Elderly Foreginers A Heavy Burden For Thai Hospitals

[Mobi]

I am 64 and have private health insurance which covers me for everything except my pre-existing conditions, which are diabetes and coronary disease. So this cuts out quite a lot, but I am covered for any accident (if I am injured in an accident in my own car I am also covered by my motor insurance)and critically, such illnesses as cancer. There is this kind of insurance cover available for over 60's in Thailand for a price which is not too unreasonable. It is better than nothing and I have already had cause to claim on it when I slipped over and smashed my wrist badly, necessitating surgery to put all the bits back together. The insurance paid up without a murmur.

If I required open heart surgery I would be able to afford to pay the bill, but I could also elect to return to my home country - England , declare my intention to settle there, get a UK address, sign on with a GP and I would receive free treatment on the British national health service.

In any event, I know for a fact that in an emergency, all expat Brits would receive medical treatment in the UK and if it was established that they were non-resident, then the hospital would pursue them to have the bill paid - but they WOULD NOT refuse treatment, regardless of their ability to pay.

Similarly, if you are truly destitute and in need of medical treatment, the British embassy will repatriate you after checking if there are any friends or relations in the UK who could cough up the money for the airfare. If the embassy pays the bill, then your passport will be restricted and withdrawn as soon as you arrive in the UK and will not be returned to you until you have paid the bill.

I would imagine that any expat who throws himself at the mercy of a Thai government hospital will receive the most rudimentary treatment and will not be offered surgery or any expensive life-saving drugs, chemo therapy etc. They would just be admitted and basically left to die - hence the low cost to Phuket hospitals of 1.3 million Baht for treating many farangs in 2009.

Elderly farangs who decide to remain living in Thailand must make arrangements on what to do in an emergency and this should include taking out medical insurance, however limited, and leave instructions on how to be repatriated, should the need arise.

But I still stick by my earlier post in maintaining that Thailand gains infinitely more from thousands of retirees living here than it loses in unpaid medical costs from the few who are unable to pay.

[Bobr]

I would not be surprised if insurance companies are the driving force behind these articles being published. The insurance industry tends to be very influential politically and puts a lot of money into lobbying. I'm sure they would like nothing more than a law forcing every expat who wants to live in Thailand to buy one of their worthless policies.

I say their policies are worthless because most of them exempt motorcycle accidents, and that's one of the main causes of sudden hospitalization.

[Pib]

I'm sorry, I just can't get excited about this news report. The article talks one state run hospital during a recent 12 month period spending 1.3 million baht on 17 penniless foreigners. That averages out to 1.4 penniless foreigners per month and 76,000 Baht per those 1.4 patients per month. And I expect the hospital treats thousand of patients per month. Every country has this issue with homeless, poor, and legal or illegal immigratants...and oh, by the way, I have no doubt many more penniless Thai's left the hospital with many unpaid bills even after the 30 baht/gold card program reimbursements.

No, I'm not saying what is happening is right, but the numbers/amounts seem small if this is what the average Thai hospital incurs in unpaid bills from foreigners. And keep in mind that hospitals prices have a built-in factor knowing that X-amount of patients will not fully pay their bills.

Edited January 20, 2011 by Pib

[Thongkorn]

I keep seeing and hearing people say that treatment in the UK is free, its not, National Insurance Contrbutions . ever heard of it.

[Jingthing]

Jing, you have suggested above that the Thai goverment offer insurance....my question is..why should they ?....the retiree's are not PR or citizens

I am saying if you are going to require something for a class of people it is only fair if that thing that is required is humanly possible to obtain. How a government offer is structured, whether owned by them or merely regulated by them, is a technical matter, but obviously for retired expats it would be PAY IN system, and not free.

Another option if they go with a requirement is to allow exceptions for people who can document that they made a good faith application for coverage and were DENIED. I recall reading that was the policy in Malaysia, though I can't confirm that is their current policy.

Obviously, the Thai government doesn't need to offer us anything and is under no legal obligation to be fair. One can hope that they would be though; is that so unreasonable?

Edited January 20, 2011 by Jingthing

[el jefe]

I've paid a portion of my wages into Medicare since it's inception in 1965. So theoretically my "pile" of money is there when I reach Medicare age.

Now consider this: If I need a medical procedure that, for instance, costs $200,000 in the US, but only costs $30,000 in a quality hospital in Bkk I am not allowed to use the lower cost, equally as good (there are internationally accepted metrics on quality) at a fraction of the cost--I must return to the US where my "out-of-pocket expenses" will likely be close to the total cost here.

That this situation exists to me exemplifies the depth of corruption between the US government and the Pharmaking. (Medical Industry).

Allowing Americans "choice" would create enormous savings, and lower medical costs overall due to competition (zero competition now) but it will never happen and so the ongoing fleecing of Americans by its own government continues... just my opinion.

It's not just America either. Recently I was looking at customer feedback on a site where I buy meds to import to the US (it was a pharmacy listed at pharmacychecker.com if this is allowed) and a poster on the store review that I was reading commented that he had been happy with his purchase as the total cost was less than the Australian medical system's co-pay was. This is the same exact position that I found myself in when I last had insurance, that often I could buy quality generic meds at a lower cost that what my insurance company made me pay for a co-pay.

The part that I don't get is that medical costs have risen so fast and so enormously over just the past few years and as a US Registered Nurse, I see decreased earnings power, not increased--so where is all this money going? I leave that answer up to you, the reader....

This is a thread about medical costs and medical insurance in THAILAND. I think you're confused with your misplaced rant.

