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

[Sheryl]

More off topic  posts removed

[Sheryl]

OP - it is also possible there is a hospital social worker or equivalent. Who could help push gor transfer among other things. Worth looking into.

 

And look for an office of the "Saint Camillus Foundation of Thailand" which is somewhere within the hospital.

 

 

[scorecard]

18 hours ago, BananaStrong said:

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.  

Foreigners who are legally employed in Thailand have membership of the Thailand Social Security Fund SSF (employers are required by law to register new employees (Thai or foreign) with the SSF. You cannot refuse to join. 

The fund builds a retirement package for all members and provides Injury and Sickness benfits and more.

 

On retirement all members can  1). Take arefund of their accumulated monies in the fund or 2). take a monthly pension.

 

Also when members retire and take their contributions they can elect to continue their Injury and Sickness membership and pay their monthly SSF member contibutions at a bank for transfer to the SSF. Monthly contibution is about 450Baht a month.

 

Many foreigners (me incl.) never check the full details while they are employed. It's worthwhile to check the full SSF benefits and details etc.

 

HR departments should be able to provide a lot of detail. 

 

Good luck.

[jimmiejackson]

59 minutes ago, Sheryl said:

OP - it is also possible there is a hospital social worker or equivalent. Who could help push gor transfer among other things. Worth looking into.

 

And look for an office of the "Saint Camillus Foundation of Thailand" which is somewhere within the hospital.

 

 

Thank you for both of your updates, this helps a lot and I appreciate your time.

[still kicking]

18 hours ago, dj230 said:

what's one doing in Thailand without at least a few thousand dollars in their immediate funds, even credit cards typically have $10,000 on them, a months expenses is roughly $1000 on the low end 

Creditcard? I can't even get one since I am a pensioner but always have some cash 

[RichardColeman]

On 1/2/2023 at 8:02 PM, jimmiejackson said:

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

 

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

Not been able to travel for THREE years ? Seriously ? Sounds like he left it too late.

[4MyEgo]

21 hours ago, Northstar1 said:

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

There is no requirement for expats to have insurance, and until such time, they will continue to come here and around the world, that's just part of life.

 

Have you ever considered that some can't get insurance because of age, pre-existing conditions or is far too expensive.

 

I had insurance up until last year, it jumped 100% because the insurer changed under righters, that said, I am fortunate enough to have money to back me up if I fall ill, but not everyone is in the same boat.

 

It's a crappy situation for most to be in, through no fault of their own, for insurers it's all about risk and profits.

 

Terrible situation for this guy to be in and he has placed a heck of a burden on his friends and family, but it is what it is and his friend is asking for advice, it isn't time for the blame game and life isn't black and white, there has to be some grey in there.

 

I hope his friend can get him transferred to a public hospital, but what kind of treatment he gets there one can only tell in the future.

 

At the end of the day, I commend his friend for taking on the burden, that's what mates do, but there is also a degree as to how far he can support him financially without putting himself in a bad place.

 

Compassion doesn't cost anything, don't get me wrong, would love to see everyone with affordable insurance opportunities, but the reality is, we live in a dog eat dog world. 

[Northstar1]

1 hour ago, 4MyEgo said:

There is no requirement for expats to have insurance, and until such time, they will continue to come here and around the world, that's just part of life.

 

Have you ever considered that some can't get insurance because of age, pre-existing conditions or is far too expensive.

 

I had insurance up until last year, it jumped 100% because the insurer changed under righters, that said, I am fortunate enough to have money to back me up if I fall ill, but not everyone is in the same boat.

 

It's a crappy situation for most to be in, through no fault of their own, for insurers it's all about risk and profits.

 

Terrible situation for this guy to be in and he has placed a heck of a burden on his friends and family, but it is what it is and his friend is asking for advice, it isn't time for the blame game and life isn't black and white, there has to be some grey in there.

 

I hope his friend can get him transferred to a public hospital, but what kind of treatment he gets there one can only tell in the future.

 

At the end of the day, I commend his friend for taking on the burden, that's what mates do, but there is also a degree as to how far he can support him financially without putting himself in a bad place.

 

Compassion doesn't cost anything, don't get me wrong, would love to see everyone with affordable insurance opportunities, but the reality is, we live in a dog eat dog world. 

