 years that basically says Thai Health Insurance companies won't insure older folks.  I inquired with  Aetna International and was quoted almost $7700 USD a year (for Thailand) for a single man 72 years old. and doesn't cover pre-existing conditions.  Threw that in the bin.  So what would I expect to pay for Thai Aetna at 72 yo per year - I already have Aetna National Insurance in USA that would cover Covid treatment, hospitalization etc etc. at 100% unlimited coverage.  But not sure if Thai Immigration will accept that.

[MyFriend You]

9 minutes ago, TunnelRat69 said:

At what cost may I ask??   I have read many posts in the past 12 years that basically says Thai Health Insurance companies won't insure older folks.  I inquired with  Aetna International and was quoted almost $7700 USD a year (for Thailand) for a single man 72 years old. and doesn't cover pre-existing conditions.  Threw that in the bin.  So what would I expect to pay for Thai Aetna at 72 yo per year - I already have Aetna National Insurance in USA that would cover Covid treatment, hospitalization etc etc. at 100% unlimited coverage.  But not sure if Thai Immigration will accept that.

Mea Culpa

 

Internationalism answered my inquiry back a couple pages, sent these links - but cutoff is still 75 yo:

 

till 75 yo, but only one policy "visa friendly" and not cheap.

below 70yo some other insurers.

https://misterprakan.com/th/health/plans?gender=Male&age=75&lg=en&ipd=1&opdf=0&leadid=348157

 

at 65 there is choice of 4 insurers, can be carried with them to 90 or longer

https://misterprakan.com/th/health/plans?gender=Male&age=65&lg=en&ipd=1&opdf=0&leadid=348157

Edited November 8, 2021 by TunnelRat69

[MyFriend You]

On 11/6/2021 at 7:02 PM, Salerno said:

Yes (depending on the policy obviously, but foreign policy now OK).

Thank You

[1FinickyOne]

1 hour ago, Longwood50 said:

Do you have a better idea.  Whose to say that irrespective of what the hospital charges that you are getting quality service.  

I see nothing wrong with a patient shopping for services particularly routine services like blood work, x rays, annual physicals, required vaccinations etc. 

This current system where the hospital charges what it wants, the patient does not care because they are insured only leads to more overcharging and higher insurance premiums.  Even the insurance companies really don't care so long as they can pass the cost on to their customers via higher premiums. 

The current system is like having a dinner on the company account.  You don't care what the cost is and you only want the best. 

I see nothing wrong with a patient who needing a procedure shopping with several qualified physicians before selecting one.   The consumer is then making a choice between the perceived quality of the care being received versus the expense and making a value judgement.  

My system of private pay is not without its shortfalls the primary one being that some people will put off medical care because of its costs.  But the alternative of having third party pay does just the opposite.  Its like a medical buffet where the patient selects the most expensive items on the buffet and doesn't care how much they eat.   There is nothing in the world more wasted than something that is "free"  And right now, once the patient reaches their deductible or co-pay they don't care in the least how much the hospital or doctor charges.  

I have plenty of complaints about the current system.. money and medicine are a toxic mix... I self insure so I do not take part in the problem you are discussing. I do have issues w/doctors proscribing unnecessary tests... etc etc.. and have been lied to about the results to incur a mere 500 baht in extra tests but sent out with a diagnosis of a heart problem that was non existent. 

 

I just did an overnight for a minor issue and was fine the next day, however, I left with 4 doctors appointments w/doctors who really had nothing to do with the obvious issue that caused the problem. I cancelled them all.  One even recommended me stay another day to rehydrate or - I could go home and drink a lot of water... however, when I was in the hospital, I was vulnerable to the 'up-selling' of services and even when I had the sense to decline, a 2nd doctor was sent in to sell me on more procedures... when you are in pain, it is difficult to place your own logic over someone who is there to alleviate the pain... 

[Adumbration]

6 hours ago, starky said:

They tried that on me I said I work offshore and the rest of the time I am overseas it's near impossible for me to receive sms (which is true) I said you can leave my accounts password only or I will be removing all my money closing my accounts and moving to a bank that respects my wishes as a customer. Problem solved. Have you spoken with your bank?

You should get out my other threads.  I have just wasted 1 month dealing with my banks.  The Commonwealth bank is a f8888king nightmare.  They have now suspended my commsec trading account, cdia account, and my Mastercard.  

 

Which Australian bank do you have that lets you have password only.

 

And moving all you money is not a threat anymore in the wake of fractional banking.  They don't care for depositor at all.  They are only interested in peddling debt.

 

Please let me know which bank you are with that lets you have password only access.