[astral]

I can see the time is coming when, in order to "qualify" for a retirement visa, you will have to be over 50 years of age, show a monthly income or have 800,000 baht in the bank AND you will have to make an annual one off payment for a government run medical insurance scheme and what they will charge for that is anyones guess, but one thing is for sure, the Thai's will come out in front, financially, from the scheme.

You may have to pay 20,000 baht medical insurance attached to your retirement visa, even if you are in perfect health. Now, multiply that by all the farang retired here and that's a nice little earner which more than enough pays for the odd sick farang in hospital.

Interesting idea.

If you want to join the Malaysia My Second Home (MM2H)scheme, the equivalent of

a retirement visa in Thailand, then you have to show that you have health insurance.

Mind you with local companies refusing to cover anyone over 70, it can be difficult.

[LaoPo]

The simple/sensible solution would be to require all retiree's in Thailand to have valid medical insurance as part of the visa issue/renewal process, no insurance no renewal of visa....its that simple.

It is completely beyond me why someone would live in a foreign country, with no access/right to "free" medical treatment and not have medical insurance even at a basic level

I fully agree with your first (and second) sentence. EVERYBODY applying for a visa (from outside the EU) to the Schengen countries MUST have full medical insurance, otherwise no visa. Even for tourist visas.

Anyone with some intellect does NOT go and live in a far away country WITHOUT medical insurance coverage, one way or another.

If he/she does so, don't blame the country's medical system or hospitals; it's your own fault if something happens to you.

Incomprehensible that there are members here who try to explain they don't have any medical insurance but still want to stay and grow older in Thailand...just wait and see how expensive hospitals will get in a few years

It's plain stupid and it's contemptible behavior trying to benefit from doctors and hospitals in the knowledge you can't pay for it in case something happens.

A few years ago I felt touched about a very sick person, a member here and even a former moderator, in Phuket who ended up is hospital and no insurance; I stepped in and sent a substantial amount to help and pay the bill; that person first demanded to have the money sent to the spouse which I refused and I sent it to another moderator who I trusted (to pay for the bill) otherwise the money would have been confiscated by the spouse.

The gratitude was so great that I was rewarded with nasty messages and even threats from the sick patient, lateron, upon my question if there was a chance seeing some of the money back, which was promised BEFORE I sent the money.

Yeah I know...TiT.

LaoPo

[LaoPo]

I can see the time is coming when, in order to "qualify" for a retirement visa, you will have to be over 50 years of age, show a monthly income or have 800,000 baht in the bank AND you will have to make an annual one off payment for a government run medical insurance scheme and what they will charge for that is anyones guess, but one thing is for sure, the Thai's will come out in front, financially, from the scheme.

You may have to pay 20,000 baht medical insurance attached to your retirement visa, even if you are in perfect health. Now, multiply that by all the farang retired here and that's a nice little earner which more than enough pays for the odd sick farang in hospital.

Interesting idea.

If you want to join the Malaysia My Second Home (MM2H)scheme, the equivalent of

a retirement visa in Thailand, then you have to show that you have health insurance.

Mind you with local companies refusing to cover anyone over 70, it can be difficult.

That's not just in Thailand; it's everywhere the same and it's beyond me WHY anyone would be disappointed or even angry if an insurance company would refuse someone at the age of 70 or older.

What and where on earth was his/her insurance before that time ? ..how can anyone expect that an insurance company welcomes a 70 year old, knowing the insured person will die within a few years anyway and they have to pay for the likely very expensive costs in hospital?

Those costs can't possibly being paid from the premium income of the insured person.

LaoPo

[Soutpeel]

IThat's not just in Thailand; it's everywhere the same and it's beyond me WHY anyone would be disappointed or even angry if an insurance company would refuse someone at the age of 70 or older.

What and where on earth was his/her insurance before that time ? ..how can anyone expect that an insurance company welcomes a 70 year old, knowing the insured person will die within a few years anyway and they have to pay for the likely very expensive costs in hospital?

Those costs can't possibly being paid from the premium income of the insured person.

LaoPo

I think you will find in a lot of cases, the vast majority of the complaining retiree's have come from "nanny state" type countries where "free" medical has been the order of the day, and anytime you are in "trouble" you can run to a goverment agency and demand they do something, this is borne out by the number of posters who are suggesting the Thai goverment set up funds/insurance schemes for just them....so I will go back to an original question posed earlier.....Why should they ?

[jayjay0]

I can see the time is coming when, in order to "qualify" for a retirement visa, you will have to be over 50 years of age, show a monthly income or have 800,000 baht in the bank AND you will have to make an annual one off payment for a government run medical insurance scheme and what they will charge for that is anyones guess, but one thing is for sure, the Thai's will come out in front, financially, from the scheme.

You may have to pay 20,000 baht medical insurance attached to your retirement visa, even if you are in perfect health. Now, multiply that by all the farang retired here and that's a nice little earner which more than enough pays for the odd sick farang in hospital.

It goes back to the old saying, "They don't want us here, they just want our money here."

Sounds like a bargain to me. Back in Canada I was paying 20,000 baht a year to wait for any thing other than a check up in the Doctors office. I once waited a year for a MRI prescribed by a Specialist who I waited 6 months to see.

Any one walking into a situation at the age of 50 would jump at such a bargain. Retirement with cheap medical and it is for life. You may be in perfect health but tell the hospital you don't have insurance because you were in perfect health last week. Insurance works the same way in the western world. You pay no matter what your condition is or you don't get it. I was in Canada and had a extended medical package with a automatic cut off at 70. When a person reached 70 it was by by thanks for your money. Here it would make no difference.

