Ihm just curious: pricing at government hospitals

[DUS]

Hi,

 

In the past, I went to BNH Hospital here in BKK whenever I needed to see a doc. BNH like other private hospitals are indeed very good but it comes at a price of course. 

 

1 year ago I visited my first government hospital during a trip to Krabi when I got an open cut which got infected. Saw the doctor, got antibiotics for 1 week and paid less than 400 Baht for this. At the time, I couldn't believe how cheap it was. This motivated me to visit Chulalongkorn Hospital here in BKK, yesterday. Went there on an appointment, waited roughly 2 1/2 hours, saw the doctor regarding what was then diagnosed as a shoulder cuff tendonitis and was prescribed some meds. Total bill was 1,919 Baht, including 469 for the medication (medical service 550 Baht, doctor fee 800 Baht)

 

Now, I don't complain about the absolute price for the service as it is still reasonable of course. But being surprised by the higher than expected price (based on my experience in Krabi), I left the hospital with these questions:

 

1/ Was the fee I paid in Krabi an anomaly? 

 

2/ Are government hospitals in BKK just always more expensive than outside the capital?

 

3/ Did I pay a "farang fee" at Chula?

 

To be honest, I don't know what the 550 Baht "medical service" charge is (maybe I should have asked) but this is more than the "general hospital fee" or what it is called at BNH. Also, the doctors fee at 800 Baht compared to 1,200 Baht I paid last week for an assistant professor at BNH for a spine injury. Not a huuuuge markup for the latter at a private hospital.

 

Again, I am not complaining about Chula´s bill and I will be happy to go there again in 2 weeks for the follow-up consultation. As I am likely having to visit doctors more regularly in the months and years ahead, I am just a bit curious to hear about your experiences with government hospitals and their fees. Yes, I admit, after the experience in Krabi I had HOPED to pay less than 1,000. For the almost 2k I paid I could have had a consultation at BNH, I guess.

 

DUS

[Celsius]

Who ever told you Chula is a public hospital?

 

Now watch the 100's of confused emoticons below.

[FriendlyFarang]

Many hospitals combine public and private services (might be in different buildings though), the hospital to which you went probably does this as well.

You probably went the private care section of Chulalongkorn hospital, and were thus charged the private care rates.

 

Often they don't give you a choice though (I don't know how it is at Chulalongkorn, just speaking in general). The public care section of the hospital might be just for people who are treated under the 30 baht scheme or social insurance, self pay is not an option. If you pay yourself you are forced to visit the private care section.

 

Doctors fee at a government hospital is usually 50 baht, if you have to pay more that that you are in their private care section.

[KannikaP]

I use Nahresan University Hospital in Phitsanulok. Always a bit of a wait, but good service and cheap meds. Annual Check Up is Bht 2200, PSA test is Bht 250, and ear cleaning was Bht 300. Nice girls there too.

Had to go there a year or so back with chest pains late one night. Straight to ER, all checks incl chest X-ray, free of charge. Was a pulled muscle!

[norbra]

THis morning I had a diagnosis session with a plastic surgeon  in a government hospital.

100 baht

replacedment of lesion dressing 90 baht.

Quoted  5000 baht for excision of 2 lesions

 

[Sheryl]

Chula is a government hospital.

 

But like most government hospitals it has an after hours clinic where senior doctors can be seen on a private basis.

 

From the OP details sounds like he went through that channel.

 

To access public channel at Chula need to arrive at crack of dawn to get into queue and would take pretty much all day.  

[GarryP]

27 minutes ago, Sheryl said:

Chuka is a fovernmwnt hospital.

 

But like most govetnment hospitals it has an after hours clinic where senior doctors can be seen on a private basis.

 

From the OP details sounds like he went through that channel.

 

To access public channel at Chula need to arrive at crack of dawn to get into queue and would rake pretty much all day.  

I would not recommend the craack of dawn thing at Chula. Been there and done that. After waiting about 7 hours I gave up and went to a private hospital instead.

[cjinchiangrai]

I go to the local clinic every three months. It takes about three hours to go through the cycle and costs about 1500 baht including three months of meds. They are very nice.

