3 hours ago, Watawattana said:

@Roadsternut thanks - very interesting.

This topic morphed a bit into some unfair NHS bashing.   And some NHS supporting (IMHO correctly from the emergency/clinical side, management side not so). As I live in Hong Kong and am currently going through some treatment in the public health system here, and it’s structure is similar to the NHS, I thought I’d compare the figures you quoted with HK.  Please note my figures are different to yours and could reflect my search wording, but I’ve been consistent with that wording when comparing stats/countries.

First thing I found is I think the figures you quote are based public + private spending.  No issue with that of course, but thought that as the topic morphed into the NHS I thought I’d concentrate on public spending only.  All results are from consistent searches on Google.

Spent on public healthcare:

• % GDP - Hong Kong 4.3%, UK 9.2%, USA 7-8%

• Per capita = Hong Kong £1,620, UK £13,500, US £9,300

Overall personal tax burden (income, sales, NI etc., and not very easy to compare like-for-like) - Hong Kong 17%, UK 39%, US 25%

Life expectancy (men) = Hong Kong 83, UK 79, USA 76

Life expectancy (women) = Hong Kong 88, UK 83, USA 81

Infant mortality (deaths per 1000 live births) = Hong Kong 1.7, UK 3.9, USA 5.6

Treatable mortality (deaths per 100k population) = Hong Kong 12, UK 85, USA 95

Cancer survival rate (5 years) = Hong Kong 56%, UK 50%, USA 70% (not clear if this is private or public sector or both)

Access to emergency healthcare - Hong Kong is 100%, same as UK

The UK spends much more on public health than the other 2, and taxes people much more too.  So, why is Hong Kong so efficient compared to the UK?  This is all my opinions based on my observations.  I’m ignoring the US as I think the model is so very different (aka I don’t understand it 🤐).

• Supply chain costs - Hong Kong’s population is a ninth of the UK, but is concentrated in a small land area - makes it easier for a single supply contract to cover individual aspects of the entire public health system.  Actually, land area is no excuse for the NHS not to effectively coordinate the supply chain.  Fragmentation drives up costs, but this alone cannot explain the cost differential between UK & HK.

• Corruption - Hong Kong has an independent anti-corruption authority - is independent of the police and all government departments.  For balance, their boss does report to the HK CEO (equivalent of a Prime Minister, so not 100% independent, but the media would be on the CEO like a ton of bricks if he interfered).  No need to look too much further than what happened during the pandemic to see the levels of nepotism and corruption in the NHS…

• Management costs - Hong Kong has a single management structure across the whole 'country', no NHS England/Scotland/Wales/Northern Ireland, no 42 separate Integrated Care Boards, no multiple NHS or Foundation Trusts or Primary Care Networks that lie on top of the individual hospitals or GP surgeries.  All of this management costs a disgusting amount of money.  Also, Hong Kong doesn’t do DEI with the bloated HR structure “needed” to support that.  When DT 2.0 started on about this when he took office I looked at a job site for UK NHS DEI hires - there was literally £100s of millions per annum of posts being advertised!  Did the same today, no better, see screen cap below.

• IT costs - In Hong Kong, the sharing of information from GP to consultant to surgeon is seamless.  Ditto for all the nursing, dietician, physio, scanning and indeed all other support functions.  It absolutely is not in the UK, with the sharing of paper still highly common - drives delays, lost key information, missed appointments, riskier clinical outcomes, physical and mental health risks for patients and therefore additional costs.  Lesson?  Dear NHS, come to HK and buy the same system as is used here.  It works.

In summary, from a health point of view, the figures seem to indicate that Hong Kong is a healthier place to live, with less of my income disappearing in taxation and then into brown envelopes.  Doesn’t make it a perfect place of course. Also doesn't make the UK (or USA) a bad place either.

Part of that reply is reasonable, part of that reply is nonsense,

Life expectiancy; UK and US populations are broadly similar, and so outcomes can be compared. Hong Kong has a genetically distinct population. When China, like Japan, approves new cancer diagnostic tests, it demands clinical trials data based on Chinese populations. Broadly speaking, tests developed for a Anglo-Saxon population would not be as accurate when carried out on an Asiatic population, and vice versa. Patterns of things like breast cancer, lung cancer, are very different. UK cohorts of Chinese heritage people show similar longer life spans.

