Analysis Thailand in Trouble: Expats Exit as Vietnam Steals the Show

[spidermike007]

16 hours ago, TroubleandGrumpy said:

Yes it is - but that is not the4 main problem here. If anyone wants cheap living with English speaking and reasonable services etc etc then India is the best bet.  However, India has some disadvantages - and unless you have been there, you will never know - suffice to stay I will never visit there again.   

I lived in working India for a long time and I've been there in several occasions before and after, and I love India, and so does my Thai woman. I'd go back there in a nanosecond, it's a fascinating country with a super rich culture. But it's not a destination I would choose as an expat, on any level. 

[spidermike007]

16 hours ago, richard_smith237 said:

 

I wanted to take just these two particular points because many of the others are largely subjective. That said, I broadly agree that Thailand stands out as a significantly better destination for foreigners compared to its neighbouring countries.

 

However, healthcare remains a serious concern.

 

First, there's the issue of dual pricing. At the lighter end of the scale, we see it in places like national parks - and while it's objectionable in principle, most people aren't too bothered. In the private sector, we have the freedom to take our business elsewhere. The real problem arises with state-sanctioned dual pricing in government hospitals. If we fall seriously ill, we're can be charged substantially more than a Thai citizen would be for the same treatment (i.e. long term cancer treatment and operations costing 2 Million Baht instead of 1 MB.

In my view, this is indefensible. When it comes to healthcare, there should be an option for long-term residents to pay into the system and receive equitable care. For me, this is where dual pricing becomes genuinely troubling - it's the big stuff that matters.

 

Secondly, while the quality of treatment is generally excellent, there's a troubling lack of accountability when mistakes are made - a factor that certainly helps keep costs down. Personally, I’d prefer to be in a private hospital in Bangkok over most places in the world. But the question is - at 80, will I still be able to afford the premiums? And that brings us full circle, back to the need for a system that ensures long-term, affordable care.

 

I can’t say whether neighbouring countries offer anything better in this regard, but this remains a major red flag when considering a long-term life in Thailand, especially if one hopes to grow old in comfort with the security of health care.

 

 

 

I agree with what you said about private hospitals here, but I also feel that I'd rather be in a public hospital in Bangkok than most other hospitals anywhere else in the world, unless I had a great healthcare plan which I don't. So, as someone who's self insured the top public hospitals here work for me very well. 

[spidermike007]

14 hours ago, Presnock said:

I agree with your comments on Thailand and its people.  I already spent a couple of years in VN, enjoyed some of it but after all it was war!  The beaches are nice, I like the food and I can speak and read (or used to anyway and got paid for it) Vietnamese.  I married a Thai after my American wife passed away from breast cancer, and have a daughter from each of those ladies.  My half Thai daughter doesn't plan on living in Thailand, has taught herself to be fluent in Korean and after college plans to work in Korea and not Thailand.  Her mother of course only wants to live here in Thailand and I still enjoy life with her so I plan to stay until they burn the bones.  As for the political scene, it could never get any worse than that currently in the US with DJT, as it seems to me none of the citizens there are happy anymore based on what I hear from many different areas, and different generations of Americans.  Here, they came out with a long term visa perfect for my situation and I don't have to concern myself with 90-day reports, nor taxes on my civil pension.  I love it here, have travelled throughout, enjoyed that and meeting the different people and did that over time from 1972 until I retired here in 2005.  Good luck to all on whatever is to come.

Total agreement here. I travel back to the States frequently, a minimum of twice per year and I can tell you for a fact that Americans right now are rather joyless, and lacking in humor, they don't seem to be enjoying their lives very much, they're living, working, eating, and sleeping. Not much of a life, and many of them seem bitter, disenfranchised, disappointed, highly divided, and utterly joyless, no thanks. 

[spidermike007]

15 hours ago, Shocked farang said:

The official inflation in 2024 in the US was 2.9% based on the consumer price index.

I agree but when the government lies to us, as they always do, and they use obscure commodities like magnesium ore to skew the Consumer Price Index, it has no bearing on reality. When you're actually spending time there and going into the supermarkets and buying your normal staples, that's when you have a sense of where inflation really is, and it really is truly in the neighborhood of 20% right now. 

