Why is Thai health care so good?

[mania]

13 hours ago, Mike Lister said:

Went to a well known hospital chain yesterday to try and get a lesion removed from my back, I asked the doc how much. 4K he said so I said fine, go ahead. At the last moment the nurse hands me the quotation which includes the hospital charges, 10K baht!. You're taking the pith I said, goodbye.

 

Today I went to Dr Siri's clinic, Assist. Prof Siri that is....15 mins., job done, 980 baht, including meds. No biopsy I asked? No, he said, there's no need.

 

Good quality health care doesn't have to be expensive.

 

 

 

 

 

That is good news but also what really scared me a few years ago

 

I also went to a major hospital chain at Chiang Mai branch for a abdominal cramping I had been having. 

Had a ultrasound 5k baht & was told no problem but you do have kidney stones & need a CT scan with dye 13k baht

 

Ok did agree to that 13k but like you or even worse when laying on table & getting IV put in for dye a nurse comes & asks me to sign something. I asked why & what was it about. She said doctor would also like some "other tests". I could see in the print it was another 23k I refused & actually wanted to bolt as you did but went ahead with CT as I was connected to machine already.

 

Later doctor again confirmed same info as 5k ultrasound 3 too large to pass stones. Claimed I needed surgery asap & also possible a second procedure due to a narrowing of UPJ operation would be 150-200k baht

 

Well I had a 2nd opinion from another well known CM Thai Kidney specialist & he seeing report agreed & I needed to do this.

 

I still felt uneasy & returned to the USA where I was basically laughed at 🙄 They said yes you have stones & many folks do. If it ever causes problems we can review then a course of action but at that time there was no need to go further

 

Eight + years later here I sit without problems

 

Sorry for the long story but that upselling at major hospitals kind of was like a kick in the gut for me because after living many years in Thailand, speaking Thai well etc I felt I knew about Thailand.

 

Yes I knew of corruption  etc everywhere from police to monks & expected it but never in my wildest dreams did I expect such behavior at a major hospital regarding my health or pushing needless operations as all operations carry risk.

 

It scared me to think "what if" I was admitted unconscious for something? "What if" my wife was told by some upselling doctor I needed this & that or the worse could happen? Of course my wife would willingly spend every last baht if she thought my life was at risk.

 

But yes this really made me wonder & continues to do so today as we still have a home in Thailand & visit 3 months a year always wondering about moving back permanently 

 

 

 

Edited July 6 by mania

[Mike Lister]

5 minutes ago, mania said:

 

That is good news but also what really scared me a few years ago

 

I also went to a major hospital chain at Chiang Mai branch for a abdominal cramping I had been having. 

Had a ultrasound 5k baht & was told no problem but you do have kidney stones & need a CT scan with dye 13k baht

 

Ok did that but like you or even worse when laying on table & getting IV put in for dye a nurse comes & asks me to sign something. I asked why & what was it about. She said doctor would also like some "other tests". I could see in the print it was another 23k I refused & actually wanted to bolt as you did but went ahead with CT as I was connected to machine already.

 

Later doctor again confirmed same as ultrasound 3 too large to pass stones. Claimed I needed surgery asap & also possible a second procedure due to a narrowing of UPJ operation would be 150-200k baht

 

Well I had a 2nd opinion from another well known CM Thai Kidney specialist & he seeing report agreed & I needed to do this.

 

I still felt uneasy & returned to the USA where I was basically laughed at 🙄 They said yes you have stones & many folks do. If it ever causes problems we can review then a course of action but at that time there was no need to go further

 

Eight + years later here I sit without problems

 

Sorry for the long story but that upselling at major hospitals kind of was like a kick in the gut for me because after living many years in Thailand, speaking Thai well etc I felt I knew about Thailand.

 

Yes I knew of corruption  etc everywhere from police to monks & expected it but never in my wildest dreams did I expect such behavior at a major hospital regarding my health or pushing needless operations as all operations carry risk.

