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

[KhunLA]

1 minute ago, roo860 said:

Bloody hell, is it your 'time of the month'? ????

NO, just a responsible adult, who follows most rules and more importantly, simple common sense.  

[KhunLA]

8 minutes ago, nigelforbes said:

I have CAD but my health insurance (CIGNA) specifically excludes coverage for anything heart related, I pay 125k per year for the insurance BTW.

 

I have a couple of million in cash but a major cardiac event could run to 5 mill., according to Sheryl previously. 

 

I use cash in bank for my visa and the cash is actually there and it's mine, even though I use an agent.

 

Should I head to the airport today or can I wait until next week!

Sheryl usually prices private hospitals.  Be kind of hard to spend 5 mill at a gov't hospital.

 

But if you're at that much of a risk, then maybe you should adjust your living location where healthcare won't effect your loved ones.

 

I got few baht, but at my age (if emergency), I'm not wasting their inheritance on a couple mediocre years more of hanging around.   Take me home let me die in peace.  Non emergency, and I'm on the next plane out to be a burden on Medicare, use them tax dollars I paid 30 some yrs into.

[MRToMRT]

9 hours ago, it is what it is said:

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.

I am not disagreeing but Thailand makes it possible for foreigners to stay without insurance. Thailand should sort this out by making its visa system work equitably re insurance and stopping IO corrupt interaction with corrupt agents.

[nigelforbes]

1 minute ago, KhunLA said:

Sheryl usually prices private hospitals.  Be kind of hard to spend 5 mill at a gov't hospital.

 

But if you're at that much of a risk, then maybe you should adjust your living location where healthcare won't effect your loved ones.

 

I got few baht, but at my age (if emergency), I'm not wasting their inheritance on a couple mediocre years more of hanging around.   Take me home let me die in peace.  Non emergency, and I'm on the next plane out to be a burden on Medicare, use them tax dollars I paid 30 some yrs into.

"adjust your living location", that sounds like code for go home.

 

Am I, "at that much risk",? My cardio isn't telling me to prepare for the end or to do anything special. But there again, most people who suffer from CAD just drop dead, so who knows.

 

Medicare, what's that! I'm a Brit where the health care system is in its knees plus Anyway, I will still be chargeable during the first six months, because the NHS is a residency based system, and chargeable at 150% of the price, because I'm expat!

 

 

[farmerjo]

I would make a call to the Thai tourism authority to see if they have anything in place.

Did that 300 baht on arrival tax ever get of the ground?

[KhunLA]

5 minutes ago, nigelforbes said:

But there again, most people who suffer from CAD just drop dead, so who knows.

 

Medicare, what's that! I'm a Brit where the health care system is in its knees plus 

Life's choices ... with any luck, "we'll" just drop dead in our sleep.  Maybe another stent or 2 ????  

 

But open heart / bypass ... I'll pass at my age, as just a matter of time before something else kraps out.

 

NHS ... lovely system ????

Medicare is USAs version, for retired & poor people, open to all (retired/poor) and almost free, and have to take you, without expectation of being reimbursed at public hospitals.

The drug plan sucks though, and overpriced.

 

IF I can make to the states, then I'm saved ... IF ... and IF actually wanting.  As my niece has privileges at a few Philly, PA, USA hospitals.  I would need a long healthy prognosis to even bother, if not ... I'll pass.

 

I'd rather watch the sunset here with my dog, kid & wife.

[nigelforbes]

12 minutes ago, KhunLA said:

Life's choices ... with any luck, "we'll" just drop dead in our sleep.  Maybe another stent or 2 ????  

 

But open heart / bypass ... I'll pass at my age, as just a matter of time before something else kraps out.

 

NHS ... lovely system ????

Medicare is USAs version, for retired & poor people, open to all (retired/poor) and almost free, and have to take you, without expectation of being reimbursed at public hospitals.

The drug plan sucks though, and overpriced.

 

IF I can make to the states, then I'm saved ... IF ... and IF actually wanting.  As my niece has privileges at a few Philly, PA, USA hospitals.  I would need a long healthy prognosis to even bother, if not ... I'll pass.

 

I'd rather watch the sunset here with my dog, kid & wife.

Exactly, and that was my initial point.

[brianthainess]

11 hours ago, NoDisplayName said:

Not working?  On what kind of visa?

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

 

His agent said pay your own bills.....

[sandyf]

1 hour ago, nigelforbes said:

Anyway, I will still be chargeable during the first six months, because the NHS is a residency based system, and chargeable at 150% of the price, because I'm expat!

You are only "expat" if you choose to be so.

[IvorBiggun2]

12 hours ago, Keep Right said:

free loading expats that should never be in Thailand in the first place because of their medical condition. 