[Harrisfan]

1 minute ago, spidermike007 said:

I agree but when the government lies to us, as they always do, and they use obscure commodities like magnesium ore to skew the Consumer Price Index, it has no bearing on reality. When you're actually spending time there and going into the supermarkets and buying your normal staples, that's when you have a sense of where inflation really is, and it really is truly in the neighborhood of 20% right now. 

20% a year is bs. Probably more like 5 or 6% which over 3 years is 20%. 

[Mike_Hunt]

4 minutes ago, spidermike007 said:

Total agreement here. I travel back to the States frequently, a minimum of twice per year and I can tell you for a fact that Americans right now are rather joyless, and lacking in humor, they don't seem to be enjoying their lives very much, they're living, working, eating, and sleeping. Not much of a life, and many of them seem bitter, disenfranchised, disappointed, highly divided, and utterly joyless, no thanks. 

You are the company you keep. 

[Mike_Hunt]

1 minute ago, Harrisfan said:

20% a year is bs. Probably more like 5 or 6% which over 3 years is 20%. 

These people make up their own reality. 

[Harrisfan]

2 minutes ago, Mike_Hunt said:

You are the company you keep. 

This is true. The French hermit smells his own farts.

[NoshowJones]

18 hours ago, crazykopite said:

Life was much better under military rule since the criminal managed to somehow install his daughter as PM life has become intolerable after 20 years of supporting the Thai economy I’m starting to get itchy feet maybe a new venture in a new country is on the horizon only time will tell !

What a load of nonsense. The soldiers responsible from the unelected coup leader Prayut down to his generals, probably had about the same low IQ as the Somchai in the street, yes Thaksin was certainly a criminal, but he was an elected PM and like his daughter and sister is University educated while Prayut only had a Military Academy education.

Prayut is a far bigger criminal than Thaksin ever was.

[ravip]

Nothing good last forever!

Imagine a huge number of foreigners settle down in Vietnam, including the grumpy old geezers now complaining in Thailand.

 

If Vietnam is good now, it will be worse than Thailand, after an invasion of foreigners!

 

Edit

If Vietnam takes the foreigners, Thailand will be better, eventually.

[actonion]

23 hours ago, MalcolmB said:

Thailand is ten times better than Communist Vietnam.

Thailand has visas to suit everyone. 
Next week they will be Cambodia is going to beat Thailand.

Next month the Philippines.

 

But the reality is Thailand is the best. Always has been, always will be.

So why this story  of  low foreign numbers if u think  Thailand is the best

[MalcolmB]

2 minutes ago, actonion said:

So why this story  of  low foreign numbers if u think  Thailand is the best

The low Thai tourist numbers are ten times higher than the record Viet numbers.

[KhaoHom]

I don't like / trust Vietnamese people, but that's me. If you think you're an outsider in Thailand... Wait till you settle in Vietnam!

 

There's no denying the country is going to steal Thailand's itinerant expat population as well as all it's industry.

 

I enjoy the buzz of Bangkok, but I'd be gone if I weren't married to a Thai national. Thailand simply doesn't care about resident expats (O). Retirement visa requires 65k pm. Thats the salary of three BKK office workers - maybe four. What do we get? Nothing.

 

Now, taxes ...

 

Thailand feels stagnant, rudderless, x rates suck hugely.

[NanLaew]

23 hours ago, MalcolmB said:

Thailand is ten times better than Communist Vietnam.

Thailand has visas to suit everyone. 
Next week they will be Cambodia is going to beat Thailand.

Next month the Philippines.

 

But the reality is Thailand is the best. Always has been, always will be.

 

Absolutely correct, if only because of the following.

 

23 hours ago, henryford1958 said:

Vietnam is OK for tourists but without a retirement visa it is a non starter for expats.

 

[Shocked farang]

23 minutes ago, spidermike007 said:

I agree but when the government lies to us, as they always do, and they use obscure commodities like magnesium ore to skew the Consumer Price Index, it has no bearing on reality. When you're actually spending time there and going into the supermarkets and buying your normal staples, that's when you have a sense of where inflation really is, and it really is truly in the neighborhood of 20% right now. 