 

It scared me to think "what if" I was admitted unconscious for something? "What if" my wife was told by some upselling doctor I needed this & that or the worse could happen? Of course my wife would willingly spend every last baht if she thought my life was at risk.

 

But yes this really made me wonder & continues to do so today as we still have a home in Thailand & visit 3 months a year always wondering about moving back permanently 

 

 

 

Ouch! I've run into a similar but smaller scale problem several times. The issue seems to be, is what is found, medically relevant and not, is what is found the cause of the patients problems. Conducting a test and finding something, isn't always grounds to take drastic action and doesn't always mean the problem has been found. Similarly, running a test and not finding anything, doesn't mean there isn't a problem.

 

I gave a second opinion doctor a CD containing a very recent MRI to evaluate, despite the CD, he insisted on also doing an xray of the same area and charging far more for it than an X-ray should cost. When I challenged the hospital, they said the x-ray was, "medically necessary".

 

In a hospital bed after my thyroid was removed, I was in pain because of a back problem. The ever so helpful surgeon called a "friend" who specialised in back issues and an MRI was done. An hour later I got the diagnosis, back surgery required, 300k, it could be done the next day, no mention of risk, alternatives etc. Meanwhile the thyroid surgeon hovered and asked several times over two days, was I going to proceed. (I didn't). three weeks later the back problem resolved and has been good ever since.

 

It seems to be loss of face if something isn't found and a diagnosis given, regardless of whether it's the right one or not. If the wrong thing is treated and the original problem persists, it can always be claimed it was, "medically necessary", regardless.

 

It's a mine field out there.

 

[mania]

1 minute ago, Mike Lister said:

Ouch! I've run into a similar but smaller scale problem several times. The issue seems to be, is what is found, medically relevant and not, is what is found the cause of the patients problems. Conducting a test and finding something, isn't always grounds to take drastic action and doesn't always mean the problem has been found. Similarly, running a test and not finding anything, doesn't mean there isn't a problem.

 

I gave a second opinion doctor a CD containing a very recent MRI to evaluate, despite the CD, he insisted on also doing an xray of the same area and charging far more for it than an X-ray should cost. When I challenged the hospital, they said the x-ray was, "medically necessary".

 

In a hospital bed after my thyroid was removed, I was in pain because of a back problem. The ever so helpful surgeon called a "friend" who specialised in back issues and an MRI was done. An hour later I got the diagnosis, back surgery required, 300k, it could be done the next day, no mention of risk, alternatives etc. Meanwhile the thyroid surgeon hovered and asked several times over two days, was I going to proceed. (I didn't). three weeks later the back problem resolved and has been good ever since.

 

It seems to be loss of face if something isn't found and a diagnosis given, regardless of whether it's the right one or not. If the wrong thing is treated and the original problem persists, it can always be claimed it was, "medically necessary", regardless.

 

It's a mine field out there.

 

Good night! That back operation was a scary thought I bet!

 

Your right it is a minefield out there. I will also admit that I am sure it often happens elsewhere in the world too.

 

But yes at the end of the day it is good if we are conscious & have a choice as you & I both did. But that scenario of "what if" that I wondered about always haunts me a bit. Especially now that I am older (67) & would likely have to self insure in Thailand

[geisha]

Apparently, pre existing illness can have many meanings, like for ex, were you hospitalized, did you have surgery etc. It’s really hard to find out exactly what it means.  But you can still get insurance but depending on circumstances they won’t cover your pre existing illness. I’d love someone to explain this to me. For example , I take meds to keep my tension down.Does that mean insurance won’t cover this ? Any info appreciated. 

 

[geisha]

I’ve been told Allianz is very good ??

[Mike Lister]

1 hour ago, geisha said:

Apparently, pre existing illness can have many meanings, like for ex, were you hospitalized, did you have surgery etc. It’s really hard to find out exactly what it means.  But you can still get insurance but depending on circumstances they won’t cover your pre existing illness. I’d love someone to explain this to me. For example , I take meds to keep my tension down.Does that mean insurance won’t cover this ? Any info appreciated. 