Can’t get insurance? And have no money?

go home!

what about the $400k or $800k for a visa?

without proper planning and money, Thailand isn’t a retirement destination, only a place to spend your early retirement years.

[DavisH]

7 hours ago, scorecard said:

Foreigners who are legally employed in Thailand have membership of the Thailand Social Security Fund SSF (employers are required by law to register new employees (Thai or foreign) with the SSF. You cannot refuse to join. 

The fund builds a retirement package for all members and provides Injury and Sickness benfits and more.

Private schools certainly don't have to provide access to SSO for their teachers. We pushed very hard for this, and not have it, but the teacher pays the full amount (school contributes nothing - scumbags). I did not join as I have another fund. 

[scorecard]

12 minutes ago, DavisH said:

Private schools certainly don't have to provide access to SSO for their teachers. We pushed very hard for this, and not have it, but the teacher pays the full amount (school contributes nothing - scumbags). I did not join as I have another fund. 

Sure, I should have mentioned that some teachers are exempt from the 'compulsory SSF membership'.

 

I'm not sure about teachers employed full-time by language schools, are they exempt from joining the SSF, do you know?

[cdemundo]

On 1/2/2023 at 8:25 AM, KhunLA said:

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.

"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."

 

I gotta agree with this part,  if he is below poverty also Medicaid so between Medicare and Medicaid should be OK.

Too late for this guy, but for others best to keep in mind.

 

[marcusb]

A teacher friend went stateside in 2020, wasn't aware he could get a "pension" payout from SS.

he returned in 2022, went to the office had a check few days later. Might be worth looking into. 5 years is 50-60,000 I believe.  Good luck. 

[GammaGlobulin]

On 1/2/2023 at 11:06 PM, OneMoreFarang said:

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!

 

Good advice. 

But... 

Still a horror show. 

 

Each to his own, of course. 

But... 

I just hope that when my time comes, 

I will have easy access to the L-pill, 

And depart painlessly like a true James Bond. 

 

End of Life can be a horror show unless one is prepared in mind and spirit. 

 

I am glad I came across this sad story, in time, to remind me to prepare for my quick demise, when the time is ripe. 

 

I just wish to go silently into that good earth. 

 

No muss. 

No fuss. 

 

No horror show in hospitals on a respirator. 

 

I am ready to meet my maker when my days become clearly numbered. 

 

My only wish is that I will be able to go out like Jackie Gleeson, on a huge bed, in a beautiful room, at home, with Alice by my side, and a pool cue in my casket. 

 

Death and dying is sometimes a horror show, just like birth. 

 

 

[GammaGlobulin]

The problem is that this friend, this US CITIZEN, is not an endangered species. 

 

The US GOV is willing to spend billions to save endangered species. 

 

It's all a matter of skewed priorities. 

 

If only this person were a major bank in distress, then the GOV would give him a bailout. 

 

You guys really should read much more Noam Chomsky. 

 

In truth, I am extremely sorry to read this topic. 

 

Here we stand at the very edge of Armageddon, on so many fronts, and yet, there is no solid backstop to help these fairly-rare cases in a humanitarian way. 

 

So, am I the only one who does not understand this super rich society in which we live, this uncaring society dripping with wealth? 

 

No wonder, I have always been a fan of Upton Sinclair. 

 

 

[GammaGlobulin]

1 hour ago, cdemundo said:

"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."

 

I gotta agree with this part,  if he is below poverty also Medicaid so between Medicare and Medicaid should be OK.

Too late for this guy, but for others best to keep in mind.

 

While your suggestion/option might sound correct, in theory, this option might not be best for everybody.

 

Personally, I would prefer to die in Thailand.

 

How much does hospice care cost in Thailand, done on the cheap, with just a bottle of oxygen, and hospital-prescribed drugs to keep one comfortable?

 

I would not wish to return to the USA just to die in a hospital, even a teaching hospital.

 

Give me hospice in Thailand, any old day, rather than boarding a plane back to the USA.

 

Honestly speaking....

