Friend (US Citizen) in ICU, no savings or insurance - don't know what to do for the best

[jimmiejackson]

Hi everyone,

 

This is a very long story so I'll try to keep it short.

 

Friend is a US citizen, has lived in Thailand about 20 years.

 

Worked and paid into SSF for at least 10 of those years that I know of. Left one job, got another, job turned out to be a mess, never paid him or his SSF.

 

This was in 2019 or so, he then got diagnosed with advanced TB.

 

Through treatment and related complications he hasn't been able to work since and through the support of me, friends and family has been able to keep his head above water just about.

 

Hasn't been able to travel to US due to requirement of Medivac which he can't afford.

 

Anyway a few days ago he was rushed to ICU at Camilian Hospital (the closest to his condo) as he couldn't breathe, it was touch and go.

 

He's now stable, on a ventilator and positive for Pneumonia which is being treated.

 

So far the bill is running to 30-40,000 Baht a day.

 

Between me, another friend and his family we've been able to keep the bills paid but today the specialist said he will likely be in ICU for at least 10 more days if not more.

 

We literally won't be able to afford it.

 

My Thai is ok but too limited to deal with something of this complexity and his friend who is Thai is doing her best but isn't in the best mental state as you can imagine.

 

I've tried calling in favours but my list has run out.

 

We have contacted Chula and the Chest Hospital where he was receiving treatment but haven't received anything resembling a go ahead to get him transferred.

 

I'm not asking for money, I know he should have had insurance etc but this is where we find ourselves.

 

If we take him home, he will certainly die in a horrific way (essentially drowning in sputum), but we can't afford to keep him there. There has been no clarity on what happens if we stop paying the bills (obviously a hospital isn't going to tell you that it's "ok" to do that) or what happens if we try to transfer him elsewhere, or even how that would be logistically possible.

 

So I'm looking for any guidance or advice you would kindly be able to give. Thank you.

[Mitkof Island]

30,000 to 40,000 baht a day in the ICU? There must be something cheaper in Bangkok.

[jimmiejackson]

1 minute ago, Mitkof Island said:

30,000 to 40,000 baht a day in the ICU? There must be something cheaper in Bangkok.

I'm sure there is, although I think the actual ICU cost is around 12,000 a day. The rest is for testing, machinery and various other line items.

 

The bigger issue I guess is at some point soon we'll run into a brick wall where it doesn't much matter how much the ICU costs because we don't have anything left to pay with.

[BananaStrong]

best of luck.  keep your spirits high for yourself and for your friend, and you are a good friend for posting here.  My company has horrible insurance, I know it, and it probably would only cover minor accidents; however, I've done nothing about it.  I think they cover me up to about 20,000 in a gov't hospital, total.  rest out of my pocket.  

[dj230]

Tell him to take out a loan, put it on a credit card or liquidate his belongings

 

surely he has assets in excess of 300k baht, house, car, cellphone, laptop, jewellery, gold, etc. 

 

it sucks what happened but there’s no real easy way to say it other than someone has to pay and it should be him. 

[proton]

Has he no family back home to help?

[jimmiejackson]

7 minutes ago, dj230 said:

Tell him to take out a loan, put it on a credit card or liquidate his belongings

 

surely he has assets in excess of 300k baht, house, car, cellphone, laptop, jewellery, gold, etc. 

 

it sucks what happened but there’s no real easy way to say it other than someone has to pay and it should be him. 

He doesn't unfortunately, I'm sure he did at one point but not working for 3 years has cut him to the bone. He's also barely conscious and on a ventilator so entirely unable to organise anything himself.

 

So whether or not I like it, I'm in the position of needing to figure it out.

[jimmiejackson]

12 minutes ago, proton said:

Has he no family back home to help?

He does have very little family and they have agreed to help within their ability but at the rate of $1K+ a day their ability to help won’t get us far and us slamming into a wall of having no more funds is coming up real quick.

[Liverpool Lou]

10 minutes ago, dj230 said:

Tell him to take out a loan, put it on a credit card or liquidate his belongings

He's in ICU!   How the duck could he do that?

[Liverpool Lou]

1 hour ago, jimmiejackson said:

So I'm looking for any guidance or advice you would kindly be able to give. Thank you.

The most obvious move is to let the US embassy know about his situation, urgently.   They won't be paying his bill but they will be able to provide specific advice or recommendations that no one here can.

[VinnieK]

Why don't you tell the hospital that no more money will be forthcoming.

They will transfer him to the govt one in no time.

Not that it would be free there either 

but it will be easier to stiff them.

That's where we're at..

 

 

[internationalism]

move to the nearest governmental hospital.

That's 10 minutes drive by ambulance with oxygen.

 

[brianthainess]

42 minutes ago, Liverpool Lou said:

The most obvious move is to let the US embassy know about his situation, urgently.   They won't be paying his bill but they will be able to provide specific advice or recommendations that no one here can.

Absolutely don't take on the responsibility, let the next of kin and his Embassy deal with it, I know I was in a similar situation, it can stress you out, get a contact number at his embassy, and follow their advice.  They can liaise between you and next of kin (if known).  

[Keep Right]

And this is the reason that Thai Immigration requires insurance for expats, because many expats stiff the Thai medical establishments. Thai government hospitals are for Thai citizens not free loading expats that should never be in Thailand in the first place because of their medical condition. 