 

What is interesting to me is how they have arranged the system. Monday is weekend trauma leftovers. Tuesday is Obstetrics, Wednesday is diabetes, Thursday is vaccinations and community health.... The specialists come in to treat the whole area on their topic. It actually makes sense.

 

The most critical thing for us as consumers is to understand if our malady is typical or not. It may be our only heart attack but it is not the only one for the cardiologist. If you do not need a super specialist, try the government hospital.

 

Another point, ask if your meds are the same ones the locals are getting. I reduced my meds bill by 10k a month by using the locally supplied products. Exact same care without a brand name.

[Bangkok Barry]

15 minutes ago, GarryP said:

I would not recommend the craack of dawn thing at Chula. Been there and done that. After waiting about 7 hours I gave up and went to a private hospital instead.

I visit my local village Homo Sapiens Maintenance and Repair Centre every three months to see my drug dealer who sells me a supply of pills to control blood pressure etc. I never, ever go before lunch as the Thai way is for everyone to get there at dawn and wait six or seven hours to see the doctor for five minutes. After lunch there are only a few people there. You'd think that the locals would know not to turn up en-masse as a long wait is inevitable, but......

[scorecard]

1 hour ago, FriendlyFarang said:

Many hospitals combine public and private services (might be in different buildings though), the hospital to which you went probably does this as well.

You probably went the private care section of Chulalongkorn hospital, and were thus charged the private care rates.

 

Often they don't give you a choice though (I don't know how it is at Chulalongkorn, just speaking in general). The public care section of the hospital might be just for people who are treated under the 30 baht scheme or social insurance, self pay is not an option. If you pay yourself you are forced to visit the private care section.

 

Doctors fee at a government hospital is usually 50 baht, if you have to pay more that that you are in their private care section.

Agree there can be confusion pvt/govt at the same hospital.

 

The private hospital near us also has a Social Security Fund clinic. Usually a longer wait but not that bad. Typically 40 to 50 minute wait. 

 

Different pricing pvt hospital facilities / Social Security Fund clinic. If the patient needs to use the private hospital failities for part of their visit then the bill is complex.

 

Same for inpatients, different scales but if the patient is a Social Security Fund member the room rate is much cheaper. 

 

Overal quality of healthcare is same for pvt hospital visit or Social Security Fund clinic visit. 

[billd766]

The last time I went to the local government hospital (about 10 days ago on a Sunday afternoon) to get some meds, the doctors fee was 50 baht.

 

We all had to wait nearly an hour as there was a genuine emergency and the duty doctor was incredibly busy.

[sandyf]

37 minutes ago, Bangkok Barry said:

I visit my local village Homo Sapiens Maintenance and Repair Centre every three months to see my drug dealer who sells me a supply of pills to control blood pressure etc. I never, ever go before lunch as the Thai way is for everyone to get there at dawn and wait six or seven hours to see the doctor for five minutes. After lunch there are only a few people there. You'd think that the locals would know not to turn up en-masse as a long wait is inevitable, but......

It used to be that way at my hospital despite them having appointments. One of the real benefits of the pandemic was that people started to stick to appointment times, and that has continued. 

Waiting room all very quiet now.

[sandyf]

5 minutes ago, billd766 said:

The last time I went to the local government hospital (about 10 days ago on a Sunday afternoon) to get some meds, the doctors fee was 50 baht.

Yes, 50 baht at my hospital, when I see 2 doctors on the same day, still 50 baht.

[GarryP]

42 minutes ago, Bangkok Barry said:

I visit my local village Homo Sapiens Maintenance and Repair Centre every three months to see my drug dealer who sells me a supply of pills to control blood pressure etc. I never, ever go before lunch as the Thai way is for everyone to get there at dawn and wait six or seven hours to see the doctor for five minutes. After lunch there are only a few people there. You'd think that the locals would know not to turn up en-masse as a long wait is inevitable, but......

Well as I have since moved upcountry, it will also be that way for me. Luckily the government (only) hospital in the tiny town where I live is only a hop and a skip away. I have already noted that it is exactly as you say. I'll get my queue number and <deleted> off back home for a few hours before returning.   