 

 

[jts-khorat]

On 1/2/2023 at 8:39 PM, TimeMachine said:

Sorry, I have no advice to solve this problem this time, but I am a big advocate of choosing a time in the late future to exit this life at my choosing. Deciding the right age when I am still healthy I believe is key and difficult. There is no way I can rely on assistance from people when I get older. I have a plan because I know I won't live forever and an earlier preplanned death is my choice that works for me.  Not for everyone. My discussion here may bring some to plan ahead to help avoid such situations. I'm so sorry this has happened to you and your friend but the idea no solution exists for some terrifies me.

Not to derail this thread, but I had numerous friends of older age while living here in Thailand, stating something along those lines.

 

Not a single one was able to overcome their innate instinct to prolong their life as long as possible, against all common sense (when seen from the outside). They all died in a hospital accordingly, instead of being home within a circle of their loved ones.

 

My experience, with rural hospitals at least, is that they are quite willing to release patients back home where further care would clearly not prevent death, or switch off machinery to prevent mounting costs. On the other hand, something like proper palliative care is unknown there and this responsibility falls naturally back on the family. It is not a bad system, to my mind.

 

I am sure, things in Bangkok are different, with proper care options in place, if one can afford it. In this case, this might not be an option, so if recovery is not a likely option, this man will need to think about a lot more than just the paying of bills. With modern telecommunications, family does not necessarily need to travel to be there. What about his circle of Thai aquaintances -- if he lived here for 20 years, he surely will have them?

 

As you mentioned, your friend is still conscious, and the diagnosis sounds still optimistic ("He's now stable, on a ventilator and positive for Pneumonia which is being treated." ... "today the specialist said he will likely be in ICU for at least 10 more days"). Still, as a friend, it would be wise to enquire about his thoughts on these issues, as a turn for the worse can be coming quite abrupt.

 

In the case of my friends in similar situations, some of them were so convinced that they would pull through -- or maybe in such a panic about the rapidly worsening circumstances -- that some had not even started to think about the necessary preparation for their loved ones. Believe me, it can be a mess if the list of adresses of friends and family to contact and all your banking options are on a laptop, where you have not told the password to anybody, even though you were in hospital for two weeks...

 

Lastly, I too would like to commend you that you are sticking with your friend, in his worst and lowest moments, with nowhere to turn for help. This is what friendship is for: "Do unto others as you would have them do unto you". @jimmiejackson I would be happy to count you to my friends.

[4MyEgo]

8 hours ago, Northstar1 said:

Can’t get insurance? And have no money?

go home!

Why do you think they came here for, more than likely it is more affordable to live here than in their own countries thanks to governments selling everyone short, just look at the cost of living back in your home country vs living here, do you think pensioners eat well, or is canned dog food back in the menu for them, i.e. after they have paid rent ?

 

8 hours ago, Northstar1 said:

without proper planning and money,

Some are not so fortunate, life's journey hasn't been kid to them, e.g. they could have been divorced, with say 3 kids, wife gets the lot (lottery), i.e. his life's savings and hard work has gone down the drain, seen that many times because of such laws that don't recognise the male as anything more than a saviour of the government so that the wife and kids don't fall onto the welfare system costing the government money. There can be other factors as well outside of their control, then there is as you say, no proper planning and money, always to sides of the coin.

 

8 hours ago, Northstar1 said:

Thailand isn’t a retirement destination, only a place to spend your early retirement years.

Thailand is the perfect retirement destination for pensioners who can get by, however without insurance, when and if something does go wrong, it does end up on the Thai's, but let us not forget, they do contribute to the Thai economy spending their pensions every single month of the year while they live here.

 

Perhaps the Thai government should look at including retirees onto their health system for an annual fee, maybe then things would balance out, especially for those that cannot afford health insurance or cannot obtain health insurance, can't be a one way street, although it is.

 

As I mentioned previously, compassion doesn't cost anything.

[TimeMachine]

4 hours ago, jts-khorat said:

 

Not a single one was able to overcome their innate instinct to prolong their life as long as possible, against all common sense (when seen from the outside). They all died in a hospital accordingly, instead of being home within a circle of their loved ones.

 

 

Great observation. I, too, see how people are so gripped with hanging on to life. The idea of living forever. All I can say, is it will be a very personal outcome for everyone. Like suicide and trying to end your life due to sadness and depression. Some can do it , some can't. Newer generations coming will slowly warm to the idea of planned exit. I have no guarantees, but I make the plan nonetheless and talk openly about it. Mark my words. Given the chance. I will kill myself when the the time comes. Not for a sadness reason, but to put to end a wonderful life that must end peacefully and with dignity.