Just what was the insurance company you had in mind that didn't come out ahead financially. I take it from your post you have a hard time with a company making money.

One more thing can you be specific about who they are. I have Thai friends who I give no money to who have no problem with me being here. I suppose if I was basing my social life around the bar's that might be true. Personally I don't want those people here either.

Edited January 20, 2011 by jayjay0

[jayjay0]

<br>This topic is also being discussed at length in the Phuket forum, but as far as I can see, nobody has really homed in and questioned the facts behind  the title, namely:<br><br>"Elderly Foreigners <i><u><b>A Heavy Burden</b></u></i> For Thai Hospitals<br><br>The article quotes a figure of 800,000 Baht being written off in 2008 and 1.3 million Baht in 2009.<br><br>To put it in perspective, 1.3 Million Baht would barely cover the cost of one open-heart surgery operation at a decent hospital in Thailand.<br><br>I'm sorry, but a total  loss of 1.3 million Baht for the whole of 2009 is a joke.<br><br>How many thousands of foreign retirees live in Thailand and remit millions and millions of Baht into Thailand every year? <br><br>All of which is spent, here in Thailand, to the benefit of the Thais, be they hotel owners, condo/house developers, restaurants, shops, stores, and even...God forbid it... a few bar girls and bar owners and just about any other business you could think of.<br><br>If the net cost to the state is 1.3 Million Baht to keep all these foreigners and their never ending money stream in Thailand, then it is a very small price to pay. Maybe the government, or possibly TAT could reimburse these hospitals for their losses.<br><br>Of course there are a few impecunious foreigners who will abuse the system and there always will be - whatever new stringent rules are put in place.<br><br>There is a grave danger of 'throwing the baby out with the bathwater' if substantial numbers of foreigners are discouraged, or even banned from retiring here, with all their hard earned money, pensions etc, if any changes are made to the visa retirement rules.<br><br>I am sure common sense will prevail.<br><br>I have no vested interest in this, as if necessary, I will simply leave 800K in my Thai Bank, although I would not be at all happy to do so.<br>

<br><br>

Can you give a link to where open heart surgery would cost at the least 1,300,000 baht. Just at a guess but at the most expensive hospital in Thailand you could get two of them with change.

Why are most of the posters in such denial that it is happening. If what Mobi says is true why deny it. If a person wants to retire here they should have the means to pay there way here same as where ever they come from Granted they are not going broke because of the people unable to pay but it is a part of the equation that should not be there.

[Seekingasylum]

This article is really quite disgraceful and seemingly quite symptomatic of how the Bangkok Post is intent upon following The Nation down the pan into jounalistic oblivion.

Whilst it is quite credible there may be those who cannot pay for their misfortunes there are equally many others who pay well above the average for private treatment , not only for themselves but for countless Thai members of their adopted families, which more than outweighs any notional public liability the Thai medical industry incurs on behalf of a tiny minority of distressed farangs. Moreover, what about the thousands of expatriate Thai spouses who remit annually millions of baht back to the Los from Europe where their disposible income is greatly enhanced by the not inconsiderable fact most do not have to pay for their own health care?

However, of greater concern is the quite specious comment that these farang are rendered penniless because they have wasted their money and by implication by marrying Thai wives. Certainly, buying property and land in the wife's name is an act of faith but when the marriage founders it is hardly the farang's fault that he is divested of all that he may have owned simply because the Thai in their obsession to protect their own self interests are quite content to deny the farang any rights whatsoever. To then condemn him further because he has the effrontery to get ill without the means to pay for his treatment simply because the Thai system has rendered him destitute really quite beggars belief.

And this society has the audacity to claim that it is based upon the tenets of a Buddhist faith?

Ghastly hypocrites the lot of them.

[LaoPo]

IThat's not just in Thailand; it's everywhere the same and it's beyond me WHY anyone would be disappointed or even angry if an insurance company would refuse someone at the age of 70 or older.

What and where on earth was his/her insurance before that time ? ..how can anyone expect that an insurance company welcomes a 70 year old, knowing the insured person will die within a few years anyway and they have to pay for the likely very expensive costs in hospital?

Those costs can't possibly being paid from the premium income of the insured person.

LaoPo

I think you will find in a lot of cases, the vast majority of the complaining retiree's have come from "nanny state" type countries where "free" medical has been the order of the day, and anytime you are in "trouble" you can run to a goverment agency and demand they do something, this is borne out by the number of posters who are suggesting the Thai goverment set up funds/insurance schemes for just them....so I will go back to an original question posed earlier.....Why should they ?

Indeed..why should they?

If the smart guys here on board are so dumb to go and live in a foreign country WITHOUT a health insurance...How smart are they?

They are so smart that they don't even respect their own body and mind, KNOWING that an accident or sickness could struck them any day. These same members post here day in day out expressing there opinions about so many things...but they have NO health insurance?

LaoPo

[ginjag]

I keep seeing and hearing people say that treatment in the UK is free, its not, National Insurance Contrbutions . ever heard of it.

I think most have heard of it, it is pre paid though.

No it is not free, as a person pays his dues and demands through N.I. stamps which are deducted from his earnings, weekly / or monthly. What people are saying really, (it is free) is that you don't pay at the time of treatment, apart from the prescription charge at the clinic/hospital/shop. Doctors usually diagnose, and give out a prescription, and it would be dealt with at a chemist.

