World Urged To Follow Thai Healthcare Model

[parmo1]

You are mostly comparing health systems with your own country's, you must compare it with neighbouring countries and what Thailand had previously (NOT MUCH FOR 98% of population).

Mr Lansford, foreigners in France, Belgium , Germany do get the same treatment , they just have to claim the fees from their own personal insurance policy (where appropriate). The fees for treatment in these countries are kept in check by their governments. Coverage is universal.

Europeans and other countries have bilateral agreements with the European Union.

England has a socialist model health system As well as a private system that allows the rich to jump the queue for treatment. The government does not keep the prices in check for the UK private health system.

No money changes hands in the UK National Health System, but this is being severly rundown by succeeding right wing governments who would prefer the US model despite being 22 miles from France and the best health Universal system in the western world.

I have been to one hospital in Thailand and thought it was excellent. It was just for an expensive health checkup (girlfriend must have thought i needed one)

Edited January 25, 2012 by parmo1

[Pib]

"Dr Timothy G Evans from the BRAC University's School of Public Health said research on the implementation of the decade-old universal healthcare scheme found that the scheme covered up to 75 per cent of Thai population."

Yes, the costs are covered by this scheme...BUT...that says nothing about the quality of care. A few months ago, a Thai friend went into the local hospital and did not receive her prescribed medication for 3 days. However, on the third day the mistake was discovered and she was given all three days' medication at once. Unfortunately, she did not survive.

A friend's sister recently went into the same hospital with vaginal bleeding. She was examined, released and told that all she needed was some rest. Two days later she was severely hemorrhaging found to be caused as a result of a miscarriage which caused the initial bleeding. She returned to the hospital and barely survived after follow up treatment. Not to worry, the scheme covered all costs. Unfortunately, I don't think her funeral costs would have been covered if she had not survived the botched up service.

However, if both were farang, they would have received the same service, but in a nicer room and the bill would have been around 80,000 THB.

Yes, thiese are good reasons that the world should follow the Thai model of healthcare

The quality of care can also be very good. A little over a year ago my almost 80 year old Thai mother-in-law had major back/spine surgery in a provincial hospital...she was in the hospital for 14 days. A few days after checking and a day before the surgery she was taken by ambulance to have a lower back MRI done in Bangkok...the ambulance crew was driver and a nurse...and of course she was taken back in the same ambulance. The next evening she underwent the 4 hour surgery. Care by the hospital staff during her stay was just fine and the follow-on care via several hospital visits for checkup was fine...along with all the free medications she was issued...the abulance trip to-and-from Bangkok was free also. Her total cost for the surgery, hospital stay, medications, etc., would have been "zero" except we decided to have her stay in a private room versus a ward during her 14 days stay...for this room we paid 600 baht a day for a total of 8,400 baht...all other costs were covered by the universal health care program.

Yes, the healthcare can be very good in BKK, but It is definitely not "universal" in Thailand.

Healthcare provide the mother-in-law was in a province about a 100 Km from Bangkok...the hospital only sent her to Bangkok via ambulance to get an MRI in preparation for the operation the next day back at the province hospital.

I agree that the quality of care can vary greatly from hospital to hospital in Thailand, but from what I've seen over the last few years with various relatives being treated here and there for this and that ailment the care has served them well with little to no cost. And I have one relative on kidney dialysis twice a week (4 hours each treatment) and this is free also. The great majority of this care has occurred in the provinces except one case where an uncle of my wife was transferred from a province hospital to a Bangkok hospital for ICU respiratory care for several weeks...all free.

[finnomick1]

Yeah, right ,it's April the first , he he he.

Oh SO right...

[longtom]

May be different from area to area? I have only good experience with public Thai hospitals. We used one in the Surin area when my GF gave birth by caesarian - she wished to use the hospital she know at her home town - and I was impressed, coming from a Scandinavian country, claiming to be among the best health care systems in the World. Especially the human care of patients, impressed me. We could afford a socalled VIP-room with en-suite, aircon, TV and guestbed; 150 baht extra a day. As my GF were moving into the Social Security scheme, but had not recieved her (blue) card, we had to pay for the service - she could claim the money back from the Amphor, when she got the card by mail - three days at hospital, operation and everything ended up around 11,000 baht. However we never claimed the money back, as I was happy to pay that rate for the service.