 

[Longwood50]

36 minutes ago, 1FinickyOne said:

I have plenty of complaints about the current system.. money and medicine are a toxic mix...

You are absolutely correct.  I believe the best solution for fixing the health insurance mess in the USA is to have a mandatory system like social security where a small portion goes into a separate account in the name of the person.  Those monies are used to pay for small medical expenses and go back to the person once a certain balance is reached.  The person knowing they are using their own money will be careful in terms of what medical services they request and what they pay for them.  

Then each person would have a major medical policy covering catastrophic illness and medical expenses.  Lets say with a 1 million or 3 million dollar cap and a $10,000 deductible.  Those policies are cheap.  

The person would be covered using their own money for less than the $10,000 and covered if they got really terrible hospital expenses.  I know this, this system of trying to limit the reimbursement to doctors and hospitals only causes the medical community to get more deceptive.  Instead of ordering 1 test that they make $100 on, they order 10 tests that they make $10 each on and of course the expense of the 10 tests is more than the 1 test.  Doctors want to keep your running back because they are limited as to how much they can receive in the way of a reimbursement for each visit.  

You do not insure your car for oil changes and tire changes.  You insure it in the event of a serious accident than runs up a large expense.  Health coverage should be the same.  Pay out of pocket for those routine physicals, blood work, x rays and have an insurance policy for those truly catastrophic expenses. 

 

[1FinickyOne]

45 minutes ago, Longwood50 said:

You are absolutely correct.  I believe the best solution for fixing the health insurance mess in the USA is to have a mandatory system like social security where a small portion goes into a separate account in the name of the person.  Those monies are used to pay for small medical expenses and go back to the person once a certain balance is reached.  The person knowing they are using their own money will be careful in terms of what medical services they request and what they pay for them.  

Then each person would have a major medical policy covering catastrophic illness and medical expenses.  Lets say with a 1 million or 3 million dollar cap and a $10,000 deductible.  Those policies are cheap.  

The person would be covered using their own money for less than the $10,000 and covered if they got really terrible hospital expenses.  I know this, this system of trying to limit the reimbursement to doctors and hospitals only causes the medical community to get more deceptive.  Instead of ordering 1 test that they make $100 on, they order 10 tests that they make $10 each on and of course the expense of the 10 tests is more than the 1 test.  Doctors want to keep your running back because they are limited as to how much they can receive in the way of a reimbursement for each visit.  

You do not insure your car for oil changes and tire changes.  You insure it in the event of a serious accident than runs up a large expense.  Health coverage should be the same.  Pay out of pocket for those routine physicals, blood work, x rays and have an insurance policy for those truly catastrophic expenses. 

 

I am going to say that what you outlined is more than people will want to pay... I had an employee who was obsessed w/wanting health insurance for her whole family. If I gave it to her, I would have had to give it to everyone and I would have been out of business... she was a terrific employee and so at the end of the year I gave her a bonus that was 2x what it would have cost for insurance and told her to buy in w/her own funds. She didn't. 

 

If you want something else to consider, the cost of housing elderly alzheimer patients will make you crazy. I read some years ago that the last 6 months of your life is costing $500,000 in medical bills on average... if you could have the option of having that $500,000 when you are 25, how would your life have been different? 

 

Plenty of "ifs" but how many docs go into medicine for the $$.... I had a housemate in college who was from a wealthy family. He was pre-med and became a doctor. He would steal candy bars from the local mom and pop store... he could turn on the charm too... and he was a total sadist. I have no doubt he could cut your liver out for $50 and enjoy the process. 

 

On the other hand, some doctors here go to school in USA which might run near $1 MM in costs - then they come back here and charge $15 for an office visit. 

 

For me, it is sad but I have lost all trust and prefer to avoid check-ups. I have had unnecessary surgeries recommended... it sort of feels like going to a car mechanic and asking them to find the problem. Even if there is none, they will find something. 

 

Personally I do not see a solution. 

[brucec64]

6 hours ago, thonglorjimmy said:

An excellent point, I'll have to confess that having been advised by somebody in the insurance industry, when I retired here at the age of 60, that medical insurance wasn't cost effective at my age, if only for the reason that premiums would escalate over the years, and should I ever have a claim then premiums would go through the roof, previous conditions may no longer be covered and I may even become uninsurable.

 

I took the conscious decision, rightly or wrongly, not to seek out medical insurance, to cover any minor ailments from my own funds and return to my home country in the event of anything serious, where I would be covered from day one, or at least join the National Health Service waiting list.