[Mobi]

Can you give a link to where open heart surgery would cost at the least 1,300,000 baht. Just at a guess but at the most expensive hospital in Thailand you could get two of them with change.

Why are most of the posters in such denial that it is happening. If what Mobi says is true why deny it. If a person wants to retire here they should have the means to pay there way here same as where ever they come from Granted they are not going broke because of the people unable to pay but it is a part of the equation that should not be there.

You’re not thinking of stents are you? Even they would cost you up to 600K,at most leading private BKK hospitals and certainly at Bangkok Pattaya and Bumrungrad these days, depending on how many stents are inserted

Open heart – cutting you open and inserting a new valve or whatever will start at well in excess of a million baht, upwards.

I think you may be a few years out of date, or you are getting your figures from provincial hospitals which I wouldn’t touch with a barge pole if major surgery was required.

The cost of fixing my broken wrist was around 300k and there was a guy admitted to Bangkok Pattaya here recently with chest pains and died on the operating table and if I recall correctly, the bill was over 1.5m.

Anyway, this isn’t about the cost of surgery, I was only quoting that number to illustrate how far the 1.3mBaht . (the total unrecovered cost to Phuket hospitals for treating farangs in 2009), would go in today’s day and age in any hospital. It’s really a pittance in the general scheme of things.

Edited January 20, 2011 by Mobi

[geriatrickid]

Maybe the government could set up a state run insurance scheme for foreigners. If it was cost effective and properly run, I am sure it would be popular and the profits could be used for te more 'genuine' needy cases.

The other alternative is for Vachira Hospital to do the same thing as it;s sister hospital in Patong. RIP OFF ALL THE FOREIGNERS!

The downside of your proposal is that the plan would run at a loss and fail. Many older people can and do obtain health insurance. They either pay a large premium to the carriers that provide a health care funding option or they are covered under their western retirees plan, especially those that were in a public service or large union plan. Right from the start your plan would attract only the worst case patients: The uninsurable. It the premium was set to reflect the anticipated payouts, the premiums would be unaffordable. There has to be a critical mass and a diversified risk to support a health insurance plan. A health insurance plan cannot specifically target older uninsurable clientele since the range of health conditions and their severity is too volatile and vast. The premiums have to be pooled with a lower cost group. This is what the public health care systems in the west do and they still bleed massive losses. It is why private health plans have caps and non renewal clauses to eliminate the high cost patients.

There is also the important "type" of retiree to consider. A great many of the elderly foreigners in Thailand don't care or consider the need for insurance. They were clueless before they came to Thailand and the lifestyle they lead in Thailand only makes them more oblivious to the need for health insurance. Go and ask some of the old drunks perched on a bar stool in Pattaya or on soi Bangla in Patong if they would be willing to pay 100,000 baht or even 50,000 baht per annum for catastrophic health care coverage and they would say &lt;deleted&gt;&gt; that, they can't afford it or won't pay.

[Jingthing]

Interesting idea.

If you want to join the Malaysia My Second Home (MM2H)scheme, the equivalent of

a retirement visa in Thailand, then you have to show that you have health insurance.

Mind you with local companies refusing to cover anyone over 70, it can be difficult.

Not exactly, as I stated before, there are exceptions for those who are REJECTED by the insurance companies for coverage.

Health Requirements

Applicant must be healthy enough to travel to Malaysia for a medical check-up, and must not be a carrier of contagious disease such as HIV or Tuberculosis. Upon successful application, applicants must obtain a valid medical insurance in Malaysia, if they do not have existing cover. However, for elderly applicants who were rejected by the insurance company because of age factor, we are able to ask for a waiver for the insurance requirement. (New update 17 March 2007) Please click to read more about How to be a Successful Applicant.

http://www.aubella.com/cms/en/eligibility/index.php

[Seekingasylum]

I keep seeing and hearing people say that treatment in the UK is free, its not, National Insurance Contrbutions . ever heard of it.

Yes, but they account for one's state pension and provide unemployment benefits.

The NHS is funded through tax collection.

Everyone normally resident in the UK is entitled to free treatment.

[Mobi]

I keep seeing and hearing people say that treatment in the UK is free, its not, National Insurance Contrbutions . ever heard of it.

I think most have heard of it, it is pre paid though.

No it is not free, as a person pays his dues and demands through N.I. stamps which are deducted from his earnings, weekly / or monthly. What people are saying really, (it is free) is that you don't pay at the time of treatment, apart from the prescription charge at the clinic/hospital/shop. Doctors usually diagnose, and give out a prescription, and it would be dealt with at a chemist.

Even in today's day and age, where they have clamped down considerably on the fakers and scroungers,and other undsirables any person who is RESIDENT in the UK, ie. has his home there and is either a British ational or a legal immigrant, will get medical care from State owned hopsitals/ clinics medical facilities and GP's free of charge,period.

This is totally regardless of whether the person has ever paid tax or national insurance contributions. The qualification is residence, not what he has or hasn't paid into the system. Further, if the person is working, he will have to pay a contribution towards his meds, but if he had no income, or has very low income ,he will get them free of charge.

Anyone else who happens to be in the UK (including UK nationals who are resident overseas) will,in the first instance, be provided with emergency medical treatment,and then the state will try to recover the cost from them. They will not be refused treatment if they have no money and they will not be asked to provide a credit card or pay a deposit in advance. They will be treated first, and the bills will be sorted later.

This is why I have already posted that any farang who is needing medical treatment should get a ticket home or ask the embassy to provide one. he will not be kicked out of a hospital once back in England. He can worry about his money later, but the truth is that if he has no money he is unlikely to be forced to pay, and he will even be provided with free accommodation.

