Gov't or commercial healthcare systems for visitors?

[World Traveller2]

I am a n Anglophone tourist who speaks very poor Thai. Periodically I want medical services.

 

Which system do you use, what is your budget (low, high etc) and how much free time do you have? I see advantages to both systems. Typically, I use the middle tier private system (e.g. Bangkok Christian, Sukhumvit Hospital) rather than high-end 'private' (e.g. not Bumrungrad) and occasionally tax-funded hospitals such as Siriraj and Chulalongkorn.  My budget for a foreign visitor is low. I am retired and enjoy the challenge of trying to 'crack' an unfamiliar system. But sometimes it is not worth the minimal savings (dollars, not percentages).

 

The only things I am certain of are that regardless where you go in Thailand, compared to India (and even Malaysia) medical services are medium-value, bureaucratic and slow. And language is always a problem. Plus, doctors' service fees are artificially low and therefore there is a tendency to 'encourage' drugs and tests. But the medical system is much better than Cambodia and much more affordable than Singapore. Big surprise. I prefer Vietnam (low cost) and India (great value).

 

Anyway, where do you go in Bangkok for your medical care?

[Longwood50]

I have used the system only minimally.  My Thai GF has used Bangkok Hospital Pattaya.  The prices there are higher but the level of service, not necessarily the quality of the services are better.  

One thing I can tell you.  The USA spends more per person on healthcare than any nation on earth.  Despite that, the cost is exorbitant.  I can get my dental examination complete with cleaning with the latest equipment by a dentist trained in the USA for less money than my co-pay back in the USA.  

I have looked at various procedures such as a colonoscopy, and cataract surgery.  Here again, I can pay for those services at about the same cost as my co-pay back in the USA. 

Those who somehow "think" that the government programs are the answer only insure that the hospitals, doctors, and drug companies are the ones who benefit because the unlimited supply of money allows them to overcharge and it ends the patients becoming consumers.  The patients don't shop for services since no matter where they go they pay the co-pay and the hospitals have no incentive to keep the price down since they know that the insurance company or government is going to pay the remainder. 

I am convinced there is no "perfect" answer to healthcare.  The closest program I can think of is for the government to mandate that everyone have a health savings account that is funded by a small percentage of their pay.  They would continue to fund that until it reaches a balance of lets say $15,000 maximum and must be replenished if the balance falls below $10,000  Each person would then have a major medical policy with lets say a deductible of $10,000 USD/ 330,000 baht.  For small bills  the amount would be paid from the persons medical savings account. 

The fact that the person was using their own money for the small bills would cause them to limit their trips for medical care to only those necessary and they would shop for the best value.  If they truly had a major health problem, the major medical policy would protect them. 

This is like your car insurance.  You insure it for a significant damage, or being stolen.  You don't insure it for oil changes, tire replacement, or car washes.  The current system is so expensive and bloated because people knowing that the trip only costs them their co-pay they act like people in the all you can eat buffet.  Once you pay you want to each as much as you can.  If that doctors visit is only going to cost you personally $10 - $25 USD then lets go and get it looked at. 

is it perfect, no.  However it is an improvement over the way the USA does it where your have no curbs on your healthcare to other parts of the world where you have no safety net. 

Before those of you who cry, well the USA has a significant portion of people who don't get healthcare because they don't have insurance.  Let me tell you, it is against the law in the USA for a hospital to deny treatment to anyone.  Just ask the Mexican mother, not only not having healthcare insurance but not even being a USA citizen if she is denied at a hospital in the USA and seeks maternity care at any USA hospital.  

[World Traveller2]

9 minutes ago, Longwood50 said:

I have used the system only minimally.  My Thai GF has used Bangkok Hospital Pattaya.  The prices there are higher but the level of service, not necessarily the quality of the services are better.  

One thing I can tell you.  The USA spends more per person on healthcare than any nation on earth.  Despite that, the cost is exorbitant.  I can get my dental examination complete with cleaning with the latest equipment by a dentist trained in the USA for less money than my co-pay back in the USA.  

I have looked at various procedures such as a colonoscopy, and cataract surgery.  Here again, I can pay for those services at about the same cost as my co-pay back in the USA. 

Those who somehow "think" that the government programs are the answer only insure that the hospitals, doctors, and drug companies are the ones who benefit because the unlimited supply of money allows them to overcharge and it ends the patients becoming consumers.  The patients don't shop for services since no matter where they go they pay the co-pay and the hospitals have no incentive to keep the price down since they know that the insurance company or government is going to pay the remainder. 

I am convinced there is no "perfect" answer to healthcare.  The closest program I can think of is for the government to mandate that everyone have a health savings account that is funded by a small percentage of their pay.  They would continue to fund that until it reaches a balance of lets say $15,000 maximum and must be replenished if the balance falls below $10,000  Each person would then have a major medical policy with lets say a deductible of $10,000 USD/ 330,000 baht.  For small bills  the amount would be paid from the persons medical savings account. 

The fact that the person was using their own money for the small bills would cause them to limit their trips for medical care to only those necessary and they would shop for the best value.  If they truly had a major health problem, the major medical policy would protect them. 

This is like your car insurance.  You insure it for a significant damage, or being stolen.  You don't insure it for oil changes, tire replacement, or car washes.  The current system is so expensive and bloated because people knowing that the trip only costs them their co-pay they act like people in the all you can eat buffet.  Once you pay you want to each as much as you can.  If that doctors visit is only going to cost you personally $10 - $25 USD then lets go and get it looked at. 

is it perfect, no.  However it is an improvement over the way the USA does it where your have no curbs on your healthcare to other parts of the world where you have no safety net. 