Or their financial condition. He should have gone home 3 years ago when he first got diagnosed. My only sympathy falls to the OP for being lumbered with this mess.

[nigelforbes]

13 minutes ago, sandyf said:

You are only "expat" if you choose to be so.

Yes, no and sort of!

 

It's true that in theory you can declare yourself resident on the day of your return as a UK resident. In practise however there are checks and balances in the NHS system which require staff dedicated to determining residency status to find out what the true story is. Items such as consistent spending patterns over time is one factor. Many people come and go for long periods, spending time in both locations. My UK bank account shows clear evidence of UK residency for months at a time, followed by many months/years of nothing, apart from rental income from an agent. My pensions were paid into a UK bank, today they are paid into my Thai bank, I'm not about to reverse that scenario, just because at some future point in time I may want to try and cheat the NHS. And my tenant pays Council Tax at my address, I don't. If I get sick tomorrow and try to return to the UK, just to use the NHS, well, it would be almost impossible since the tenant requires two months notice etc etc.

[Sheryl]

You need to meet with the hospital administration (senior person) and tell them clearly there are no more funds available to pay his bills and request that they transfer him at once to a government hospital. Make clear in this discussion that you are not related to him and have no legal obligation and that he has no close family in US.

 

They will arrange transfer once convinced no more money but your problem will be that they may refuse transfer until existing bill is paid. You can try to negotiate a payment agreement over time (monthly payments).

 

There will still be the problem of paying the government hospital but costs will be about 1/3 to 1/2 that of Camillian.

[Gottfrid]

14 hours ago, jimmiejackson said:

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.

I stopped here, as someone has to point it out. He lost too much, and had no ability to stay and take care of himself. He was in a position to be able to get help from you. He should have asked for plane ticket home, and maybe borrow for meeting US requirements from you and his family.

Instead he choosed to stay dependent on you and your money.  That has led to the situation he is in today. Partly his fault and partly yours.
 

13 hours ago, jimmiejackson said:

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.

Because you didn´t send him home from start or stopped give him money. That would have been real help from start.
 

13 hours 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. 

If he had assets, he would not need to depend on another persons economy.
 

13 hours 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.

Not your job to figure out. You have done more than enough, but started to do it the wrong way.
 

13 hours ago, jimmiejackson said:

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.

I am pretty sure there are some assets there, that can be collateral for the loan they need to take to help a family member.
 

12 hours ago, jimmiejackson said:

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

It´s not the embassy´s job to do that.

[IvorBiggun2]

Can the OP try and get 'Power of Attorney' and sell his condo and other assets? 

[steven100]

8 minutes ago, IvorBiggun2 said:

Can the OP try and get 'Power of Attorney' and sell his condo and other assets? 

i don't think he owns the condo ...  just rents it.

[Lorry]

3 hours ago, nigelforbes said:

I suspect/guess that once the private hospital realises they wont be able to recoup their losses that he will be transferred to a government hospital. Any irrecoverable loss there will be written off by government, which will provide further ammunition for government to ensure all expats have medical insurance before issuing them with visa extensions. If that sounds harsh and unhelpful it is not intended to be so, I just want to point out the realities of the inevitable sequence of events.

That's all correct. 

But don't forget that the Thai medical sector makes huge profits (huge as in HUGE) from foreign patients,  especially western tourists who usually  do have insurance and pay through the nose. .  The losses are very minor.

[Lorry]

4 hours ago, nigelforbes said:

This is untrue, not all foreigners are treated the same. The government published three separate scales of charges below. Note, this is for government hospitals, NOT private hospitals where charges are even more expensive:

 

"The new dispensation will allow Thai hospitals under the Ministry of Public Health to charge a prescribed limit for medical services based on a 3 tiered system approach. Operators and Thai hospitals will have to set the 3 tiers themselves and then submit to the Ministry of Public Health to finalize. These 3 tiers are explained below:

Tier 1

Under the new regulations, the first tier price structure is specific for Thai citizens and those from neighboring countries, such as Laos, Cambodia, Vietnam, and Myanmar, will pay relatively the same for medical procedures.

Tier 2

The second tier price structure will be applied to expatriates, namely foreigners in Thailand, who are working and paying taxes with the appropriate visas.

Tier 3

The third tier of charges and the highest in terms fees will apply to retirees and tourists".

 

https://www.pacificprime.co.th/blog/dual-pricing-at-thai-public-hospitals-and-the-implications-on-foreigners/

 

This is the theory. 

In practice,  every government hospital does whatever it wants. 

Vachira hospital in Phuket (the one who always complains about the big losses through uninsured foreign patients) is one extreme. Can be more expensive than Bangkok Hospital.