Once he is back in the system he will be given subsistence money to live on. Britain is a welfare state and that's how it works- even for expats who have been overseas for half their life.

[el jefe]

IThat's not just in Thailand; it's everywhere the same and it's beyond me WHY anyone would be disappointed or even angry if an insurance company would refuse someone at the age of 70 or older.

What and where on earth was his/her insurance before that time ? ..how can anyone expect that an insurance company welcomes a 70 year old, knowing the insured person will die within a few years anyway and they have to pay for the likely very expensive costs in hospital?

Those costs can't possibly being paid from the premium income of the insured person.

LaoPo

I think you will find in a lot of cases, the vast majority of the complaining retiree's have come from "nanny state" type countries where "free" medical has been the order of the day, and anytime you are in "trouble" you can run to a goverment agency and demand they do something, this is borne out by the number of posters who are suggesting the Thai goverment set up funds/insurance schemes for just them....so I will go back to an original question posed earlier.....Why should they ?

Indeed..why should they?

If the smart guys here on board are so dumb to go and live in a foreign country WITHOUT a health insurance...How smart are they?

They are so smart that they don't even respect their own body and mind, KNOWING that an accident or sickness could struck them any day. These same members post here day in day out expressing there opinions about so many things...but they have NO health insurance?

LaoPo

LaoPo, one size does not fit all.

Insurance companies are in business to make a profit. In order to do that, premiums are set so that the average person spends more in premiums than they would spend on reimbursable medical care. I'm extremely healthy and have a net worth approaching 8 figures (USD, GBP, Euros; doesn't matter). I've got homes on two continents and travel extensively. Good insurance that would cover me anywhere in the world would be very expensive. So I'm self-insured. If I wind up with a 1,000,000 medical bill someday, so be it. My heirs can fend for themselves.

Many people are over-insured, whether it be life insurance or medical insurance.

Your generalization about people with no insurance, is just your opinion.

I don't appreciate being called dumb.

[jayjay0]

Can you give a link to where open heart surgery would cost at the least 1,300,000 baht. Just at a guess but at the most expensive hospital in Thailand you could get two of them with change.

Why are most of the posters in such denial that it is happening. If what Mobi says is true why deny it. If a person wants to retire here they should have the means to pay there way here same as where ever they come from Granted they are not going broke because of the people unable to pay but it is a part of the equation that should not be there.

You're not thinking of stents are you? Even they would cost you up to 600K,at most leading private BKK hospitals and certainly at Bangkok Pattaya and Bumrungrad these days, depending on how many stents are inserted

Open heart – cutting you open and inserting a new valve or whatever will start at well in excess of a million baht, upwards.

I think you may be a few years out of date, or you are getting your figures from provincial hospitals which I wouldn't touch with a barge pole if major surgery was required.

The cost of fixing my broken wrist was around 300k and there was a guy admitted to Bangkok Pattaya here recently with chest pains and died on the operating table and if I recall correctly, the bill was over 1.5m.

Anyway, this isn't about the cost of surgery, I was only quoting that number to illustrate how far the 1.3mBaht . (the total unrecovered cost to Phuket hospitals for treating farangs in 2009), would go in today's day and age in any hospital. It's really a pittance in the general scheme of things.

You are rite my information is a little old. But it is not based on the most expensive hospital I can find. Here in Chiang Mai we have several quality hospitals. I really don't believe because I pay more I will necessarily get better treatment.

If I remember rite you talked about the loss being a minor thing in there over all finances. I have to agree with you on that point. It is how ever a loss that should not be. Makes no difference what we say. The bottom line is we are guests and should not have to impose on our hosts. Particularly when they have problems of there own.

[Bagwan]

When I first met my wife I was concerned about her health and took her to BPH. She was found to be suffering from a life threatening illness. The doctor insisted that she be admitted without delay and stated that unless treatment was applied then her life expectancy would be about three months. I was asked if I was going to pay the bill and I asked what would happen if I didn't. The doctor said that the patient would be told that they could not help her and that she would be immediately discharged.

I was appalled. As her 'husband' had abandoned her when she said that a second child was on the way she had struggled for ten years to care for her offspring often going without food so that they could eat. I wondered what the fate of her children would be unless she was treated and although I didn't know her very well then I volunteered to pay. The return on my investment, which is ongoing, has been repaid many times over.

If Thai private hospitals can do that to one of their own why not apply it to farangs? If I develop a serious affliction then I would rather die than spend big money on a few extra years and so leave behind enough money for my wife to spend the rest of her days in a degree of comfort and with the wherewithal to pay for her ongoing treatment. Depending on the circumstances I might consider going back to the UK for treatment and I would feel a lot better then about the freezing of my State pension.

I suggest that those who advocate a health insurance scheme for farangs rethink their opinions. The beneficiaries of any such scheme would be Thai.

[Mobi]

Can you give a link to where open heart surgery would cost at the least 1,300,000 baht. Just at a guess but at the most expensive hospital in Thailand you could get two of them with change.

Why are most of the posters in such denial that it is happening. If what Mobi says is true why deny it. If a person wants to retire here they should have the means to pay there way here same as where ever they come from Granted they are not going broke because of the people unable to pay but it is a part of the equation that should not be there.

You're not thinking of stents are you? Even they would cost you up to 600K,at most leading private BKK hospitals and certainly at Bangkok Pattaya and Bumrungrad these days, depending on how many stents are inserted

Open heart – cutting you open and inserting a new valve or whatever will start at well in excess of a million baht, upwards.