NHS Procurement. While trusts can tender themselves, the NHS does have a Procurement "one stop" service, with nationally negotiated pricing.

Spending; the Hong Kong Special Administrative Region of the People's Republic of China spends per capita much less that the UK, but your claims are complete fiction. The Hong Kong Special Administrative Region of the People's Republic of China spends about £3200 per capita, versus the UK at £4500-5300. I'm assuming there is some dishonesty in your claims as you are only considering the Hong Kong Special Administrative Region of the People's Republic of China Public Fund, and not including the Private Fund, despite knowing that more Hong Kong people depend on the private sector for services provided as part of the NHS provision.

https://www.healthbureau.gov.hk/statistics/en/dha.htm

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2024and2025

The Hong Kong Special Administrative Region of the People's Republic of China is basically a city state. The UK is not. The Hong Kong Special Administrative Region of the People's Republic of China health service doesn't have to provide services to remote islands, large retirement towns, deprived neighbourhoods. All of these present challenges that Hong Kong Special Administrative Region of the People's Republic of China, thanks to the British legacy, doesn't have to deal with. Maybe the British should have left the Kowloon Walled City, a den of social inequity, as something Beijing shoud have dealt with, after all its was always Beijing's creation. No, Britain stumped up the money, saving Beijing the bother.

Your unnecessary comment on "DEI" I find offensive, considering how Hong Kong SAR treated people of non-Chinese origin after 1997. The Hong Kong Special Administrative Region of the People's Republic of China's treatment of political opponants and its kowtowing to Beijing is offensive. Your comments come over as similar to referring to German trains being kept running on time.

Many of Hong Kong Special Administrative Region of the People's Republic of China's health outcomes are nothing to do with the healthcare system, but are more due to cultural differences. Basically Hong Kong Special Administrative Region of the People's Republic of China treats healthier people, so no wonder it looks good. I don't know whether you are Chinese, Anglo-Saxon or other. A Briton moving from UK to the Hong Kong Special Administrative Region of the People's Republic of China will likely not become healthier just because they are in the Hong Kong Special Administrative Region of the People's Republic of China, and vice versa.

You talk about corruption; cite a few headlines from the UK as if that was proof corruption doesn't occur in the Hong Kong Special Administrative Region of the People's Republic of China. The ICAC does charge people with healthcare corruption, such as procurement bribery involving public hospital equipment purchasing, and fraud involving elderly care subsidies and fake records.

The fact that the ICAC has to prosecute these cases means corruption is there. The whole reason that the British had to create the ICAC in the 1970s, but didn't feel the need to do something similar in the UK, is because bribery is ingrained in Chinese culture.

The ICAC has been weakened since the 2020 National Security Law, anti-corruption is now subordinate to so-called “national security”.

Whereas COVID19 shone a light on cronyism in the UK, and resulted in stronger measures, cronyism in the Hong Kong Special Administrative Region of the People's Republic of China is gradually reasserting as Beijing exerts greater and greater influence.

In Britain, examples of corruption are often highlighted by a free press free of government control. You cannot say the same in the Hong Kong Special Administrative Region of the People's Republic of China, given the disgraceful way dissent has been cracked down on in the former colony, which should never have been returned to Communist China.

In the UK, the trend, through NHS Digital, is for patients to be given more and more access to their medical records, and for more and more information about the activity of the NHS to be put in the public domain. In the Hong Kong Special Administrative Region of the People's Republic of China, the trend is exactly the opposite, with increasingly less information of the healthcare system being freely available.

Despite the public healthcare system in the Hong Kong Special Administrative Region of the People's Republic of China that you champion, Hong Kongers are much more reliant on the private sector, and their own pocket for healthcare, suggesting there is dissatisfaction with the government service.

Your comparison of the Hong Kong Special Administrative Region of the People's Republic of China to the UK is a false one. The Hong Kong Special Administrative Region of the People's Republic of China isn't a country. It is better to compare the Hong Kong Special Administrative Region of the People's Republic of China to London.

But your politicisation of the debate means I am no longer interested.

8 hours ago, newbee2022 said:

Why it happens soo often only to British people?

Is it a gene to rely always on #gofundme?

Can't they care for themselves? Not buying a proper insurance?

Are people from other nations more intelligent? It's only an impression, hopefully not true.

It is because other nationalities are not that important and are not worth writing about. 😃

A bit like the king really, when King Charles visits the USA for example it is world news, if any other king or queen does something similar no one bothers writing about it.