 

Conservative health insurers consider anything that has been tested (even blood) that has shown an abnormal or out of range result, to be pre-existing and may limit or exclude that part of the body for a period or permanently. 

[davidstipek]

On 7/5/2024 at 10:06 AM, Lacessit said:

It's not.

 

IME most doctors here throw a bucketful of pills at the patients.

 

 I have only met one doctor in Thailand who has bothered to inquire about my previous medical history.

 

I also wonder about the cost of anaesthesia, as it seems to be very high here compared to Australia.

Did you ever meet your anaesthese? I had major surgery in Chiangmai, Doctors making rounds in ward prior to scheduled surgeries. I had a Doctor pop his head in the door and ask about my last name. Seemed he was a neighbor of my Fathers, dad had sold him a parcel of our farm and he built his home there. He was in Thailand on rotation and was Training on Staff at Chiangmai University and making rounds with a group of his students.

 

Ended up being the Best! Cheapest! Stay ever. Bills were disapearing... Staff seemed to be on a 24/7 alert for me. Actually came to check on me more often then other patients. I got 2 or 3 sponge bathes daily (not that I needed them, wife made the comment not to expect this to continue when I was discharged!

 

Seemed everyone knew this Doctor and wanted good referrals. 

 

I had my Heart stop 3 times in the major part of the surgery and it was him who brought me back... Not the Surgeon! I would gladly have paid him 4 times his salary! I ended up having Dad sell him an additional Acre of land (equal to 4 lots). He has been back 3 times since and now stays at our house when here and rides my Harley to the Medical Center (Work)

 

Now about Anaestheises cost being out of line? My as I said went over and beyond as his staff and students😍

[Lacessit]

8 hours ago, davidstipek said:

Did you ever meet your anaesthese? I had major surgery in Chiangmai, Doctors making rounds in ward prior to scheduled surgeries. I had a Doctor pop his head in the door and ask about my last name. Seemed he was a neighbor of my Fathers, dad had sold him a parcel of our farm and he built his home there. He was in Thailand on rotation and was Training on Staff at Chiangmai University and making rounds with a group of his students.

 

Ended up being the Best! Cheapest! Stay ever. Bills were disapearing... Staff seemed to be on a 24/7 alert for me. Actually came to check on me more often then other patients. I got 2 or 3 sponge bathes daily (not that I needed them, wife made the comment not to expect this to continue when I was discharged!

 

Seemed everyone knew this Doctor and wanted good referrals. 

 

I had my Heart stop 3 times in the major part of the surgery and it was him who brought me back... Not the Surgeon! I would gladly have paid him 4 times his salary! I ended up having Dad sell him an additional Acre of land (equal to 4 lots). He has been back 3 times since and now stays at our house when here and rides my Harley to the Medical Center (Work)

 

Now about Anaestheises cost being out of line? My as I said went over and beyond as his staff and students😍

I have not had general anaesthesia in Thailand. In Australia, the anaesthetist fee is about 15% of the total fee for a cystoscopy.

 

At Bangkok Hospital in Chiang Mai, the fee for a cystoscopy under local anaesthesia is 18,000 baht. With general anaesthesia, it is 55,000 baht.

[Sheryl]

There is an old (US, but  just as  relevant here) joke about anesthetist fees.

 

A man is given a quote for surgery, thinks it is outrageously high, demands an explanation.

 

A detailed breakdown is supplied and in it, he sees $XXXX fee for the anesthetist. He is outraged but, needing the operation (and the anesthesia!) he agrees.

 

On the day of the surgery, as is customary, the anesthetist  comes to see him. Immediately after he has introduced himself. the man exclaims:

 

"So you're the man who's charging me $XXX just to put me to sleep!!!"

 

"Oh, no" the anesthetist  calmly replies. "I'm the man you're paying to put you to sleep and wake you back up again!".