I understand your point, the items that really matter to you had an increase much higher than the "official" inflation rate, that after all is just an average, I have noticed myself the incredible increase in USD of many items. 

[KhaoHom]

2 minutes ago, MalcolmB said:

The low Thai tourist numbers are ten times higher than the record Viet numbers.

 

For now. As infrastructure builds out and Thailand continues to flounder...

 

It's all but lost Japanese and Chinese. I think the European and most western nations are pretty much finished with Thailand as well. Been there done that.

 

The only viable segment are the extremely budget conscious Indians and the equally skint single male travelers. The problem with the ladder is that the f2f p4p industry has entirely died.

 

 

I recall when Thailand had a mere few million per year. I built those numbers primarily on the fact that it existed and exists as the regional international hub for travel to neighboring countries.

 

Need to ask yourself what is the draw to Thailand? Is it safe? Can I get treated in a hospital and not get ripped off? If I have a legal issue with the police or be treated fairly?

[KhaoHom]

15 minutes ago, actonion said:

So why this story  of  low foreign numbers if u think  Thailand is the best

 

Thailand excels on soft living and convenience. There's probably not another country in the world that allows you to quickly grab a gh, hotel, condo. The availability of Western food is simply everywhere. All manner of conveniences are everywhere including things like massages and other services that would be considered luxury abroad.

 

The trouble is when you take these things away. Other issues are making it difficult for the people that enjoy these services to utilize them long term. Of course, safety, health, law...

 

The amount of taxes that are placed on travelers both arriving in departing are out of control.

[Presnock]

29 minutes ago, spidermike007 said:

Total agreement here. I travel back to the States frequently, a minimum of twice per year and I can tell you for a fact that Americans right now are rather joyless, and lacking in humor, they don't seem to be enjoying their lives very much, they're living, working, eating, and sleeping. Not much of a life, and many of them seem bitter, disenfranchised, disappointed, highly divided, and utterly joyless, no thanks. 

exactly what everyone I know that still connects with me.  Some are well off money wise but still not anywhere near happy.  Family complaining more and more as prices are going up and friends of theirs losing their jobs and all needing more money and some kind of control over their future.  None seem to think it is going to get better within the next 3+ years anyway and some of those voted for this activity.  Looking like here is going to be some BIG changes coming soon too.  Also you I am sure have seen where the BBB has a provision from both parties about taxing US remittances to foreign countries.  I have contacted my bank already in the states to provide them with whatever "proof" of my citizenship if necessary so those funds I send to myself won't be levied of any tax.  Especially from what I read, the recouping of any taxes taken out of my transfers will be "convoluted" according to the email I got about this bill even though it is aimed at foreigners sending money out of the US, it will mean even more extra work for US banks and wanting less and less to have customers living overseas.  In any case, life here is still great IMHO and have no plans to relocate.

[spidermike007]

1 hour ago, Mike_Hunt said:

You are the company you keep. 

Can't handle the possibility that the US is on the decline, the quality of life is dropping, prices are skyrocketing, and very few people seem to be manifesting much in the way of and joy? 

[Jack1104]

For sure I'm coming from 20 years and see the difference. Not dual pricing is encouraging like in Bangkok BTS Thailand cut the tree of money 

[paul1804]

Personally I dont see duel pricing as a huge deterrent to visitors but Thailand's citizens are greedy for money and often with as little effort as possible! The Taxi mafia are definitely bad publicity, the over supply of weed shops isn't doing Thailand any favours both in attracting quality tourists and the social impact from the many that are coming for legal cheap weed, not always the ideal clientele!!!

But most Thai's still have a smile and a pleasant aura unlike many in Vietnam, I think Thailand needs to improve its lacking infrastructure expected by tourist's from lets say the more developed countries which is where the money is so in Thailands best long term interests! Better infrastructure also includes some form of planning which Thai's really are behind the times!! Planning also covers visas and the likes, too many frequent changes and too much paper work which often contains useless information that has no benefits but justifies the mindless enforcers of these procedures. Its really not that hard to formalise strategies and plans but Thais get lost and feel it works if you just keep adding stipulations!!!

[BarraMarra]

A simple question, if all the Tourists Exited Thailand what would the Thais do for Money.