[hotchilli]

2 hours ago, KannikaP said:

Had to go there a year or so back with chest pains late one night. Straight to ER, all checks incl chest X-ray, free of charge. Was a pulled muscle!

Was that to do with the nice girls again?

[maechanman]

Public or government hospitals sometimes have higher charges for foreigners.

Some years ago I was bitten by a dog so off I went to Pattaya City hospital for a rabies rabies jab, I needed a course of 4 and I was charged around 500 Baht per jab at Pattaya City hospital.

I was away in Buriram when my third jab was due so I went to the government hospital there where I was charged the princely sum of 20 Baht.

Go figure ,that is some differential between two government hospitals.

[Sheryl]

2 hours ago, GarryP said:

I would not recommend the craack of dawn thing at Chula. Been there and done that. After waiting about 7 hours I gave up and went to a private hospital instead.

On top of that, when you do see doctor it will be a young intern or resident in training; sometimes even a medical student. The after hours clinic gets you directly treated by a senior doctor. 

[Sheryl]

17 minutes ago, maechanman said:

Public or government hospitals sometimes have higher charges for foreigners.

Some years ago I was bitten by a dog so off I went to Pattaya City hospital for a rabies rabies jab, I needed a course of 4 and I was charged around 500 Baht per jab at Pattaya City hospital.

I was away in Buriram when my third jab was due so I went to the government hospital there where I was charged the princely sum of 20 Baht.

Go figure ,that is some differential between two government hospitals.

Pattaya City and Queen Sirikit both have separate higher fee structure for foreigners.

 

So does Siriraj in Bangkok. And Sriphat in Chiang Mai.

 

You will not usually encounter this in Issan or central Thailand. 

[rwill]

In the small town where I live in Ratchaburi the local government hospital charges me 50 baht to see a doctor.

[Mickeymaus]

36 minutes ago, maechanman said:

Public or government hospitals sometimes have higher charges for foreigners.

Some years ago I was bitten by a dog so off I went to Pattaya City hospital for a rabies rabies jab, I needed a course of 4 and I was charged around 500 Baht per jab at Pattaya City hospital.

I was away in Buriram when my third jab was due so I went to the government hospital there where I was charged the princely sum of 20 Baht.

Go figure ,that is some differential between two government hospitals.

In Pattaya City Hospital hospital you pay more but you are treated like any other patient that pays only a fraction.

[fittobethaied]

I use the government's Military Hospital in Udon Thani and only pay 50 Baht to see a doctor. The meds from their pharmacy are dirt cheap, and no other hospital charges are levied. The private hospitals have recently raised their fee to 200 Baht for the nurse to check your blood pressure and weight you, but there is no such fee at the Military Hospital. 

[Ralf001]

2 hours ago, scorecard said:

Agree there can be confusion pvt/govt at the same hospital.

 

The private hospital near us also has a Social Security Fund clinic. Usually a longer wait but not that bad. Typically 40 to 50 minute wait. 

 

Different pricing pvt hospital facilities / Social Security Fund clinic. If the patient needs to use the private hospital failities for part of their visit then the bill is complex.

 

Same for inpatients, different scales but if the patient is a Social Security Fund member the room rate is much cheaper. 

 

 

Yeah I spent January (ICU), February (ICU) and most of March (Private Ward Room) in a private hospital.

All paid for by Social security.

[mokwit]

3 hours ago, FriendlyFarang said:

Doctors fee at a government hospital is usually 50 baht, if you have to pay more that that you are in their private care section.

Just paid 50Bt Doctor fee at Chula plus another 200 tacked on. I think this is the foreigner surcharge. 

[BuddyPish]

2 hours ago, Sheryl said:

So does Siriraj in Bangkok. 

 

Yep, the bastards tried to hit me for 25k for an MRI on my wrist.
If I knew they were going to try that on, I'd have gone to Samitivej around the corner from me in Phrom Phong. 
I don't mind paying for a specialist's expertise but a bloody mri is an mri, right?