I had a friend using the public hospital at Samui for a small cosmetic operation, he never had time to make in his Scandinavian home country. He was very happy with the service and was charged 1100 baht only. I also have Thai friends using the free public hospitals and I always had a good impression from my visits.

So may well be, that some districts provide better hospital service than others?

I'm really happy that your friend got a cheap cosmetic operation, but would prefer if they give good treatment for life-threatening injuries which are very often either not recognized or not treated professionally. Ask my friend who was deliverd to the Samui hospital with severe head trauma after an accident and didn't get any treatment for 1 day, because there were no doctors available. But all these doctors are working many hours in their private clinics because they can hardly survive on the governement salary.

[Berek]

"Dr Timothy G Evans from the BRAC University's School of Public Health said research on the implementation of the decade-old universal healthcare scheme found that the scheme covered up to 75 per cent of Thai population."

Tim better head to Australia because he's obviously never heard of Medicare covering 100% of the Oz population.... And we don't have to pay the nurses ourselves to look after us in the public hospitals.

[Bagwan]

A friend who was unable or unwilling to pay what the private hospitals around Pattaya quoted for a knee reconstruction/repair, him took himself off to the Queen Sirikit at Sattahip. There he saw a surgeon who he had met previously at one of the aforementioned hospitals and was quoted a very acceptable price, a fraction of what he had previously been quoted. However the surgeon made it clear that he required an additional 40K baht 'under the table'. My friend had no complaints about how he was treated or the lack of services although he felt moved to send out for farang food.

From my observations of the QS it appears to provide a good service but the Government hospital at Lomsak reminded me of pictures of a Nazi concentration camp. Both my sister in law and step daughter delivered their babies there and they both said that the nursing service noticeably improved after I visited them. I assume they noted that a farang was part of the family and therefore the bill would be paid in full. It wasn't expensive but it wasn't 30 baht either.

I have yet to find a private hospital in Thailand that employs a dietician. What and when you eat and drink plays a part in not getting sick in the first place and certainly assists in recovery. I assume that such specialists do not exist since the hospitals would rather you get ill and/or recover slowly so as to bump up their bills. Even handing out dietary advice sheets would be a welcome innovation.

I recently read a report that said the the Great American Public were now so overweight that for the first time the present generation will statistically have a shorter life span than its predecessors. It is noticeable that Thailand has no shortage of 'fatties', and I'm not thinking of farangs. Perhaps what passes for a Health Ministry here would take note of that - or not.

The problem with socialised medicine In the UK is that it has to be paid for and any increase in taxes or National Insurance contributions may well prove to be political suicide. THe NHS is a wonderful concept but is proving very difficult to contain the costs which rise as more 'wonder drugs' and sophisticated equipment become available. There are a multitude of things in Thailand that need to be changed before a decent helath service can be provided. As for any country copying the Thai model, anybody advocating that needs help.

[geriatrickid]

Now if they could only find a way to pay the doctors and nurses salary.........

Exactly!!! My partner is a respiratory physician working at a government hospital and sometimes has to go months without receiving his salary on time, which is already far less than a manager at McDonald's. He and several of his colleagues would have left this "exemplary model" already if they weren't tied down for years by predatory government contracts.

I sympathize and know that the physicians in in such circumstances also draw the worst work schedules as well. However, the argument that will be made in response is that it the physicians under such contracts have usually received government funds to pay for their education and training. Is there a better way? Yes. Unfortunately, the way these hierarchies go around the world, the older physicians with tenure and seniority are not going to be supportive. Residents and interns that work 24 -48 hour shifts and holidays are a mainstay of western hospitals and exploited junior physicians in Thailand is the way it is, especially when many of the older physicians have a vested interest in the hospitals and clinics where they work.

[baboon]

My wife was treated for cancer under the universal healthcare scheme at a hospital near Victory Monument. Her choice not mine. She saw no reason for private healthcare when she was entitled to free care. The treatment was basically the same as private hospitals, but the service and ward was rudimentary. A few of the medicines that were not on the list of essential medicines and as such not prescribed, we bought ourselves (fluoride tablets, anasthetic gel). But the basic treatment, surgery and radiotherapy were as would have been expected under private care.