[Presnock]

23 minutes ago, paul1804 said:

Personally I dont see duel pricing as a huge deterrent to visitors but Thailand's citizens are greedy for money and often with as little effort as possible! The Taxi mafia are definitely bad publicity, the over supply of weed shops isn't doing Thailand any favours both in attracting quality tourists and the social impact from the many that are coming for legal cheap weed, not always the ideal clientele!!!

But most Thai's still have a smile and a pleasant aura unlike many in Vietnam, I think Thailand needs to improve its lacking infrastructure expected by tourist's from lets say the more developed countries which is where the money is so in Thailands best long term interests! Better infrastructure also includes some form of planning which Thai's really are behind the times!! Planning also covers visas and the likes, too many frequent changes and too much paper work which often contains useless information that has no benefits but justifies the mindless enforcers of these procedures. Its really not that hard to formalise strategies and plans but Thais get lost and feel it works if you just keep adding stipulations!!!

I agree on the double pricing.  Having been here for so much time I have been many times to just about everything worth visiting and didn't really concern myself with the price as it was something to do with the family.  As for visa changes, I retired here with a "O" visa but last year when I read about the LTR and the 50% cut in price, I jumped at it.  Just a couple of little hurdles but BOI worked with me and within a couple of weeks I had the visa.  Cuts out a lot of the other crap that I used to have to put up with i.e. 90-day reports, but now even that is online so...as for tm30, that particular office at the CH immigration opens before the rest of the shop so can get in and out quickly if the need arises to do an update.  I did the 1year check-in at the BOI/Immigration and spent less than 10 minutes there and can have an agent, or wife do it or if one leaves the country during that year, just starts the 1-year before having to do it again when one re-enters the country via the fast lane.

Now, I guess we see the political situation deteriorating but have gone through quite a few of these over the years - just so there is no shooting near me.  This latest bit might put on hold that "draft decree" that they were working on about taxes.  we'll see...or not.

[unblocktheplanet]

19 hours ago, sambum said:

I would like to know where you get the 50 baht from!

 

At one of our local hospitals they were going to charge a "farang" 19,000 baht for ONE stitch in a cut finger!!!

Whoa! They saw you coming. That can't be a govt hospital. Here in Bangkok Thais & foreigners are charge a base of B200 with B50 added on top for us.

[unblocktheplanet]

20 hours ago, TroubleandGrumpy said:

Anyone that argues price discrimination is not real or significant, needs their heads read. Or better still, they should read this legal court case outcome.  And that was a Government hospital - Private hospitals charge Expats way more than they charge to Thais. 

https://dancham.or.th/thai-court-rejects-dual-pricing-case-from-expat-in-hua-hin/#:~:text=According to press reports the,not mentioned by the court.

 

Why would anybody go to a private hospital if they didn't have premium insurance?!? Govt hospitals: as anywhere, always ask the price first and bargain!

[sungod]

I personally know no one who has sold up and moved to Viet Nam. 

 

If you think free speech in Thailand is an issue, try spouting off in Viet Nam. 

 

That said, I do enjoy visiting the place, just wouldnt want to live there. 

[richard_smith237]

6 hours ago, spidermike007 said:

Total agreement here. I travel back to the States frequently, a minimum of twice per year and I can tell you for a fact that Americans right now are rather joyless, and lacking in humor, they don't seem to be enjoying their lives very much, they're living, working, eating, and sleeping. Not much of a life, and many of them seem bitter, disenfranchised, disappointed, highly divided, and utterly joyless, no thanks. 

 

I used to be somewhat against the idea of ‘self-insuring’ – it was the last resort, something I never wanted to consider. But now, I completely understand why people feel pushed into it.

 

It’s not a choice, it’s a consequence. I often wonder what premiums will look like in 20 years – if they're already this high, how much further can they climb?

 

Having comprehensive cover through my employer has been a blessing of the past years. But as is often the case, when the job ends, so does the policy. There’s no option to carry over that corporate cover to a personal plan, which means starting afresh (first hand experience of this a couple of times) – and with that, comes the realties of facing exclusions for any pre-existing conditions.