6 hours ago, jcmj said:

I know it seems like a pain in the butt, but Always read the fine print. If they want to hide anything it will be there as we have seen over and over here. Insurance companies are not in the business lose money and the fine print is getting longer and longer. Buyer beware.

It's not about reading fine print. The absolute first thing to check when applying for travel insurance is what activities will be covered. You find out about this before you buy it and then decide if it is sufficient.

Is riding bar girls an extreme sport too? If so I would've been in a wheel chair years ago.

6 minutes ago, JamesPhuket10 said:

It is because other nationalities are not that important and are not worth writing about. 😃

A bit like the king really, when King Charles visits the USA for example it is world news, if any other king or queen does something similar no one bothers writing about it.

When Sirikit died, it was going round the world.

And when the King was in Germany driving his blue Porsche, his photos went viral.

And Charles is special because he's a kind of cranky, obsessed to horses, he loves one of them, she's his queen. " Let me be your tampon"😂

11 hours ago, Roadsternut said:

Nowhere in the article do the couple criticise the NHS. They were in Thailand on holiday. Even if their travel insurance covered their Thailand hospital bills, no travel insurance on Earth would cover all the costs of tratment. Travel insurance would only ever cover the costs needed to enable you to travel home. Spinal injury often results in months or years of rehabilitation, and that would never be completed in Thailand.

Similarly, if you were injured in the UK while on holiday some place that was not your home area, the local hospital will provide sufficient treatment to enable you to travel home. eg. if you break a leg while, say, holidaying in Cornwall, you will go to A&E, they will fit a temporary cast, and send you away with a referral letter. When you get home, you go back to your local hospital, for the temporary cast to be removed, and the fracture to be reset.

You claim NHS Emergency Medicine is "inefficient". The opposite is true, if compared to US emergency medicine. NHS A&E services achieve comparable or better health outcomes for half the cost, per patient, than the US. The NHS is more cost efficient at the system level, but less time efficient at the department level. Broadly speaking, the inefficiency of US medicine means it has greater surge capacity (ie more of the time, there are unused beds, unused equipment, doctors and nurses not doing much). The NHS though has less surge capacity (doctors and nurses do not have much times doing "nothing", equipment purchased by the NHS is often at near maximum capacity. The NHS fails on anticipating demand. The US doesn't have to worry about forecasting demand so much because there is so much wastage in their "system".

The UK spends about 12% of GDP on healthcare, about £4,500 per capita. The US spends about 18% of GDP on healthcare, about £10,500 per capita. Life expectancy at birth in the UK is about 81 years, in the US, about 78 years. Infant mortality; UK is 4.5 deaths per 1000 live births, US is 5.5 years. Treatable mortality is a measure of deaths that occur before age of 75 that could have been prevented. In the UK, that comes in at 75 per 100,000, but in the US, its 115 per 100,000. Broadly speaking, US doctors make more mistakes. The OECD average is 77 per 100,000.

Where the US shines is better cancer survival, and heart attack/stroke survival. The NHS has higher waiting times than the US, BUT in the US, for many people who lack insurance but don't qualify for Medicare, for many treatments, the idea of a waiting time is irrelevant because they are simply not getting that treatment. 100% of the UK population has access to healthcare. Even after ACA expansion, 8% of the US population does not have access even to emergency healthcare. But among the insured population, 25-35% are foregoing routine medical appointments, prescriptions, due to cost.

Maybe read the post? Said specifically they didn't read the exceptions - common to have dangerous activities excluded. If you look at say safetywings insurance it has clear tier that go up a lot to include bike riding/horse riding etc

I agree that horseback exclusion is somewhat surprising. The failure to inform the couple of this exclusion might have something to do with how travel insurance is sold, i.e., through a travel agent or on line, rather than directly from a full service insurance agent. Seems like a good agent would review such exclusions carefully with a customer, rather than just handing them an envelope with a policy in it, but a customer has a duty to understand limitations of coverage too. Curious about the policy wording: would a child riding a shetland pony led by hand by a handler at a petting zoo be excluded as well?

4 hours ago, Nemo. said:

Maybe read the post? Said specifically they didn't read the exceptions - common to have dangerous activities excluded. If you look at say safetywings insurance it has clear tier that go up a lot to include bike riding/horse riding etc

My insurance does allow mountain biking but doesn't mention in or out Pony trekking so is therefore excluded. So I guess if you want to risk the far more safe sport of pony trekking and have an accident just say that you were mountain biking. Very strange.