I think you may be a few years out of date, or you are getting your figures from provincial hospitals which I wouldn't touch with a barge pole if major surgery was required.

The cost of fixing my broken wrist was around 300k and there was a guy admitted to Bangkok Pattaya here recently with chest pains and died on the operating table and if I recall correctly, the bill was over 1.5m.

Anyway, this isn't about the cost of surgery, I was only quoting that number to illustrate how far the 1.3mBaht . (the total unrecovered cost to Phuket hospitals for treating farangs in 2009), would go in today's day and age in any hospital. It's really a pittance in the general scheme of things.

You are rite my information is a little old. But it is not based on the most expensive hospital I can find. Here in Chiang Mai we have several quality hospitals. I really don't believe because I pay more I will necessarily get better treatment.

If I remember rite you talked about the loss being a minor thing in there over all finances. I have to agree with you on that point. It is how ever a loss that should not be. Makes no difference what we say. The bottom line is we are guests and should not have to impose on our hosts. Particularly when they have problems of there own.

Chaing Mai has some good hospitals, but 'Nakhon Nowhere' doesn't....

I doubt you'd pay a lot less than the figures I have quoted for open heart surgery at a good hospital in C. Mai. In any case hospitals in C.Mai are not a lot of use if you live in Bangkok, Pattaya or somewhere else in Thailand.

As for the very few, aged, impecunious farangs who have 'imposed' on our hosts,in all probability, for many years before they fell on hard times , they must have brought in and spent far more money here than they ever left unpaid when they died.

The same couldn't be said of the thousands of Thais in the EU, many of whom have been illegal in the country for years who 'impose ' on our health service to get free medical treatment, free housing, money to live on and a whole lot more besides, from the British national health service and from other states across the EU.

I'll bet you that the cost of all this outweighs the measly amount of debts farangs leave in Thailand by a million times.

But let's get a sense of proportion about all of this. We are talking about a very few expats, at the very bottom of the pile, who have died or discharged themselves without paying their bills, and the sum total of those bills is less than the cost of one major operation at a good Thai hospital. If we were talking in terms of tens of millions of Baht annually, then fair enough, but all this fuss is completely out of all proportion to what is clearly a tiny problem. It seems to me that the 'source' of this story is a 'farang hater' par excellence...

Frankly, I am surprised that these aged, sick and dying farangs even succeeded in getting into a hospital without money in the first place as I doubt they would get past the doors of a Pattaya or Bangkok hospital without flashing an Amex or a health insurance card....

[jayjay0]

Can you give a link to where open heart surgery would cost at the least 1,300,000 baht. Just at a guess but at the most expensive hospital in Thailand you could get two of them with change.

Why are most of the posters in such denial that it is happening. If what Mobi says is true why deny it. If a person wants to retire here they should have the means to pay there way here same as where ever they come from Granted they are not going broke because of the people unable to pay but it is a part of the equation that should not be there.

You're not thinking of stents are you? Even they would cost you up to 600K,at most leading private BKK hospitals and certainly at Bangkok Pattaya and Bumrungrad these days, depending on how many stents are inserted

Open heart – cutting you open and inserting a new valve or whatever will start at well in excess of a million baht, upwards.

I think you may be a few years out of date, or you are getting your figures from provincial hospitals which I wouldn't touch with a barge pole if major surgery was required.

The cost of fixing my broken wrist was around 300k and there was a guy admitted to Bangkok Pattaya here recently with chest pains and died on the operating table and if I recall correctly, the bill was over 1.5m.

Anyway, this isn't about the cost of surgery, I was only quoting that number to illustrate how far the 1.3mBaht . (the total unrecovered cost to Phuket hospitals for treating farangs in 2009), would go in today's day and age in any hospital. It's really a pittance in the general scheme of things.

You are rite my information is a little old. But it is not based on the most expensive hospital I can find. Here in Chiang Mai we have several quality hospitals. I really don't believe because I pay more I will necessarily get better treatment.

If I remember rite you talked about the loss being a minor thing in there over all finances. I have to agree with you on that point. It is how ever a loss that should not be. Makes no difference what we say. The bottom line is we are guests and should not have to impose on our hosts. Particularly when they have problems of there own.

Chaing Mai has some good hospitals, but 'Nakhon Nowhere' doesn't....

I doubt you'd pay a lot less than the figures I have quoted for open heart surgery at a good hospital in C. Mai. In any case hospitals in C.Mai are not a lot of use if you live in Bangkok, Pattaya or somewhere else in Thailand.

As for the very few, aged, impecunious farangs who have 'imposed' on our hosts,in all probability, for many years before they fell on hard times , they must have brought in and spent far more money here than they ever left unpaid when they died.

The same couldn't be said of the thousands of Thais in the EU, many of whom have been illegal in the country for years who 'impose ' on our health service to get free medical treatment, free housing, money to live on and a whole lot more besides, from the British national health service and from other states across the EU.

I'll bet you that the cost of all this outweighs the measly amount of debts farangs leave in Thailand by a million times.

But let's get a sense of proportion about all of this. We are talking about a very few expats, at the very bottom of the pile, who have died or discharged themselves without paying their bills, and the sum total of those bills is less than the cost of one major operation at a good Thai hospital. If we were talking in terms of tens of millions of Baht annually, then fair enough, but all this fuss is completely out of all proportion to what is clearly a tiny problem. It seems to me that the 'source' of this story is a 'farang hater' par excellence...