 

Even worse: our family’s premium has almost doubled this year from to around $6,600 USD. Naturally, I refused to renew. But any new policy comes with the inevitable catch: exclusions on pre-existing conditions.

 

Then there’s the situation with Thai insurers. Many impose a moratorium on serious illnesses like cancer. So if you go for a check-up and something suspicious shows up – say a mass on the lungs – and it’s within the six-month exclusion window, you’re out of luck. Coverage isn’t truly continuous or secure.

 

Frankly, we’re held by the short and curlies. And as we age – like you, Spidermike – adequate cover becomes less a matter of cost and more an impossibility.

 

This, in my view, is one of the most pressing issues for long-term expats in Thailand today.

 

We can get our Marriage Visas, Retirement Visas, even the 20-year Thai Elite Visas… yet there’s no meaningful pathway into the national healthcare system. There should be. A system where we can contribute – financially and consistently – and in return, be entitled to care at public hospitals.

 

Take the UK as an example: the NHS surcharge for those on a Spouse Visa or ILR is currently £1,035 per year (roughly 46,000 baht). That seems entirely reasonable – even by Thai standards – and something many of us would gladly pay for reliable, long-term security.

 

As it stands, the only real options are:

Be wealthy enough to self-fund your healthcare indefinitely, sticking with the same insurer to avoid exclusions (but you're looking at over 600,000 baht per year for such cover)

 

Or, acquire Thai citizenship and join the public healthcare system - not possible for most who haven't been working here for 3 years.

 

Well… there’s one more route, but wives' tend not to let us marry a Thai government official just to piggyback on their health coverage!

 

 

 

 

 

 

 

 

 

 

 

 

[spidermike007]

6 minutes ago, richard_smith237 said:

 

I used to be somewhat against the idea of ‘self-insuring’ – it was the last resort, something I never wanted to consider. But now, I completely understand why people feel pushed into it.

 

It’s not a choice, it’s a consequence. I often wonder what premiums will look like in 20 years – if they're already this high, how much further can they climb?

 

Having comprehensive cover through my employer has been a blessing of the past years. But as is often the case, when the job ends, so does the policy. There’s no option to carry over that corporate cover to a personal plan, which means starting afresh (first hand experience of this a couple of times) – and with that, comes the realties of facing exclusions for any pre-existing conditions.

 

Even worse: our family’s premium has almost doubled this year from to around $6,600 USD. Naturally, I refused to renew. But any new policy comes with the inevitable catch: exclusions on pre-existing conditions.

 

Then there’s the situation with Thai insurers. Many impose a moratorium on serious illnesses like cancer. So if you go for a check-up and something suspicious shows up – say a mass on the lungs – and it’s within the six-month exclusion window, you’re out of luck. Coverage isn’t truly continuous or secure.

 

Frankly, we’re held by the short and curlies. And as we age – like you, Spidermike – adequate cover becomes less a matter of cost and more an impossibility.

 

This, in my view, is one of the most pressing issues for long-term expats in Thailand today.

 

We can get our Marriage Visas, Retirement Visas, even the 20-year Thai Elite Visas… yet there’s no meaningful pathway into the national healthcare system. There should be. A system where we can contribute – financially and consistently – and in return, be entitled to care at public hospitals.

 

Take the UK as an example: the NHS surcharge for those on a Spouse Visa or ILR is currently £1,035 per year (roughly 46,000 baht). That seems entirely reasonable – even by Thai standards – and something many of us would gladly pay for reliable, long-term security.

 

As it stands, the only real options are:

Be wealthy enough to self-fund your healthcare indefinitely, sticking with the same insurer to avoid exclusions (but you're looking at over 600,000 baht per year for such cover)

 

Or, acquire Thai citizenship and join the public healthcare system - not possible for most who haven't been working here for 3 years.

 

Well… there’s one more route, but wives' tend not to let us marry a Thai government official just to piggyback on their health coverage!

 

 

 

 

 

 

 

 

 

 

 

 

Well the one possibility that you didn't mention is using the best public hospital that you can find. I have one in Bangkok that I use for things that are of a serious nature and the treatment is outstanding and world-class, and the cost is affordable. Even for things that were of a fairly serious nature, they never even approached the amount that you're looking at, as an annual premium. 