This sums it up for me - not the best treatment but nothing more. But Christ, at least it is treatment! At least your average rice farmer is getting a chance to live these days!Thailand is on the right track in my opinion.

[toenail]

The Thai government health "care" means well but the stories above have proven that it isn't working and no one has mentioned how the hospitals are running up huge bills and the government does not quickly reimburse the hospitals. One need to realize that many of the "white collar" United Nation workers are not in touch with reality and fail to know what is really going on with issues.

[KKK]

The Thai healthcare system has NOT been around long enough to be judged as good or bad. Give it more time to settle in...at least 10 years.

[Chris Lawrence]

........ but how does this model work? Usual diatribe reporting by the Nation that hints at a topic but lacks real substance.

Then a truck load of personal experience, which only wastes time reading.

What makes this model any better than others from around the world?

Healthcare is one of the most important factors in any government budget. Maybe Thailand hasn't experienced the explosion of obesity, diabetes, heart conditions and other major western illnesses, but are heading that way via change in dietary habits? Education and health promotion are also important issues.

Just my 2 bob's

[dsprtliving]

Now if they could only find a way to pay the doctors and nurses salary.........

Exactly!!! My partner is a respiratory physician working at a government hospital and sometimes has to go months without receiving his salary on time, which is already far less than a manager at McDonald's. He and several of his colleagues would have left this "exemplary model" already if they weren't tied down for years by predatory government contracts.

I sympathize and know that the physicians in in such circumstances also draw the worst work schedules as well. However, the argument that will be made in response is that it the physicians under such contracts have usually received government funds to pay for their education and training. Is there a better way? Yes. Unfortunately, the way these hierarchies go around the world, the older physicians with tenure and seniority are not going to be supportive. Residents and interns that work 24 -48 hour shifts and holidays are a mainstay of western hospitals and exploited junior physicians in Thailand is the way it is, especially when many of the older physicians have a vested interest in the hospitals and clinics where they work.

Yes, it's true and he did study to receive his education and training on a government scholarship. Also, He never complains about the terribly long shifts and holiday work as that is just part of the job. However, if he or any scholarship recipient wants to pay back to exit the system then they are required to pay back twice the cost in full at the time of their resignation. So, he ends up having to work all night shifts, 7 day weeks and holidays at private hospitals just to make ends meet month to month. It's a sad state of affairs these health care providers often have to endure for years, so anyone that would suggest this is a model system to follow needs to take a closer look at how the system treats their employees.

[Pib]

Then a truck load of personal experience, which only wastes time reading.

I don't think first hand, personal experience which describes the medical service/product received as a waste of time to read. The end product of how well the patient was cared for and his perception of the service is a key factor in determining how good (or bad) a program is working. While the personal experience described to date has been a small sample size it never the less gives an indicator of the universal health care program. A program can look great on paper but the actual product/service may suck (or vice versa).

Edited January 26, 2012 by Pib

[Stevenredd]

This same model where even the most perfunctory of preventative medicine is not covered by insurance? Preventative care being the focus of their conversation, but you darn well better be able to pay for it out of pocket because insurance doesn't cover it. I know, I have Thai and Farang co-workers and we all suffer with that detail. Just because the entire economy is slanted away from the rest of the world making most things cheaper (unless you don't know how to bargain) doesn't mean that it's a better system. Just relatively cheaper to others. Once again, western eyes looking at Asia with rose colored glasses. Stupid. Most health care here is done in the ER.

Not an organized, orderly or useful system at all. Most of my co-workers just take care of themselves. One women (Thai, with an MBA, mind you) had Dengue. Went to the doctor once, some treatment, but mostly, "stay home and rest." Which is all you can do.

Does anyone in journalism here understand anything about due diligence in reporting?

[JohnAllan]

The UK has had its national health scheme for over 60 years. It would, perhaps, have been more sensible were the WHO to have studied that, with all its perfections and imperfections, than a scheme that is still in its relative infancy.

And I the last time I checked, Maureen was not a man's name . . .