 

Edited January 4, 2023 by TimeMachine

[daveAustin]

Yes I agree. Or at least open to those that are parents to Thais. The Thai gov is always whinging about the burden to the tax payer/hospitals if tourists or expats get sick and can’t pay in full, and yet they rake in vast amounts of coin from them. As do other countries of course, but still!

 

Op should be commended for helping his friend in his worst hour, where many would look the other way. There is always Gofundme. 
Hope things work out as best they can. 

[The Fugitive]

3 hours ago, 4MyEgo said:

Perhaps the Thai government should look at including retirees onto their health system for an annual fee,

That would be the ideal. I'd even pay monthly if Government Hospital treatment same as Thai's was made available!

[BananaStrong]

2 hours ago, daveAustin said:

There is always Gofundme. 

The American football player got 5,000,000 USD in one day.    Sure, different circumstances, but humans do have the propensity to give (ESPECIALLY from super rich countries).   Thailand?  well, I'd start the fund at home, of course.  

[The Fugitive]

6 hours ago, jts-khorat said:

My experience, with rural hospitals at least, is that they are quite willing to release patients back home where further care would clearly not prevent death, or switch off machinery to prevent mounting costs. On the other hand, something like proper palliative care is unknown there and this responsibility falls naturally back on the family. It is not a bad system, to my mind.

Same as elsewhere. Where a patient's health cannot be further improved the patient is no longer entitled to remain in hospital and will be discharged. However, where terminally ill a care package must firstly be in place. Unfortunately, that care package may only consist of three fifteen minute visits per day by a district nurse.  

[Celsius]

How much would a ventilator cost in Thailand? 

 

Just in case.

 

Would this do the job?

 

https://www.neuvar.com/product/icu-ventilator-mslvm19/?gclid=CjwKCAiAwc-dBhA7EiwAxPRylBN6td9QABjQZin-uzoOaTCdwoOkHKpvA1BmOT2sIXS0iGhhpTGhZRoCwM0QAvD_BwE&doing_wp_cron=1672802790.7503829002380371093750

Edited January 4, 2023 by Celsius

[4MyEgo]

14 minutes ago, The Fugitive said:

That would be the ideal. I'd even pay monthly if Government Hospital treatment same as Thai's was made available!

If the Thai government made it mandatory for retired and married expats to pay for health insurance into the Thai public health system, I am sure that would sort out a lot of problems, e.g. it could be paid when renewing extensions, e.g. 10,000 paid per annum and stamped into their passports.

 

The above said, the cover could be for emergency cover only, i.e. a 24 for hour stay in hospital or longer.

 

Those that have annual health insurance premiums with other insurers would need to show a current paid policy that would match up with the dates of their extensions, that way they could be excluded, that said, no proof equals 10,000 baht annual public health insurance emergency cover.

 

That's just my take on it, I mean you don't have to be Einstein to work something out like this, I would imagine foreigners who can't afford or are excluded from obtaining insurance because of age or pre-existing conditions could get the treatment they otherwise couldn't afford because of the lack of insurers wanting to take them onboard on a risk vs profit basis.

 

 

[nigelforbes]

14 minutes ago, 4MyEgo said:

If the Thai government made it mandatory for retired and married expats to pay for health insurance into the Thai public health system, I am sure that would sort out a lot of problems, e.g. it could be paid when renewing extensions, e.g. 10,000 paid per annum and stamped into their passports.

 

The above said, the cover could be for emergency cover only, i.e. a 24 for hour stay in hospital or longer.

 

Those that have annual health insurance premiums with other insurers would need to show a current paid policy that would match up with the dates of their extensions, that way they could be excluded, that said, no proof equals 10,000 baht annual public health insurance emergency cover.

 

That's just my take on it, I mean you don't have to be Einstein to work something out like this, I would imagine foreigners who can't afford or are excluded from obtaining insurance because of age or pre-existing conditions could get the treatment they otherwise couldn't afford because of the lack of insurers wanting to take them onboard on a risk vs profit basis.