 

That plan went t**s up when I had a heart attack whilst my wife and I were away on a long weekend in Singapore, I'd taken out travel insurance, at the insistance of my wife who joined me at the last minute, the insurers, luckily, reimbursed me the SGD 30,000 I'd paid for my medical issues, and I paid for follow up treatment of a further 200,000 Baht, as I recall, following my return to Bangkok. 
Whilst I was being resuscitated the hospital asked for a SGD 5,000 deposit, which she paid on our credit card, not really knowing how much was available.

 

So the point made by @brucec64 is well made, it's not always possible to travel overseas, or even upcountry, in the case of a medical emergency.
We considered relocating to the UK a while later, where I would be covered by the NHS as would my wife, once she obtained her settlement visa, but as we got nearer to doing so, we had second thoughts and backed off, but as I reach 75 next year we're considering again.

 

I think many of us believe that the Thai Government should introduce an affordable health scheme, but I thing we all accept that it's not going to happen, and in all honesty why would they want to, I can't think of any other countries who have something similar.

 

I think the current scare, valid or not, is a wake up call for many of us.  

I have been with Aetna (formerly Bupa) for over 10 years. Never put a claim in until this year. I had a hip surgery a year ago, two emergency claims, and surgery tomorrow, for a total of 1.3m bht. Aetna paid for 100% of all. There is always a bit of back and forth for surgeries, but so far they have come through.

Premiums do go up with age, but I was informed last time I renewed that premiums were based solely on age, and as long as you get in before 65 and always renew, you would never get kicked out.

[Longwood50]

2 hours ago, 1FinickyOne said:

Personally I do not see a solution. 

There is no solution.  There are only alternatives.  Everyone seems to think there is a "perfect solution". 

To me, I have concluded that if society decides to mandate and/or provide health insurance, you will have a system that the medical community exploits.  They will charge whatever they can and provide more services than really required to line their pockets. 

Alternatively you can have a market based health care system where patients select what exams, tests, and procedures they want done and they are willing to pay for them.  Unquestionably you will have some patients who make bad decisions to "save money" and it will cost them their health. 

The only middle ground I can see is for the government to "protect" its citizens by mandating a program like social security where each person is forced to put a small percentage of their income away in a health savings account until it reaches a maximum of $10,000.  They would be able to spend any amount from the savings for medical expenses.  Those would include the routine office visits, xrays, lab tests, blood work etc.  When the balance in the account falls below $10,000 the deductions from the persons income resume until such time as the $10,000 threshold is reached.   That would instill some incentive on the part of patients to only seek necessary medical assistance and to shop for the best value. 

The deductions from the persons pay would also cover the premiums for a major medical policy with a $10,000 deductible.  If the person faced catastrophic medical expenses the $10,000 in their account would cover the deductible and then the major medical policy would kick in.  Those major med policies are cheap. 

Is it a perfect solution, no nothing is perfect.  The current system costs a ridiculous amount in bureaucratic overhead for hospitals and doctors to get paid and for insurance companies to cover the expense of monitoring and paying claims.  That expense would be mostly eliminated if the patient was the one doing the monitoring when they selected the doctor or hospital to go to for their treatment and paid directly.  

 

[1FinickyOne]

2 hours ago, Longwood50 said:

There is no solution.  There are only alternatives.  Everyone seems to think there is a "perfect solution". 

To me, I have concluded that if society decides to mandate and/or provide health insurance, you will have a system that the medical community exploits.  They will charge whatever they can and provide more services than really required to line their pockets. 

Alternatively you can have a market based health care system where patients select what exams, tests, and procedures they want done and they are willing to pay for them.  Unquestionably you will have some patients who make bad decisions to "save money" and it will cost them their health. 

The only middle ground I can see is for the government to "protect" its citizens by mandating a program like social security where each person is forced to put a small percentage of their income away in a health savings account until it reaches a maximum of $10,000.  They would be able to spend any amount from the savings for medical expenses.  Those would include the routine office visits, xrays, lab tests, blood work etc.  When the balance in the account falls below $10,000 the deductions from the persons income resume until such time as the $10,000 threshold is reached.   That would instill some incentive on the part of patients to only seek necessary medical assistance and to shop for the best value. 

The deductions from the persons pay would also cover the premiums for a major medical policy with a $10,000 deductible.  If the person faced catastrophic medical expenses the $10,000 in their account would cover the deductible and then the major medical policy would kick in.  Those major med policies are cheap. 

Is it a perfect solution, no nothing is perfect.  The current system costs a ridiculous amount in bureaucratic overhead for hospitals and doctors to get paid and for insurance companies to cover the expense of monitoring and paying claims.  That expense would be mostly eliminated if the patient was the one doing the monitoring when they selected the doctor or hospital to go to for their treatment and paid directly.  