[slapout]

They might get a more rounded view of the Thai health care system if they go to the villages/government hospitals and see how it actually works. It may look impressive on paper/theory but having watched the diagonses, treatment and subsquent death of 4 inlaws in the past 6 years, it does not appear to set any high standard.

I wonder how close they checked on the accounting of monies, drugs, medicines, etc going into and out of the system, as well as treatments?

[gregb]

Now if they could only find a way to pay the doctors and nurses salary.........

Exactly!!! My partner is a respiratory physician working at a government hospital and sometimes has to go months without receiving his salary on time, which is already far less than a manager at McDonald's. He and several of his colleagues would have left this "exemplary model" already if they weren't tied down for years by predatory government contracts.

I sympathize and know that the physicians in in such circumstances also draw the worst work schedules as well. However, the argument that will be made in response is that it the physicians under such contracts have usually received government funds to pay for their education and training. Is there a better way? Yes. Unfortunately, the way these hierarchies go around the world, the older physicians with tenure and seniority are not going to be supportive. Residents and interns that work 24 -48 hour shifts and holidays are a mainstay of western hospitals and exploited junior physicians in Thailand is the way it is, especially when many of the older physicians have a vested interest in the hospitals and clinics where they work.

Yes, it's true and he did study to receive his education and training on a government scholarship. Also, He never complains about the terribly long shifts and holiday work as that is just part of the job. However, if he or any scholarship recipient wants to pay back to exit the system then they are required to pay back twice the cost in full at the time of their resignation. So, he ends up having to work all night shifts, 7 day weeks and holidays at private hospitals just to make ends meet month to month. It's a sad state of affairs these health care providers often have to endure for years, so anyone that would suggest this is a model system to follow needs to take a closer look at how the system treats their employees.

While I can accept nobody likes to be in debt, the fact is nobody forced your friend to accept that scholarship. Given that a reasonable interest rate will cause a debt to double every 7-10 years, it is not unreasonable for the government to demand twice the scholarship fee back when the student wishes to terminate the contract. On average, it probably works out about right. I have a hard time considering that to be mistreatment of employees.

Your friend is quite welcome to get a private loan, pay off his student debts, and work anywhere of his choosing with a traditional crippling loan if he doesn't like the current scheme. Nobody put a gun to his head. The government scholarship program provides opportunities for the poor to have a top quality, overseas education with the understanding that people who accept the money will use what they learned for the benefit of the Thai people. It is actually a very good system and one that I am happy the government employs. I have a friend who is a brilliant electrical engineer and with that scholarship scheme you malign it would never have been possible for him to reach his potential. Yes, he now has to work long hours at a state university for exceedingly low pay, but it gave him a chance he otherwise wouldn't have had, and his students are now benefiting from that.

It is important to separate the scholarship program from the universal healthcare scheme. The fact that a product from the former work in the latter to pay off their debt to the state does not mean that it is appropriate to link the two. They are very different things.

[philw]

Gregb, thanks for a clear and accurate post.

Appreciated.

Is it correct that the employment obligation is something like 5 years ??

[MaiChai]

My girlfriend was very sick last year and we were given a very bumpy ride. Basically they won't treat you until you pay up front. In some instances she was in an emergency situation; same story, not payment upfront no treatment. It was a terrible time and we are both still emotionally scarred by the experience.

Latest horror story: girlfriends grandmother gets an op on her back. Again the same story; no payment in advance no operation. So we send the money and she gets the op. She hasn't woken up from the op yet and its been 5 days. What was the reason? They wanted more money upfront before they would give her a certain medicine to wake her up. This is a terrible way to treat people. So if she doesn't wake up do we sue the hospital for malpractice?

The Thais can keep their health system. While they are patting themselves on the back saying what a wonderful system they have, the reality is that there are alot of mistakes being made, lack of ethics when it comes to charging, and simply alot of people are dieing as a result. Something needs to be done about the system.

If I get sick, I will book myself on a flight straight away to the UK and get treated there. I have paid my tax in the UK and am entitled to care under the NHS.

Thailand is not the paradise some of you think it is.

Edited January 27, 2012 by MaiChai

[hellodolly]

Well the WHO just took a nose dive in my respect for them.

Do they even know what Thailand is doing never mind all the talk?

[wxyz]

They may as well cite the N Korean model.