 

 

I agree completely, that would be the sensible and caring thing to do The only flaw in that approach is that it doesn't derive any income from foreigners, for the Thai insurance industry hence it doesn't increase GDP.....which is the main purpose of allowing foreigners here in the first place. Every aspect of allowing foreigners to remain here is intended to benefit the economy, no measure will ever be enacted  that doesn't accomplish that. Even leaving the country means buying a re-entry permit.

[4MyEgo]

 

4 minutes ago, nigelforbes said:

I agree completely, that would be the sensible and caring thing to do The only flaw in that approach is that it doesn't derive any income from foreigners, for the Thai insurance industry hence it doesn't increase GDP.....which is the main purpose of allowing foreigners here in the first place. Every aspect of allowing foreigners to remain here is intended to benefit the economy, no measure will ever be enacted  that doesn't accomplish that. Even leaving the country means buying a re-entry permit.

I believe that as foreigners who live here on a full time basis, i.e. those who do their annual extensions, not the ones who come in on the 12 monthly multi-entry ones would benefit as would the Thai government as it's 10,000 baht per head per year on those on marriage extensions and those on retirement extensions. Those on the O-A I believe it's called, the 12 monthly with the multi-entry would have to continue to have insurance in place.

 

The Thai insurance industry in my opinion doesn't really come into the maths for most foreigners here as they would cater to the Thai's as most foreigners don't trust them in my opinion, talking from 3rd party talks on their experiences.

 

Fact is most foreigners, remember I am talking about married and retired expats, contribute more than most Thai's to the Thai economy on an annual basis, e.g. if a Thai is making 40,000 baht per month, take out tax etc then they would be spending less than what a foreign pensioner would spend here per month.

 

I am not on the pension, but I know I spend double the above amount per month to live here with no health insurance because paying 150,000 baht per year for me is excessive in my opinion, no inpatient, emergency cover only, that policy would be cheaper back in my country. 

[nigelforbes]

12 minutes ago, 4MyEgo said:

 

I believe that as foreigners who live here on a full time basis, i.e. those who do their annual extensions, not the ones who come in on the 12 monthly multi-entry ones would benefit as would the Thai government as it's 10,000 baht per head per year on those on marriage extensions and those on retirement extensions. Those on the O-A I believe it's called, the 12 monthly with the multi-entry would have to continue to have insurance in place.

 

The Thai insurance industry in my opinion doesn't really come into the maths for most foreigners here as they would cater to the Thai's as most foreigners don't trust them in my opinion, talking from 3rd party talks on their experiences.

 

Fact is most foreigners, remember I am talking about married and retired expats, contribute more than most Thai's to the Thai economy on an annual basis, e.g. if a Thai is making 40,000 baht per month, take out tax etc then they would be spending less than what a foreign pensioner would spend here per month.

 

I am not on the pension, but I know I spend double the above amount per month to live here with no health insurance because paying 150,000 baht per year for me is excessive in my opinion, no inpatient, emergency cover only, that policy would be cheaper back in my country. 

Think, captive audience and low hanging fruit, that's what we are, I am at least. I spend 50k a month whilst Mrs Nigel does her own thing because she has her own business. So the GDP take from me personally is not that far removed from the average Thai at 40k that you mentioned, plus, I spend 125k per year on my insurance, which basically covers ingrown toenails, (left foot only). On top of which, the private hospital system gets the pleasure of my money from time to time. I can't see why Thai Gov. would want to give up that income and further stretch an already stretched health care system (which is only going to get worse, by virtue of an ageing population.

[4MyEgo]

5 minutes ago, nigelforbes said:

I can't see why Thai Gov. would want to give up that income and further stretch an already stretched health care system (which is only going to get worse, by virtue of an ageing population.

I suppose one has to find out how many expats have private cover and how many expats don't.

[IvorBiggun2]

1 hour ago, The Fugitive said:

That would be the ideal. I'd even pay monthly if Government Hospital treatment same as Thai's was made available!

It is available. A Thai that doesn't use the government hospital that he's registered to pays the same prices, which ain't much, as per a farang. No discrimination there.

Edited January 4, 2023 by IvorBiggun2

[nigelforbes]

5 minutes ago, 4MyEgo said:

I suppose one has to find out how many expats have private cover and how many expats don't.

Knowing how many OA visa's there are might help. Anyone?