 

And then there is a great deal of satisfaction in just saying no to the insurance mafia. 

[richard_smith237]

On 6/19/2025 at 12:20 PM, save the frogs said:

 

There seems to be a lot of BS in this article.

 

Dual pricing at medical facilities? I seriously doubt it. 

Street markets? No, there's no dual pricing. And things are so dirt cheap in street markets anyway. If you can't afford street food, you ain't gonna survive in Vietnam either. 

 

Yeah. National Parks maybe. And people are flocking to National Parks every day, right? And temples. 

 

 

Dual pricing in hospitals is not 'BS' by any means - in fact Thailands Administrative Courts set a legal precedent allowing the practice of tiered driving in hospitals...  

 

Thus: @save the frogs - you might want to reconsidered your angle on this - Dual Pricing in Hospitals is very real. 

 

https://www.thaiexaminer.com/thai-news-foreigners/2021/10/01/dutchman-tiered-healthcare-case-rejected/?utm_source=chatgpt.com

 

Primary Example: 

 

Summary:

A Dutch expat, Mr Erwin Buse - who has been living in Prachuap Khiri Khan and undergoing cancer treatments at Hua Hin Hospital. He filed a lawsuit with the Administrative Court in Phetchaburi, claiming Thailand’s tiered (dual) pricing system for public hospital services was unconstitutional and discriminatory against foreigners

 

 

What the Case Was About:

Thailand’s four-tier pricing structure (effective 2019):

1. Thai nationals
2. Foreigners from neighboring countries
3. Expats with non-immigrant visas and work permits
4. Tourists and long-term retirees

Mr Buse argued that this system violated constitutional guarantees of equal protection, especially since his cancer treatment at Hua Hin Hospital was significantly more expensive than it would have been for Thai nationals. 

 

 

The Court's Ruling:

The Administrative Court dismissed the case, ruling that:

• The tiered pricing “is not unfairly discriminatory” because it reflects the socioeconomic status of foreigners, who are generally wealthier.
• Charging foreigners more is justified “for the benefit of Thailand” and is considered constitutional.

Consequently, the policy remains in effect: foreigners, retirees, and tourists in tier 4 may still pay substantially higher fees - even double - for the same medical services, such as MRI scans or lab tests, and cancer treatments.

 

 

Key Implications:

Legal precedent: The ruling supports ongoing acceptance of dual pricing in public healthcare.

• Financial impact: Expats with serious conditions like cancer may face significant extra costs - hundreds of thousands of baht.
• Broader context: This aligns with wider government policies mandating private health insurance for foreign residents.

 

Takeaway from this: 

The Administrative Court has upheld Thailand’s tiered hospital pricing system, finding no constitutional violation and affirming the right to charge foreigners more.

As a result, expats seeking long-term healthcare in public hospitals - especially for big-ticket treatments like cancer care - should be prepared for significantly higher out-of-pocket expenses unless they opt for private hospitals or secure comprehensive private insurance.

 

 

[richard_smith237]

53 minutes ago, spidermike007 said:

Well the one possibility that you didn't mention is using the best public hospital that you can find. I have one in Bangkok that I use for things that are of a serious nature and the treatment is outstanding and world-class, and the cost is affordable. Even for things that were of a fairly serious nature, they never even approached the amount that you're looking at, as an annual premium. 

 

May I ask which Public Hospitial you use ?

Siriraj comes highlighly recommended - but of course wait lists can be long - thus I'm wondering which other hospital you have been very happy with - might give it a try (even though I'm covered - its good research for the future).

 

An additional facet to using the public hospitals is that many of the Surgeons and specialists at the private hospitals, also work at the Public hospitals. 

 

But, another point: at public hospitals such as Siriraj, a lot of Operations (simpler ones of course) are carried out by trainees, under the supervision of a senior surgeon - they have to learn somewhere, but that is also worth consideration. 

 

53 minutes ago, spidermike007 said:

And then there is a great deal of satisfaction in just saying no to the insurance mafia. 

 

I have potentially 800k bahts worth of treatment required this year alone (if carried out at a private Hosptials).

 

Thus: I wonder how much and MRI and arthroscopic surgery is at your Public Hopital and how long the wait times for treatment are.