Before those of you who cry, well the USA has a significant portion of people who don't get healthcare because they don't have insurance.  Let me tell you, it is against the law in the USA for a hospital to deny treatment to anyone.  Just ask the Mexican mother, not only not having healthcare insurance but not even being a USA citizen if she is denied at a hospital in the USA and seeks maternity care at any USA hospital.  

Different system than USA in Canada and indeed most countries. Canadian system has its pros and cons. For a pro - I will never go broke after a car accident or cancer. And there is no incentive for physicians to push unnecessary tests and treatments. For cons, the system is slow, limited services and even *after* my co-pay due to my low income provincial plan, it is still cheaper to pay out of pocket in Malaysia etc for dental and physiotherapy.

 

While I recognize the historical, financial and political reasons, what bugs me about the Canadian system is the lack of choice. As far as I know Canada and maybe Eire are the only advanced western nations that make 'private' health care and insurance effectively criminal. So, nanny state limiting options. My friends in Switzerland have more choices. In Canada it's not a dual system, it is a monopoly. And guess what happens if insurance is paying? Raises the prices, of course!

 

But we gave gotten off track. My question is about Thailand.

Edited December 21, 2021 by World Traveller2

[World Traveller2]

17 minutes ago, Longwood50 said:

I have used the system only minimally.  My Thai GF has used Bangkok Hospital Pattaya.  The prices there are higher but the level of service, not necessarily the quality of the services are better.  

One thing I can tell you.  The USA spends more per person on healthcare than any nation on earth.  Despite that, the cost is exorbitant.  I can get my dental examination complete with cleaning with the latest equipment by a dentist trained in the USA for less money than my co-pay back in the USA.  

I have looked at various procedures such as a colonoscopy, and cataract surgery.  Here again, I can pay for those services at about the same cost as my co-pay back in the USA. 

Those who somehow "think" that the government programs are the answer only insure that the hospitals, doctors, and drug companies are the ones who benefit because the unlimited supply of money allows them to overcharge and it ends the patients becoming consumers.  The patients don't shop for services since no matter where they go they pay the co-pay and the hospitals have no incentive to keep the price down since they know that the insurance company or government is going to pay the remainder. 

I am convinced there is no "perfect" answer to healthcare.  The closest program I can think of is for the government to mandate that everyone have a health savings account that is funded by a small percentage of their pay.  They would continue to fund that until it reaches a balance of lets say $15,000 maximum and must be replenished if the balance falls below $10,000  Each person would then have a major medical policy with lets say a deductible of $10,000 USD/ 330,000 baht.  For small bills  the amount would be paid from the persons medical savings account. 

The fact that the person was using their own money for the small bills would cause them to limit their trips for medical care to only those necessary and they would shop for the best value.  If they truly had a major health problem, the major medical policy would protect them. 

This is like your car insurance.  You insure it for a significant damage, or being stolen.  You don't insure it for oil changes, tire replacement, or car washes.  The current system is so expensive and bloated because people knowing that the trip only costs them their co-pay they act like people in the all you can eat buffet.  Once you pay you want to each as much as you can.  If that doctors visit is only going to cost you personally $10 - $25 USD then lets go and get it looked at. 

is it perfect, no.  However it is an improvement over the way the USA does it where your have no curbs on your healthcare to other parts of the world where you have no safety net. 

Before those of you who cry, well the USA has a significant portion of people who don't get healthcare because they don't have insurance.  Let me tell you, it is against the law in the USA for a hospital to deny treatment to anyone.  Just ask the Mexican mother, not only not having healthcare insurance but not even being a USA citizen if she is denied at a hospital in the USA and seeks maternity care at any USA hospital.  

Excellent suggestion about how to improve healthcare in USA. Have you suggested this solution to your representative in Congress? We have the same problem in Canada - in fact in Emergency ward at hospitals, I see a high percentage of apparent drug addicts who have no incentive to improve their condition because they could come in every day with some new symptom. And we have a shortage of physicians.

 

What are the challenges the Thai has? I read that for some years any Thai citizen can get hospital services for THB40.

[Longwood50]

6 hours ago, World Traveller2 said:

Excellent suggestion about how to improve healthcare in USA.

I have but you have to understand there is not an interest of the government, and certainly not the hospitals, doctors, or drug companies to have to compete and lower health care costs. Quite the opposite.  They all want "MORE MONEY"  The government wants the control of those healthcare dollars to manipulate the system.  It also wants the votes of those beholden to all those medical dollars.  The hospitals, doctors, and drug companies are loathe to actually have to compete and they want the patients not caring about what something costs.  They want them to come in for more tests, more procedures, and more drugs. 

Universal healthcare and health care insurance is peddled to the public as serving the interests of the patients.  No, it is opening up the vault with untold billions of dollars to the health care community.  

It is a situation identical to student loans.  They are peddled to the public as "helping the poor student get a good education"  No, student loans are like handing a credit card to a nymphomaniac outside a whore house that accepts Mastercard and Visa.  It gives the colleges the ability to raise tuition and not compete based on value.  

 

[Sheryl]

I chose the doctor, not the hospital. According to the specific expertise I need.

 

At one time or another over the past 40 years I've been treated at pretty much every major private hospital in Bangkok.

 

I have also assisted Cambodian friends in accessing govetnmwnt hospitals here, both Banfkok and the provinces. It does take a lot of time and patience.

 

Personally I don't tend to use governmwnt hospitals because I do not live in Bangkok and it's a 6 hour round trip drive and one can't make appointments online (or even, usually, by phone) and the additional  costs in travel, hotel stays etc more than outweighs the savings in fees.l compared to a private hospital.  But ifI lived i  Bangkok I would at times make use of the after hours clinics at major govt hospitals.