[jimmiejackson]

33 minutes ago, VinnieK said:

Why don't you tell the hospital that no more money will be forthcoming.

They will transfer him to the govt one in no time.

Not that it would be free there either 

but it will be easier to stiff them.

That's where we're at..

 

 

Yes this seems to be the option we might have to take. 
 

I doubt and believe I’ve read before they can’t just throw you out onto the street. So I assume it’s going to be their responsibility to offload the problem to another provider somewhere. 

[jimmiejackson]

12 minutes ago, brianthainess said:

Absolutely don't take on the responsibility, let the next of kin and his Embassy deal with it, I know I was in a similar situation, it can stress you out, get a contact number at his embassy, and follow their advice.  They can liaise between you and next of kin (if known).  

From what I understand the Embassy was contacted before and not interested in helping but I can try again, thanks. 

[Northstar1]

Should have never happened!

thailand is no place for older people with no insurance 

no pity from me!

we’ll be reading another similar story tomorrow 

[brianthainess]

Get him moved to a public hospital ASAP ! ask the embassy what should I do WHEN he dies ? always get a name. sorry to be so blunt but....

[brianthainess]

3 minutes ago, Northstar1 said:

Should have never happened!

thailand is no place for older people with no insurance 

no pity from me!

we’ll be reading another similar story tomorrow 

Isn't it past your bedtime  ?

[NoDisplayName]

Not working?  On what kind of visa?

If it's a non-O, what about his 400K/800K in the bank?

 

[Northstar1]

4 minutes ago, brianthainess said:

Isn't it past your bedtime  ?

Not quite, but soon!

rather than checking for overstayers, perhaps they should be checking for insurance, if none then send them home!

what about yesterday? A man from the UK has dementia and wants to come to Thailand?

we can read about him soon!

[brianthainess]

1 minute ago, Northstar1 said:

Not quite, but soon!

rather than checking for overstayers, perhaps they should be checking for insurance, if none then send them home!

what about yesterday? A man from the UK has dementia and wants to come to Thailand?

we can read about him soon!

He has lived in Thailand for 20 years, you do not have to have insurance to live here so should be self insured. 

[dj230]

1 hour ago, jimmiejackson said:

He doesn't unfortunately, I'm sure he did at one point but not working for 3 years has cut him to the bone. He's also barely conscious and on a ventilator so entirely unable to organise anything himself.

 

So whether or not I like it, I'm in the position of needing to figure it out.

I mean 300k baht isn't much in terms of assets, a car is easily worth a million baht, even an iPhone is worth 20-30k, surely he has something he can sell or give you to sell 

 

you have to ask yourself if he's worth giving your money to, you clearly said you don't have anymore money, he had a health condition he knew about and didn't save up or get health insurance so in my opinion it's his fault. If it was a freak accident, thats another story.

 

I've given friends around 200k for medical bills, I didn't expect any of it back but they ended up doing favors for me. 

[it is what it is]

58 minutes ago, Keep Right said:

And this is the reason that Thai Immigration requires insurance for expats, because many expats stiff the Thai medical establishments. Thai government hospitals are for Thai citizens not free loading expats that should never be in Thailand in the first place because of their medical condition. 

 

this is not a thai problem as such, tourists/foreigners  get sick, have accidents, need medical assistance in every country in the world. i've visited 50+ countries and non has had a mandatory insurance requirement.

 

a countries economy benefits greatly from tourism, governments need to allocate what would be an extremely small percentage of this to pay for such situations.

 

this is in no way to condone not having relevant insurance or self insuring which would in most cases provide excellent care should the worst happen

[pagallim]

Did he serve in the US military?   There may be a route to support via that if he was.

[OneMoreFarang]

It's his problem!

It seems the guy relied on you, and maybe others, for too long already.

His life is his problem and not your problem. 

Don't make his problem your problem. You helped him already a lot. 

If he dies, then that happens because of his decisions. You are not to blame for his decisions.

Don't make it your problem!

 

[proton]

As a matter of interest how much would ICU be in a govt hospital a day in Bangkok?

[KhunLA]

1 hour ago, NoDisplayName said:

Not working?  On what kind of visa?

If it's a non-O, what about his 400K/800K in the bank?

 

I'm guessing he's an overstay, possibly for a couple years.

@jimmiejackson

Another expat makes the rest of us look bad.  Cut your losses, if his or his wife's family are helping.  Tells you everything you need to know.

 

At his age, guessing their house is free & clear.  Put it on the market, cheap.  If cheap enough, and located good, I may even buy it.

 

Car should have been sold by now.   If you can't rustle up only 1 mill, you shouldn't be in the country.

 

The day he got diagnosed with TB, he should have been on a plane to the USA, and used his Medicare.  Plan A is available & free, almost.

 

At least in the USA, they can't kick him out of the hospital, if life threatening.

[KhunLA]

36 minutes ago, KhunLA said:

@jimmiejackson

 Cut your losses, if his or his wife's family are helping.  Tells you everything you need to know.

Should read ... "are NOT helping"

[jimmiejackson]

He isn’t on overstay but there is no money in the bank. 
 

He has no assets to speak of,  nothing that would be even worth taking the effort to sell. 
 

He’s made decisions that are very contrary to the way I do things but I’m not going to just abandon him. 
 

Appreciate the help so far.