Frankly, I am surprised that these aged, sick and dying farangs even succeeded in getting into a hospital without money in the first place as I doubt they would get past the doors of a Pattaya or Bangkok hospital without flashing an Amex or a health insurance card....

Yes in all likely hood some have. But you forgot to mention that they received various goods and services for that money. Should they give all that back.

I maintain that they are our hosts and the fact that we have spent money here should not justify free medical.

Ya the source could well be a farong hater. Learned to hate other nationalities from watching Thai Visa.

Just for clarification are you talking only for private to make money hospitals. Sounds like it to me. In that case we might be talking apples and oranges witch I suspect from your comment about not being in Bangkok or Pattaya.

[LaoPo]

IThat's not just in Thailand; it's everywhere the same and it's beyond me WHY anyone would be disappointed or even angry if an insurance company would refuse someone at the age of 70 or older.

What and where on earth was his/her insurance before that time ? ..how can anyone expect that an insurance company welcomes a 70 year old, knowing the insured person will die within a few years anyway and they have to pay for the likely very expensive costs in hospital?

Those costs can't possibly being paid from the premium income of the insured person.

LaoPo

I think you will find in a lot of cases, the vast majority of the complaining retiree's have come from "nanny state" type countries where "free" medical has been the order of the day, and anytime you are in "trouble" you can run to a goverment agency and demand they do something, this is borne out by the number of posters who are suggesting the Thai goverment set up funds/insurance schemes for just them....so I will go back to an original question posed earlier.....Why should they ?

Indeed..why should they?

If the smart guys here on board are so dumb to go and live in a foreign country WITHOUT a health insurance...How smart are they?

They are so smart that they don't even respect their own body and mind, KNOWING that an accident or sickness could struck them any day. These same members post here day in day out expressing there opinions about so many things...but they have NO health insurance?

LaoPo

LaoPo, one size does not fit all.

Insurance companies are in business to make a profit. In order to do that, premiums are set so that the average person spends more in premiums than they would spend on reimbursable medical care. I'm extremely healthy and have a net worth approaching 8 figures (USD, GBP, Euros; doesn't matter). I've got homes on two continents and travel extensively. Good insurance that would cover me anywhere in the world would be very expensive. So I'm self-insured. If I wind up with a 1,000,000 medical bill someday, so be it. My heirs can fend for themselves.

Many people are over-insured, whether it be life insurance or medical insurance.

Your generalization about people with no insurance, is just your opinion.

I don't appreciate being called dumb.

1. I agree about insurance companies being in business to make profit; but that's not the point. It's about the unexpected chance that someone falls ill or has an accident that justifies a health insurance.

2. Your point of being extremely healthy doesn't mean a thing when you cross the road, have a car accident and get seriously wounded.

3. I don't understand why you explicitly describe your financial situation; I would never do that but I'm not you and if you feel offended by me calling people without a health insurance dumb, I'm sorry, but I was talking about the average ones who do not or cannot afford a health insurance but still decide to go living in a foreign country without health insurance and that's dumb, yes.

But if you're willing to pay for the costs for yourself, be my guest and you're the golden rule to a general rule: the exception.

4. I'm fully insured -worlwide- for 10K Baht/month, including my wife's insurance and I'm happy I am, since an unexpected -out of the blue- situation landed me in hospital a nice 7 times the past 2 1/2 years for a minimum stay of 7 days each; and if you learn that a day in hospital costs a beautiful Bt 40K/day or Euro 1.000/day in my country you will understand that being insured feels a lot better than to have to pay Bt 2 Million++ yourself; and that's excluding very expensive tests.

But, I don't understand people who say that good insurance is so expensive; it's not, it's relative, but, of course, up to you.

I hope, with you, that you won't end up in a hospital somewhere and whilst staring at the ceiling...think of this conversation one day

No health insurance is ASKING for trouble.

LaoPo

Edited January 20, 2011 by LaoPo

[ksamuiguy]

Living and working in Thailand over 30 years, with work permit and proper visa. I pay Social Insurance along with my employees. I pay the maximum of 750 baht a month and I can use any government hospital FREE, all costs covered. ALL!

It may not be 5 Star service and you have to wait like every one else. But the service is good and the Doctors are ok. In an emergency you can use any hospital and they will reimburse you for most costs.

I've paid a portion of my wages into Medicare since it's inception in 1965. So theoretically my "pile" of money is there when I reach Medicare age.

Now consider this: If I need a medical procedure that, for instance, costs $200,000 in the US, but only costs $30,000 in a quality hospital in Bkk I am not allowed to use the lower cost, equally as good (there are internationally accepted metrics on quality) at a fraction of the cost--I must return to the US where my "out-of-pocket expenses" will likely be close to the total cost here.

That this situation exists to me exemplifies the depth of corruption between the US government and the Pharmaking. (Medical Industry).

Allowing Americans "choice" would create enormous savings, and lower medical costs overall due to competition (zero competition now) but it will never happen and so the ongoing fleecing of Americans by its own government continues... just my opinion.

It's not just America either. Recently I was looking at customer feedback on a site where I buy meds to import to the US (it was a pharmacy listed at pharmacychecker.com if this is allowed) and a poster on the store review that I was reading commented that he had been happy with his purchase as the total cost was less than the Australian medical system's co-pay was. This is the same exact position that I found myself in when I last had insurance, that often I could buy quality generic meds at a lower cost that what my insurance company made me pay for a co-pay.

The part that I don't get is that medical costs have risen so fast and so enormously over just the past few years and as a US Registered Nurse, I see decreased earnings power, not increased--so where is all this money going? I leave that answer up to you, the reader....