 

I think you are young, surely younger than I am... having a $10,000 [I assume US $ ] reserve account for healthcare is not very much, even here in Thailand. 5 yrs ago it cost me about that for a stent for my heart - 20 minutes on the operating table... I am sure it would be more now, likely $15k and bypass surgery is not going to be cheap. 

 

Interestingly, the Thai have it figured out pretty well, certainly better than the USA... w/their 30 baht coverage for all. You must be familiar w/how their system of public health care works.  

 

I have a friend who went in for an operation scheduled to be 3 days in hospital and 300,000 baht... complications almost killed him but he got out after 2 months in the ICU the bill was 2MM baht... and mostly he had no idea what was going on most of the time... 

 

Another wrench into the equation is that from a businessman's perspective, I am awed and floored at what the expenses must be to run a facility like a relatively new Bangkok hospital as they have in CM... I would love a peak into their books, - what are their daily expenses and what sort of investment is needed for all the medical equipment and to keep all up to date... not a business venture I would want to be part of..

 

as you say, no solutions. 

[Longwood50]

12 hours ago, 1FinickyOne said:

Interestingly, the Thai have it figured out pretty well, certainly better than the USA... w/their 30 baht coverage for all.

You have to remember the $10,000 USD was for medical care that the person would cover themselves.  After than a major medical policy to cover catastrophic health care. 

In terms of the 30 baht plan.  Why 30 why not 10 why not zero.  The 30 baht plan does not mean health care costs 30 baht only that the patient is charged 30 baht.  Again, that only encourages people to use healthcare excessively because it is cheap.  

With the 30 baht plan the patient goes in and gets an operation costing 1 million baht and the government pays.  Then everyone paying taxes covers the cost of the 1 million baht operation.  So what about that is "free" 

The system whether here in Thailand or in the USA encourages people to unnecessarily use the healthcare system and intensifies the health care system to provide excess medical care to reap profits.  

Its like an all you can eat buffet versus and ala carte menu.  When you have an all you can eat, you don't care how much of the food you take, and discard anything you don't consume. WASTE.  If it is ala carte and you are paying for each item consumed, you choose wisely.  The same is true for health care.  If the patients were responsible for each health care procedure requested they would shop for it, and choose judiciously. 

The only way I can think of to encourage such shopping is to have each person have a government account using deductions from their money.  They would shop for the small health care expenses and the larger ones covered by either a private major medical policy or government catastrophic health care coverage. 

I can tell you I am guilty.  I had procedures done under Medicare strictly because the government would pay for them.  One a cosmetic procedure to raise my eyelids.  The government policy said if they were "restricting my vision" they would be covered.  You don't think the doctor who did the surgery made sure what was reported to Medicare ensured that the "test" showed I was impaired.  If I had to pay for the surgery, I would not have done it. 

[1FinickyOne]

55 minutes ago, Longwood50 said:

The 30 baht plan does not mean health care costs 30 baht only that the patient is charged 30 baht.

of course not, it is free essentially. but I would not expect most Thai to have $10,000 and money for insurance.. 

 

55 minutes ago, Longwood50 said:

a cosmetic procedure to raise my eyelids. 

Any surgery is dangerous, in my opinion. You want to raise your eyelids, I have a dog for you... 

Edited November 9, 2021 by 1FinickyOne

[Longwood50]

24 minutes ago, 1FinickyOne said:

of course not, it is free essentially. but I would not expect most Thai to have $10,000 and money for insurance.. 

If you read the original post this was an idea for USA citizens not Thailand.  However the same thing could work here if the government mandated a deduction from peoples wages going into some sort of reimbursement account.   The government is essentially providing the major medical portion right now.  However the 30 baht is hardly enough to get people to shop for health care.  

The bottom line is if you make health care so cheap to the patient, they will misuse it and providers knowing they are getting paid by the government will prescribe too much of it. 

 

[itsari]

On 11/7/2021 at 11:43 AM, Pedrogaz said:

As a 67 year old long term resident here with a home, partner, cars etc......paying outrageous taxes on cars but getting nothing back. I would go back to Europe if I hadn't invested so much on this racist country.

The government should allow all longer term (one year plus) resident to access the Thai government healthcare system for a reasonable fee instead of forcing us into the claws of these morally bankrupt private hospitals and insurance companies that charge foreigners much more than Thais.

The racism you make the point of will stop any progress towards any conciliation towards integrating  retired foreigners into the Thailand  health system .

 

 

 

[1FinickyOne]

30 minutes ago, Longwood50 said:

The bottom line is if you make health care so cheap to the patient, they will misuse it and providers knowing they are getting paid by the government will prescribe too much of it. 