On the other side,  many government hospitals that rarely see foreigners can't be bothered and just charge foreigners Thai prices,  much easier for the cashier. 

[orchis]

1 hour ago, IvorBiggun2 said:

Can the OP try and get 'Power of Attorney' and sell his condo and other assets? 

It has been stated he has no assets.

[Sheryl]

A large number if off topic posts (along with some thoroughly unhelpful ones) have been removed.

 

The OP is looking for practical advice in a very, very difficult situation.

 

This thread is not the place to argue about the UK NHS, health insurance issues, etc

[BritManToo]

5 hours ago, KhunLA said:

NO, just a responsible adult, who follows most rules and more importantly, simple common sense.  

I would say simple common sense is to accept death when it comes, and not shovel money into the greedy hands of private hospitals.

 

As for the OP, walk away, it's not your problem.

[digbeth]

2 hours ago, IvorBiggun2 said:

Can the OP try and get 'Power of Attorney' and sell his condo and other assets? 

even if he has assets to sell, getting power of attorney from unconscious guy is not possible

 

getting the guy declared incompetent and appointing the OP as his guardian is too complicated and opens up the opportunity of the hospital going after OP for the remainder of the cost accrued

[Liverpool Lou]

15 hours ago, NoDisplayName said:

Not working?  On what kind of visa?

Completely irrelevant and NOYB.

[Mickeymaus]

I think the OP should talk to the hospital. For sure it is not the first case for them where a patient cannot pay the bills. And it also needs to be clarified if he can get healthy again. They can keep him alive for a very long time to make money. Does he have other problems that weaken his immune system - medication, liver problems or AIDS for instance. Many people are infected with TB but they don't get sick as long as their immune system is okay. 

[jimmiejackson]

3 hours ago, Sheryl said:

You need to meet with the hospital administration (senior person) and tell them clearly there are no more funds available to pay his bills and request that they transfer him at once to a government hospital. Make clear in this discussion that you are not related to him and have no legal obligation and that he has no close family in US.

 

They will arrange transfer once convinced no more money but your problem will be that they may refuse transfer until existing bill is paid. You can try to negotiate a payment agreement over time (monthly payments).

 

There will still be the problem of paying the government hospital but costs will be about 1/3 to 1/2 that of Camillian.

Thanks to all who replied.

 

I was hoping Sheryl would respond so thank you for that.

 

Called the Embassy, they weren't interested in doing anything except informing his family where he was.

 

Hospital is going around in circles so I've informed his Thai friend of what you suggested and hopefully we can get somewhere with it.

[Liverpool Lou]

3 hours ago, IvorBiggun2 said:

Can the OP try and get 'Power of Attorney' and sell his condo and other assets? 

What assets?   Can he afford a lawyer to draw up the POA?

[jimmiejackson]

2 minutes ago, Liverpool Lou said:

What assets?   Can he afford a lawyer to draw up the POA?

I could afford it but the price for a lawyer to sell a 3 year old phone and a barely functional laptop probably, I'm just guessing here, doesn't really make sense ????

[VocalNeal]

My take from this apart form the financials is that anyone who has not been inoculated against pneumonia should investigate it. 

[Sheryl]

12 minutes ago, jimmiejackson said:

Thanks to all who replied.

 

I was hoping Sheryl would respond so thank you for that.

 

Called the Embassy, they weren't interested in doing anything except informing his family where he was.

 

Hospital is going around in circles so I've informed his Thai friend of what you suggested and hopefully we can get somewhere with it.

The person you want to speak with (who should speak English well) is the Director of Administration. Don't waste time talking at lower levels.

[NoDisplayName]

38 minutes ago, Liverpool Lou said:

Completely irrelevant and NOYB.

I'm sorry.  I thought it might be something overlooked by OP.

 

If he's been in Thailand for 20 years, not working for at least 3, then he's probably on a non-O extension.  With no assets, he wouldn't have an elite visa, so must be either marriage or retirement.

 

Both of those have financial requirements.  With no incoming pension mentioned, I assumed he must have either 400k or 800k in the bank, enough to cover accrued medical bills and move to a government hospital.

[Sheryl]

3 hours ago, NoDisplayName said:

I'm sorry.  I thought it might be something overlooked by OP.

 

If he's been in Thailand for 20 years, not working for at least 3, then he's probably on a non-O extension.  With no assets, he wouldn't have an elite visa, so must be either marriage or retirement.

 

Both of those have financial requirements.  With no incoming pension mentioned, I assumed he must have either 400k or 800k in the bank, enough to cover accrued medical bills and move to a government hospital.

OP has clearly stated there is no money in the bank.

 

We need to accept OP's  statement that there are no funds and no assets and proceed from there. He clearly knows this man and his situation well.