Edited January 28, 2012 by wxyz

[metisdead]

Posting in all capitals or in all bold, and using large or unusual fonts and colors is bad netiquette. One post using all caps and a reply have been removed.

[TheKeeNok]

Stupid question, but I assume a foreigner married to a Thai would not be allowed to part take in the system. I guess you could use the $1 a visit system if u took up Thai nationality!

[Pib]

My girlfriend was very sick last year and we were given a very bumpy ride. Basically they won't treat you until you pay up front. In some instances she was in an emergency situation; same story, not payment upfront no treatment. It was a terrible time and we are both still emotionally scarred by the experience.

Latest horror story: girlfriends grandmother gets an op on her back. Again the same story; no payment in advance no operation. So we send the money and she gets the op. She hasn't woken up from the op yet and its been 5 days. What was the reason? They wanted more money upfront before they would give her a certain medicine to wake her up. This is a terrible way to treat people. So if she doesn't wake up do we sue the hospital for malpractice?

The Thais can keep their health system. While they are patting themselves on the back saying what a wonderful system they have, the reality is that there are alot of mistakes being made, lack of ethics when it comes to charging, and simply alot of people are dieing as a result. Something needs to be done about the system.

If I get sick, I will book myself on a flight straight away to the UK and get treated there. I have paid my tax in the UK and am entitled to care under the NHS.

Thailand is not the paradise some of you think it is.

Unfortunate news regarding the girlfriend and grandmother, but they must have opted for care outside the universal healthcare/gold card program (i.e., private care whether at a public hospital or not) as there is no upfront payment required for covered services under the gold program/universal healthcare...the govt reimburses/pays the hospital for care under the universal health care program.. When going to a hospital for care they would have had to told the hospital up front whether they are applying for care under the gold program which would pay the bill and also set what services are covered, or told the hospital they will be paying. This is the first administrative thing that happens when walking into a hospital for care....that is, what insurance program will you be using, are you paying, etc. Sounds like in GF and grandmother's cases it was pure private care, no insurance coverage of any kind to include not using the govt gold card program.

[metisdead]

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[Naam]

Latest horror story: girlfriends grandmother gets an op on her back. Again the same story; no payment in advance no operation. So we send the money and she gets the op. She hasn't woken up from the op yet and its been 5 days. What was the reason? They wanted more money upfront before they would give her a certain medicine to wake her up.

no fairy tales please!

[softgeorge]

The Hospital and Health care system is light years ahead of anything that Australia has to offer. Australia should be looking at the thai system and the high standard that it has. Australia doesn't even have a dental scheme and the cost of attending a dentist is way out of reach for the average Australian.

[MaiChai]

Update on the grandmother. She has now woken up now that money has been give to the hospital and the medicine has been released to the patient. She had a slipped disc in her spine, which they had tried to treat for a year without any success. So an op was required.

My girlfriend was livid and was threatening to sue to hospital if anything happened to her grandmother.

This is a true story. Get sick and try the system yourself if you don't believe me. Best system in the world; who are they kidding?

Since my girlfriend was very ill last year, I took out insurance before I came over, simply because the situation is no longer the same as before. Health care can become very expensive in Thailand now. In the past I never bothered with insurance because treatment was very cheap here. Each of my children were delivered in hospital for 6000 baht. Hate to think how much it would cost now. As a comparison, my daughter just spent a night in a hospital outside Bangkok with a temperature; that was 4000 baht.

Edited January 29, 2012 by MaiChai

[endure]

If I get sick, I will book myself on a flight straight away to the UK and get treated there. I have paid my tax in the UK and am entitled to care under the NHS.

If you've lived outside the UK for more than 90 days you're entitled to the same care as any visiting foreigner - A&E treatment and that's about it.

[Siam Simon]

If I get sick, I will book myself on a flight straight away to the UK and get treated there. I have paid my tax in the UK and am entitled to care under the NHS.

If you've lived outside the UK for more than 90 days you're entitled to the same care as any visiting foreigner - A&E treatment and that's about it.

If you're a UK passport holder and native speaker, how will they find out at the hospital that you present yourself at that you've been living abroad? Are such checks carried out by hospital admin personnel?