[NamKangMan]

I can see the time is coming when, in order to "qualify" for a retirement visa, you will have to be over 50 years of age, show a monthly income or have 800,000 baht in the bank AND you will have to make an annual one off payment for a government run medical insurance scheme and what they will charge for that is anyones guess, but one thing is for sure, the Thai's will come out in front, financially, from the scheme.

You may have to pay 20,000 baht medical insurance attached to your retirement visa, even if you are in perfect health. Now, multiply that by all the farang retired here and that's a nice little earner which more than enough pays for the odd sick farang in hospital.

It goes back to the old saying, "They don't want us here, they just want our money here."

Sounds like a bargain to me. Back in Canada I was paying 20,000 baht a year to wait for any thing other than a check up in the Doctors office. I once waited a year for a MRI prescribed by a Specialist who I waited 6 months to see.

Any one walking into a situation at the age of 50 would jump at such a bargain. Retirement with cheap medical and it is for life. You may be in perfect health but tell the hospital you don't have insurance because you were in perfect health last week. Insurance works the same way in the western world. You pay no matter what your condition is or you don't get it. I was in Canada and had a extended medical package with a automatic cut off at 70. When a person reached 70 it was by by thanks for your money. Here it would make no difference.

Just what was the insurance company you had in mind that didn't come out ahead financially. I take it from your post you have a hard time with a company making money.

One more thing can you be specific about who they are. I have Thai friends who I give no money to who have no problem with me being here. I suppose if I was basing my social life around the bar's that might be true. Personally I don't want those people here either.

I just pulled the figure of 20,000 baht out of my hat. THEY ("they" being the Thai Governemnt and law makers) may decide to make the annual farang insurance payment, attached to your retirement visa, 100,000 baht a year. I don't know what they would charge, BUT, in true Thai style, it will be an overcharge and be more than enough to cover the odd farang who gets hospitalised. Remember, you will have to pay this, annually, NOT show this ammount of money in your bank. They may use a "blanket payment" from everyone, every year, to cover the few that do require medical treatment throughout the year. So, you will receive treatment in any Thai hospital, upon showing your passport with a current retirement visa which has the medical insurance attached to it.

That just leaves the question, how much do you think is a fair price to pay, for a Thai hospital and doctor, by way of insurance each year?

Now, if the Thai Government does not come up with a medical insurance scheme for farang, and insists you source your own insurance from a private company, many will have problems. They may bring in a law that you have to produce your policy document upon renewal of your retirement visa. This will basically mean anyone over 70 year of age, or anyone with a pre-existing condition, will not get insurance and therefore, will not get a retirement visa.

I'm guessing this will push those over 70 years of age, or those with pre-existing conditions, back onto "tourist visas." Then, when they see all the older farang on tourist visas in hospital without insurance, they will then bring in a law that states any farang over 50 must show an insurance policy document to get a 60 day tourist visa.

It will be just another thing they bring in that will make it harder for farang to live here and be a good money spinner for the Thai Governemnt.

The billions of baht that farang expats bring into this country, every year, and the Thai Government are not even prepared to wear the cost of the few minority that fall sick each year and can not pay the medical bill really shows the Thai Government has nothing but contempt for farang and/or see an opportunity to implement yet another "compulsory" payment a farang must make in order to live in Thailand.

They just keep making it harder, more costly, and more bureaucratic to be able to live here.

[LaoPo]

That just leaves the question, how much do you think is a fair price to pay, for a Thai hospital and doctor, by way of insurance each year?

Now, if the Thai Government does not come up with a medical insurance scheme for farang, and insists you source your own insurance from a private company, many will have problems. They may bring in a law that you have to produce your policy document upon renewal of your retirement visa. This will basically mean anyone over 70 year of age, or anyone with a pre-existing condition, will not get insurance and therefore, will not get a retirement visa.

I'm guessing this will push those over 70 years of age, or those with pre-existing conditions, back onto "tourist visas." Then, when they see all the older farang on tourist visas in hospital without insurance, they will then bring in a law that states any farang over 50 must show an insurance policy document to get a 60 day tourist visa.

It will be just another thing they bring in that will make it harder for farang to live here and be a good money spinner for the Thai Governemnt.

The billions of baht that farang expats bring into this country, every year, and the Thai Government are not even prepared to wear the cost of the few minority that fall sick each year and can not pay the medical bill really shows the Thai Government has nothing but contempt for farang and/or see an opportunity to implement yet another "compulsory" payment a farang must make in order to live in Thailand.

They just keep making it harder, more costly, and more bureaucratic to be able to live here.

Yeah sure, blame the Thai Government ..why on earth should the Government pay for the medical costs of the minority that have accidents or fall ill ?

Do you really think the Governments of France, Spain, USA (the largest tourist countries on this planet) will pay hospital/doctors costs for the people who wish to live there as retirees or expats??; give me a break...

Well, I see it a bit different since anyone who comes to Thailand to live here should have a proper health insurance in the first place; period.

Don't blame the country or it's system you wish to live in but take care of your own responsibilities!

LaoPo

[Credo]

In the US, hospitals are required to treat life threatening situations.  Those that don't will lose federal funding.  There are very few hospitals which can afford to lose federal funding.

In Thailand, if the person is married, then the marital assets should go toward medical treatment.  In Phuket they were having a look at overseas funds that were used to buy land, houses and fund businesses.  Perhaps a careful scrutiny of these could go toward medical costs, when necessary.