6 hours ago, Roadsternut said:

Travel insurers are increasingly adding alcohol exclusions into policies; if there is any evidence you were consuming alcohol at the time of the incident, whether or not it was actually a contributing factor, irrespective of whether you were actually impaired, and with zero reliance on any hospital blood alcohol measurements that are likely never made.

Essentially they expect that if you are on holiday, you mustn't touch a drop, not even a shandy.

Do hospitals in Thailand routinely check the blood alcohol level even for non motoring accidents? Note to self, if you do trip on the uneven footpath walking back from dinner or a bar make sure somebody gets me a few beers from 7-11 to drink on the way to hospital for the purpose of numbing the pain and calm my nerves.

5 hours ago, Rams86 said:

Is riding bar girls an extreme sport too? If so I would've been in a wheel chair years ago.

I use a wheelchair when travelling in Thailand. Never been near a bar yet.

It is the duty of the Thai authorities in cooperation with the western embassies to provide support to citizens from Europe and Britain. The fraud with the insurance companies is obvious......

ALWAYS know the exclusions, people.

Some insurance co's distinguish between surfing and kite-surfing, for example. One is classified as more dangerous and may not be covered.

Also, driving a motorbike yourself AND riding pilion on a Grab might be both excluded from coverage, depending.

Seem like an OK couple but an idiot move for not reading the policy detail.

20 hours ago, newbee2022 said:

Why it happens soo often only to British people?

It does not only happen to British people, so most of your post is nonsense.

Some other countries may have tighter regulations on their insurance companies, particularly in the EU, but I do not know that as a fact.

14 hours ago, Geoff914 said:

Technically a British person who leaves the UK is NOT entitled to free NHS care, having paid taxes all their lives. And probably continue to pat tax on their UK pension. An immigrant who arrives legally of on a rubber boat is entitled to free NHS treatment.

Does anybody happen to know if when Kemi Badenoch's mother came to the UK from Nigeria for medical treatment and just happened to be heavily pregnant and gave birth in the UK, was the birth of the baby private or NHS.

"In interviews, Badenoch denied claims she was an "anchor baby" and asserted that her family did not know she was eligible for a British passport until she was a teenager.!"

Which begs the question how did her heavily pregnant mother even get on a plane? Don't be so quick knock British people who return to the UK for health care. Thousands of others do.

That's the difference between us, I don't differentiate.

On 5/17/2026 at 2:12 AM, Woke to Sounds said:

ALWAYS know the exclusions, people.

Some insurance co's distinguish between surfing and kite-surfing, for example. One is classified as more dangerous and may not be covered.

Also, driving a motorbike yourself AND riding pilion on a Grab might be both excluded from coverage, depending.

Seem like an OK couple but an idiot move for not reading the policy detail.

Even if you could ride on a motorcycle taxi, how many passengers wear helmets? That alone would be instant disqualification.

4 hours ago, JensenZ said:

Even if you could ride on a motorcycle taxi, how many passengers wear helmets? That alone would be instant disqualification.

Or one bottle of beer.

12 hours ago, JensenZ said:

Even if you could ride on a motorcycle taxi, how many passengers wear helmets? That alone would be instant disqualification.

Well, every time I get Grab the driver offers me a helmet and I wear it.

But then two questions arise for me:

1) How many tourists with insurance cover would refuse to wear the helmet? And 2) Would the quality of the helmet be a factor in a claim being paid or denied IF an accident occurred? 🤔

On 5/16/2026 at 1:51 PM, Liverpool Lou said:

On 5/16/2026 at 10:58 AM, jcmj said:

... it seems like a pain in the butt, but Always read the fine print. If they want to hide anything it will be there as we have seen over and over here

Insurance companies do not hide anything in the (non-existent) "fine print", all insurance policies have perfectly legible policy conditions.

Absolute bo!!ox - and we've done this dance enough times before.

On 5/16/2026 at 6:09 PM, Nemo. said:

Maybe read the post? Said specifically they didn't read the exceptions - common to have dangerous activities excluded. If you look at say safetywings insurance it has clear tier that go up a lot to include bike riding/horse riding etc

What exactly constitutes a “dangerous activity” ???