 

Seriously, I have had surgery under general anesthesia in Thai hospitals 6 times and another 2 times in a Thai-affiliated hospital in Phnom Penh. On all occasions the anesthetist  met me beforehand -- sometimes in my hospital room, sometimes not until in the induction suite - talked to me, asked abut relevant history etc. Standard procedure.

 

Two things I never begrudge in a hospital bill:  surgeon fee and anesthetist  fee (assuming both did their job properly).

[ayahuasca]

 

First thing to consider is the environment:

 

In countries without free speech, various forces suppress negative data that impacts reputation, and so on. 

 

I know first-hand and second-hand of hospitals in such countries giving legal threats for any negative information about them.
 

Second thing to consider is medical training:

 

The top medical schools in this particular country do not break above the 200 mark for ratings globally. Do you know that medical students in this country do not first get a proper 4 year college education but go right into medical school? 

If not, what else do you not know? 

 

You will see some western training listed on some MD’s résumés, but if you dive deeper, you will see that it was probably a 2 month short-course, and perhaps taken online. One site to check American board certification is here: https://www.certificationmatters.org/find-my-doctor/

Such a certification means they are actually keeping up on the latest research--there are similar certifications in Europe but less easy to research.  And 95% of all medical research is in English. So if your medical professional is not fluent in English, that’s a problem, esp. if your condition is serious. 

 

Compared to top hospitals in the "west", say the top 50 in Europe and the U.S., there truly is no comparison. If you actually do considerable medical research on your condition you will note this issue. (Other nearby countries to consider for advanced treatment are South Korea, and Taiwan, Singapore + Japan)

 

Yes, there are a few doctors here who are rather savvy, but that does not fix all the limitations you will find in private (and public healthcare). Aside from a deeply flawed structure, keep in mind that this country's GDP is less than that of Boston, MA, USA--i.e. limited resources. 

 

There are a lot of well-meaning, friendly expats in Thailand, however, a large majority of them have NOT had the advantage of a top notch education, nor experience with say, top 50 hospitals in the world. So watch whose advice you take. Again, beware of taking advice from people who really don’t know what they are talking about.

Edited July 9 by ayahuasca
typos

[simon43]

On 7/5/2024 at 9:37 AM, digbeth said:

what's the situation like for UK's NHS, 

back when I was in the UK even to get registered wit GP there's a waiting list, and once you're on, getting appointments to see GP could be weeks

...

 

18 months ago I went back to the UK, registered for a GP within 1 day, saw the GP in person 2 days later, referred to hospital immediately.

 

Hint - to see a GP, it helps to get out of bed early, be first on the telephone for an appointment etc. I had no problem...

[KhunLA]

16 hours ago, ayahuasca said:

 

First thing to consider is the environment:

 

In countries without free speech, various forces suppress negative data that impacts reputation, and so on. 

 

I know first-hand and second-hand of hospitals in such countries giving legal threats for any negative information about them.
 

Second thing to consider is medical training:

 

The top medical schools in this particular country do not break above the 200 mark for ratings globally. Do you know that medical students in this country do not first get a proper 4 year college education but go right into medical school? 

If not, what else do you not know? 

 

You will see some western training listed on some MD’s résumés, but if you dive deeper, you will see that it was probably a 2 month short-course, and perhaps taken online. One site to check American board certification is here: https://www.certificationmatters.org/find-my-doctor/

Such a certification means they are actually keeping up on the latest research--there are similar certifications in Europe but less easy to research.  And 95% of all medical research is in English. So if your medical professional is not fluent in English, that’s a problem, esp. if your condition is serious. 

 

Compared to top hospitals in the "west", say the top 50 in Europe and the U.S., there truly is no comparison. If you actually do considerable medical research on your condition you will note this issue. (Other nearby countries to consider for advanced treatment are South Korea, and Taiwan, Singapore + Japan)

 

Yes, there are a few doctors here who are rather savvy, but that does not fix all the limitations you will find in private (and public healthcare). Aside from a deeply flawed structure, keep in mind that this country's GDP is less than that of Boston, MA, USA--i.e. limited resources. 