I think in the present public health system the docs are on salary here and are not in need of extra work and do not benefit by it... and I doubt there are many Thais seeking unnecessary surgery... 

 

but look, try as you might, you are not going to change the system here or in USA even if you have a brilliant idea... 

[itsari]

2 hours ago, Longwood50 said:

You have to remember the $10,000 USD was for medical care that the person would cover themselves.  After than a major medical policy to cover catastrophic health care. 

In terms of the 30 baht plan.  Why 30 why not 10 why not zero.  The 30 baht plan does not mean health care costs 30 baht only that the patient is charged 30 baht.  Again, that only encourages people to use healthcare excessively because it is cheap.  

With the 30 baht plan the patient goes in and gets an operation costing 1 million baht and the government pays.  Then everyone paying taxes covers the cost of the 1 million baht operation.  So what about that is "free" 

The system whether here in Thailand or in the USA encourages people to unnecessarily use the healthcare system and intensifies the health care system to provide excess medical care to reap profits.  

Its like an all you can eat buffet versus and ala carte menu.  When you have an all you can eat, you don't care how much of the food you take, and discard anything you don't consume. WASTE.  If it is ala carte and you are paying for each item consumed, you choose wisely.  The same is true for health care.  If the patients were responsible for each health care procedure requested they would shop for it, and choose judiciously. 

The only way I can think of to encourage such shopping is to have each person have a government account using deductions from their money.  They would shop for the small health care expenses and the larger ones covered by either a private major medical policy or government catastrophic health care coverage. 

I can tell you I am guilty.  I had procedures done under Medicare strictly because the government would pay for them.  One a cosmetic procedure to raise my eyelids.  The government policy said if they were "restricting my vision" they would be covered.  You don't think the doctor who did the surgery made sure what was reported to Medicare ensured that the "test" showed I was impaired.  If I had to pay for the surgery, I would not have done it. 

I see your point 

[lapamita]

On 11/7/2021 at 5:43 AM, Pedrogaz said:

 

The government should allow all longer term (one year plus) resident to access the Thai government healthcare system for a reasonable fee instead of forcing us into the claws of these morally bankrupt private hospitals and insurance companies that charge foreigners much more than Thais.

 YES best way... i was insured in thai on a 4mb plan costs 75000 (  w expected  premium in 15yrs -75  at 340.000. inflation adjusted/agegroup change.)..mai 2020 bcs of covid asked the insurance company to temporary stop contract against a fee until return to th. no way . so last 2 yrs i stoped pay, meaning  if i make new contract again waiting period of 2 yrs.

they are expensive for waht you get,,, the best insurance AXA was quoting  10mb plan at 60k , but impossed a 50% RISK PREMIUM BCS OF SMOKING  or want to exclude smoking related desase, incl all ...the estimate premium calculation for me at 75 incl risk premium was 462.000 ( calculated aprox 6 yrs ago)..for local insurance not worldwide , Not opd . even ..no pre conditions and the complete checkup done in BKK hospital costs payed by axa.

 

many expat will fall into a trap , when calculating inflation adjustment and age group change,,let your insurance calculate it, and get it in written form ( not by a promise of a salesman !!!). the headoffices will calculate on request.

 

problem with goverment insurance, their must be a special tarif, and this must be higher than the regular tarif, bcs of the risk of older  insured person. what lead to high costs, but still it would be possible at a extrem lower rate

 

self coverage is nearly impossible todAy with hospital costs rssing 1000% and more over 20 years..long time ago, yes it would work and i was done so.

 

by the way my GF  is thai, and premiums at the insurance are equal of foreigner,,, and her premium increased over 4 years by 50% too ( inflation adjustment a year ago -and age group change)

[Longwood50]

2 hours ago, 1FinickyOne said:

I think in the present public health system the docs are on salary here and are not in need of extra work and do not benefit by it... and I doubt there are many Thais seeking unnecessary surgery... 

 

but look, try as you might, you are not going to change the system here or in USA even if you have a brilliant idea..

No the system like most is rigged by those who benefit from it.  The hospitals, doctors and pharmaceutical companies don't want competition and consumers making choices.  They want consumers/patients to use as much healthcare as possible. 

In terms of the Thai doctors yes most that work in the hospital are on some sort of salary.  That does not mean that the hospital does not encourage them to upsell for more treatment and more expensive treatment.  Also all of them have pharmacies that sell prescription drugs and so again, there is a profit motive to prescribing medication.  Lastly, I don't know this as a fact, but given my experience with hospitals here the doctors are pretty insistent on keeping you running back repeatedly.  It would not surprise me if they are on some sort of incentive based on the fees collected from patients.