That was something I spent a couple of months trying to get clarified by an insurance company some years ago.

They repeatedly avoided giving direct answers, so I eventually started presenting them with specific activities one by one to establish whether cover actually applied. In my experience, the wording used in many policies is often sufficiently vague and non-specific that it inevitably creates considerable “wiggle room” when a substantial claim is involved.

I know LL will no doubt vehemently deny that interpretation, but when insurers rely on broad umbrella terms such as “dangerous activities” without properly defining them, it is difficult not to conclude that the ambiguity is at least partially intentional.

After all, horse riding - something parents all over the world routinely allow their young children to participate in - can hardly be considered some form of extreme adrenaline sport. We are not talking about BASE jumping off cliffs or wingsuit flying here.

In the following thread, I raised precisely the same broader concerns regarding vague policy wording, interpretive ambiguity, and the extent to which insurers leave themselves room for manoeuvre at claim stage:

https://aseannow.com/topic/1394107-brit-backpacker-hurt-in-crash-faces-large-bill/page/6/

May 10

On 5/10/2026 at 5:37 PM, Yellowtail said:

It is not possible for insurance companies to list every event that is included or excluded.

If you buy a month of travel insurance from Tommy's Travel for $8, not much is covered.

Which is exactly what gives the insurance companies their “wiggle room”.

Getting drunk, riding a motorcycle without a licence, and not wearing a helmet obviously voiding coverage is fair enough. Most people would accept that.

The problem is the huge grey area in between.

For example, plenty of ordinary tourists have jumped into the back of a pickup truck to be driven up a steep road for a rafting or kayaking trip. If that truck crashes, does the insurer suddenly classify that as participation in a “dangerous activity”? Then what happens if the kayaking trip itself results in a capsized boat and a head injury? Does some obscure helmet clause suddenly appear?

That’s the issue. While it may be unrealistic to expect a travel insurer to list every conceivable excluded activity, I don’t think it’s unreasonable to expect clear, guaranteed cover for common tourist activities and recreational sports.

I ended up in nearly two months of back-and-forth emails just trying to get confirmation for very ordinary activities, and the company seemed extremely reluctant to give direct answers.

At one point I became very blunt in my emails:

“Would I be covered for the following activities? Please answer yes or no only"

• Skiing on piste

• Skiing off piste

• Skiing off piste with a guide

• Scuba Diving (Pad qualified up to 18m)

• Wake Boarding (lake - cable pull / Boat in lake / Boat in Sea)

• Water Skiing (lake - cable pull / Boat in lake / Boat in Sea)

• Cycling - On the road / Around a dedicates cycling park

• Recreational and competitive sports (non-professional)

  • Tennis (and tournaments) Football (and tournaments)

This is just what I remember off the top of my head, but I actually provided them with a much longer list. I really had to push to get straight answers - and the reason I did so was after reading so many of these 'insurance void' reports.

My concern was exactly this sort of scenario: you suffer a head clash during a casual football game, end up with a brain bleed, and then suddenly the insurer argues it was a “dangerous sporting activity” requiring separate sports coverage.

That was precisely the type of retrospective interpretation I was trying to avoid.

I wanted clear confirmation, in advance, that anything reasonably foreseeable as part of my normal trips and activities would actually be covered if something went wrong - its not a big ask.

On 5/16/2026 at 11:18 AM, ChipButty said:

I don't understand the 10 days for Dengue fever, I've had it twice, only the first time did I stay in hospital, the second time I stayed home,

It is potentially fatal; less than 5% death rate. From diagnosis to death can be as quick as 4 days.

On 5/19/2026 at 6:36 PM, richard_smith237 said:

Getting drunk, riding a motorcycle without a licence, and not wearing a helmet obviously voiding coverage is fair enough. Most people would accept that.

I recently queried my insurance policy. The confirmed that you can ride a motor bike up to 125cc wearing a helmet and having a UK motorcycle licence and no endorsements. No mention of having an IDP. For riding a motor bike personal liability was not covered. Passenger on motorcycle taxi was not covered.

I asked about intoxication and they said not covered if drunk. I said what does that mean, there are levels of being drunk. He went away and came back and said "can't stand up". I was expecting to be told a blood alcohol level. So I guess if I was found lying in the gutter then drunk. If just staggering back to the hotel then not drunk, by the definition of the insurance company.