 

There are a lot of well-meaning, friendly expats in Thailand, however, a large majority of them have NOT had the advantage of a top notch education, nor experience with say, top 50 hospitals in the world. So watch whose advice you take. Again, beware of taking advice from people who really don’t know what they are talking about.

Yes & no...

... Yes, I accept it is a 3rd world country, and all that comes with that.

...No, accessibility & affordability for regular check up to identify and manage things before they get out of hand is as important as the availability of high tech solution when needed, for better results.

 

A Yank, so high insurance, high deductibles, and silly high cost of meds & services keep most from knowing and managing their small issues, they might not even know about.  In that aspect, I consider TH much better than what's available in the USA.  

 

And from some reading, postings, what's available in the other 'universal healthcare' countries, not any better.  As it seems unless life threatening, theirs a long Q for services, and then it becomes life threatening due to the delay.

 

USA ... can't afford proper check ups ... not a pulse / BP / say 'ahh' check up.

Others ... wait to long for proper check ups

TH ... walk in and get anything I request immediately.  Full yearly check ups, for less than cost of insurance premiums & deductibles (USA).   

 

Just the Medicare Plan B for meds, which doesn't cover much w/deductibles, is ฿75k a year, just for the premiums.   I can't get that sick here, and have  full yearly check ups for much less.  I've been here 23+ years, in  today's $$$, that's ฿1.7M.

 

I've had procedures, surgery done here, that would have bankrupted me if back in the USA, or had to wait for the gov't programs to authorize & Q up for, which can be life threatening in itself, as my mother found out.

 

OK, not me now, as niece has privileges at 3 hospitals at Philly, USA, so have an in, if needing life saving treatment, if it can wait a few days 

  

Living semi rural, I accept the fact, that if an emergency, and care required within the hour or I die  ... then I'm dead.  Not much difference no matter where I live, as I won't be near a metro area anyway.

 

Does require you to 'know your body' and due diligence on research, and trust yourself.  Eat healthy, and avoid unhealthy lifestyle & vices.

 

 

Edited July 10 by KhunLA

[LarryChenard]

On 7/8/2024 at 7:22 PM, davidstipek said:

Did you ever meet your anaesthese? I had major surgery in Chiangmai, Doctors making rounds in ward prior to scheduled surgeries. I had a Doctor pop his head in the door and ask about my last name. Seemed he was a neighbor of my Fathers, dad had sold him a parcel of our farm and he built his home there. He was in Thailand on rotation and was Training on Staff at Chiangmai University and making rounds with a group of his students.

 

Ended up being the Best! Cheapest! Stay ever. Bills were disapearing... Staff seemed to be on a 24/7 alert for me. Actually came to check on me more often then other patients. I got 2 or 3 sponge bathes daily (not that I needed them, wife made the comment not to expect this to continue when I was discharged!

 

Seemed everyone knew this Doctor and wanted good referrals. 

 

I had my Heart stop 3 times in the major part of the surgery and it was him who brought me back... Not the Surgeon! I would gladly have paid him 4 times his salary! I ended up having Dad sell him an additional Acre of land (equal to 4 lots). He has been back 3 times since and now stays at our house when here and rides my Harley to the Medical Center (Work)

 

Now about Anaestheises cost being out of line? My as I said went over and beyond as his staff and students😍

For those interested in maintaining good health beyond hospital stays, incorporating supplements like mullein leaf can be beneficial. Mullein is known for its respiratory support and overall health benefits, which might complement the high-quality care you experienced. It’s always reassuring to have both excellent medical care and supportive health products.

It is not every day that a medical professional goes above and beyond, especially at such a critical time. Clearly, his dedication and the exceptional care you received made a difference. It's also interesting that the personal connection has led to ongoing positive interactions that have even spread to your family and home. This is a testament to the value of building strong relationships in healthcare. That's great! 

Edited July 23 by LarryChenard

[Sigmund]

It's good but wait till you get the tab from a private swanky US owned clinic in Thailand....