In the end, I went to www.mrithailand.com 

Sorted for the princely sum of 8k

[nigelforbes]

12 minutes ago, BuddyPish said:

Yep, the bastards tried to hit me for 25k for an MRI on my wrist.
If I knew they were going to try that on, I'd have gone to Samitivej around the corner from me in Phrom Phong. 
I don't mind paying for a specialist's expertise but a bloody mri is an mri, right?

In the end, I went to www.mrithailand.com 

Sorted for the princely sum of 8k

An MRI is an MRI, as long as the site that is administering the MRI is accredited and the operative qualified. Interpretation of the MRI results is another story, that is not something I would leave to an MRI shop.

[BuddyPish]

1 minute ago, nigelforbes said:

An MRI is an MRI, as long as the site that is administering the MRI is accredited and the operative qualified. Interpretation of the MRI results is another story, that is not something I would leave to an MRI shop.

Neither would I.

[Sheryl]

4 hours ago, nigelforbes said:

An MRI is an MRI, as long as the site that is administering the MRI is accredited and the operative qualified. Interpretation of the MRI results is another story, that is not something I would leave to an MRI shop.

Actually there is difference by machine.  3 Tesla machines give stronger/better images, especially of soft tissue, than do 1.5 which is what most imaging centers have.

 

However whether this will matter much to the diagnosis, depends on the specifics of the case. For many things 1.5T is perfectly adequate.

[dallen52]

I've used pattaya public a few times.

They will elevate prices for farang. 

Even requiring a deposit before treatment. 

CT scans and tests They certainly cream you on.

 

Currently in Nangrong and use the public hospital for more serious medical treatment. 

Serious guttate psoriasis outbreak 2 weeks ago. 

About one hour wait. 

Doctor was first class.

Heaps of meds given. 

Antibiotics prednisolone antihistamines and 20 tubes of cortisol type cream. 

Total cost 320 baht.

I'm registered with the hospital. 

But no actual charge for the service. 

[dallen52]

4 hours ago, maechanman said:

Public or government hospitals sometimes have higher charges for foreigners.

Some years ago I was bitten by a dog so off I went to Pattaya City hospital for a rabies rabies jab, I needed a course of 4 and I was charged around 500 Baht per jab at Pattaya City hospital.

I was away in Buriram when my third jab was due so I went to the government hospital there where I was charged the princely sum of 20 Baht.

Go figure ,that is some differential between two government hospitals.

I use Nangrong which is part of Buriram. 

No charge the previous visit. 

Just 320 for the mega supply of meds

[superal]

19 hours ago, Sheryl said:

Pattaya City and Queen Sirikit both have separate higher fee structure for foreigners.

 

So does Siriraj in Bangkok. And Sriphat in Chiang Mai.

 

You will not usually encounter this in Issan or central Thailand. 

As is the case in the local gov; hospital near where I live , up in Issan near Surin . 

In fact there is a 3 tier structure for fees .

1/ Local Thais 

2/ Non Thai Aseans 

3/ Foreigners/ non Thai .

I was admitted as an inpatient for 4 days last year and was presented with an itemised bill every early morning . The bill was a long list which charged for every nursing activity e.g. the administration of giving me pills .   Also last year at the same hospital I had an eye check up along with 7 Thai patients . We went around the eye test machines as a group which took under 1 hour . My bill was 2400 baht . The Thais paid 350 baht.   With regards to the queuing system in Thai Gov; hospitals , it is quite the norm to go to the hospital at 07 00 am to register and get a ticket . If I go there at say 09 30 and get a ticket , I go back home and return about 14 00 hrs .    The patient waiting areas are normally full up with the patient and their families making finding a seat not easy . Having said that I attended the private Bangkok Hospital in Korat at a given appointment time but so did another 10 patients for the same appointment time . Thai hospitals cannot manage appointment bookings for some reason or are they too lazy ? If I have a more trivial medical need I go to a local doctors private surgery in town . ( there are several with senior doctors from the gov; hospital ) . Rarely long queues and a better class of doctor as opposed to the fresh out of medical school junior gov; hospital doctor .