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Many Doors Still Closed To Bangkok's Sick, Poor


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Many doors still closed to capital's sick, poor

The Nation

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The 43-year-old man was sleeping on Bangkok's streets without a home and without hope.

BANGKOK: - His emaciated body, constant vomiting and diarrhoea clearly testified to his frail health, but no help was forthcoming from a hospital designated to provide free medical treatment for men like him.

Chukiat Sittipaisanseri collapsed in a chair in the waiting room of the privately run hospital in Min Buri district last Friday.

Doctors and nurses had paid little attention to him.

"We sent him there in the hope of ensuring he could get the medical treatment he needed. But at the hospital, he was sent to an X-ray room and nothing more," Sittipon Chuprajong of the Mirror Foundation said.

Although the hospital is a private facility, it has participated in the government-initiated universal healthcare scheme.

Sittipon tried to fight for Chukiat's right to treatment at the hospital but an on-duty doctor simply said he could find no indication the patient needed treatment.

"I asked whether the hospital would pay attention to just the haves, not the have-nots. He asked back if I had money," Sittipon complained.

Such sad cases, according to stories told among friends and acquaintances, are not uncommon. Even after the government promised access to healthcare for all, the underprivileged still battle against diseases very much on their own.

To the homeless like Chukiat, the battle is bitter. It was, most of the time, lonely.

His plight caught the attention of the Mirror Foundation after someone alerted this charity organisation about the ailing man on Bangkok streets.

"We went to check on him and found him languishing on Sukhumvit Soi 38," Sittipon said.

After his decision to send Chukiat to the private hospital did not deliver the intended result, Sittipon called the Prachabodi Centre for help. The centre has been operating under the supervision of the Social Development and Human Security Ministry.

"He's in serious condition," the centre's social worker Mongkhon Srisang said.

He too wondered why the private hospital had decided not to provide treatment for Chukiat.

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-- The Nation 2012-05-15

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Why a private hospital doesn't provide non-emergency care to patients isn't the question. It should be why didn't they arrange for transport to a government hospital? That and what is that blue crap on the floor.

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Why a private hospital doesn't provide non-emergency care to patients isn't the question. It should be why didn't they arrange for transport to a government hospital? That and what is that blue crap on the floor.

The patient was most likely taken to the hospital because it was the designated reception center for the patient.

Has it occured to you that the public hospital may have been inadequately staffed, or suffering from crowding ?

You do realize that these private hospitals do benefit from government subsidies don't you? Despite the use of the term "private", this does not mean that these hospitals pay their way. They benefit from the government procurement program for drugs and the cost ceilings imposed on various drugs.

Feel free to go and mop the remnants of the slurpee up.

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No surprise from an administration which is primarily focused on bringing their self-exiled puppetmaster back to Thailand. The rest of the time, they're either eating food, tending to their mia noi, playing golf or planning their next whiskey fest, with an occasional all-expenses paid visit to Europe in the guise of government business (stuffing money in numbered accounts, maybe?).

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Why a private hospital doesn't provide non-emergency care to patients isn't the question. It should be why didn't they arrange for transport to a government hospital? That and what is that blue crap on the floor.

This was my immediate thought too...why not a gov't hospital? Seems like hidden agenda with this scenario...as for the blue stuff.... :huh:

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And Thailand likes to call itself a first word country. What a f@#$%^g joke! bah.gif

I've never seen anyone claim that. The term these days is "developing".

And this sort of thing also happens in the US, which fact is of course is even more of a "joke" - not.

What?

The poor cannot afford 30 baht?

Do you have any compassion?

I think the point is that this doctor/hospital was refusing to give effective treatment to this patient under that scheme?

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Why a private hospital doesn't provide non-emergency care to patients isn't the question. It should be why didn't they arrange for transport to a government hospital? That and what is that blue crap on the floor.

The patient was most likely taken to the hospital because it was the designated reception center for the patient.

Has it occured to you that the public hospital may have been inadequately staffed, or suffering from crowding ?

You do realize that these private hospitals do benefit from government subsidies don't you? Despite the use of the term "private", this does not mean that these hospitals pay their way. They benefit from the government procurement program for drugs and the cost ceilings imposed on various drugs.

Feel free to go and mop the remnants of the slurpee up.

What are you talking about? This person was not dying. he was checked out and x-rayed. He has no insurance and no means to pay for a PRIVATE hospital and the way it is set-up in Thailand is one needs to go to their GOVERNMENT hospital unless it is an emergency.

Crowding?????????????????????? Where is there not crowding when somebody goes to a free hospital? Does that mean everyone has the right to go to a privately run for profit facility in non-emergency situations? Of course not. Not only that, the lines and wait times are not nearly generaly that long here at a public hospital than a private hospital in the US or those offering free care in the west.

The only thing this hospital should have done, if he didn't have his own means, was to arrange for him to get to a public hospital AFTER the determined it was not an emergency situation and he was stable.

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Thailand's class system is fairly rigidly enforced, but one cannot be blind to the fact that these government 'schemes' are completely unrealistic. The Thai government (over the last two decades), has chosen to pursue a dual private-public healthcare system that enables the wealthy to afford world-class healthcare. That quality cannot be offered for free, under any circumstances. The United States is an excellent example of this problem. Free healthcare models have significantly reduced quality and availability of care so that the society at-large can access them. It's a cost-benefit choice. The PTP initiative is quixotic at best. Thaksin's policies have already taxed an overburdened healthcare system. It reminds me of Thaksin's proposal, earnestly delivered, to the Swedish government that Thailand trade chicken meet for Saab fighter planes. Someone has checked out of reality.

Edited by Unkomoncents
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I think the point is that this doctor/hospital was refusing to give effective treatment to this patient under that scheme?

A private hospital is not under this scheme and only obligated to provide emergency treatment. The examined him and x-ray'd him and determined there was no emergency and am sure told him to go to a government facility or it was clearly known. I only have fault with their not arranging for him to get there if he couldn't on his own but apparently he did get there.

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Thailand's class system is fairly rigidly enforced, but one cannot be blind to the fact that these government 'schemes' are completely unrealistic. The Thai government (over the last two decades), has chosen to pursue a dual private-public healthcare system that enables the wealthy to afford world-class healthcare. That quality cannot be offered for free, under any circumstances. The United States is an excellent example of this problem. Free healthcare models have significantly reduced quality and availability of care so that the society at-large can access them. It's a cost-benefit choice. The PTP initiative is quixotic at best. Thaksin's policies have already taxed an overburdened healthcare system. It reminds me of Thaksin's proposal, earnestly delivered, to the Swedish government that Thailand trade chicken meet for Saab fighter planes. Someone has checked out of reality.

What country with free healthcare also doesn't have private options available? And the US doesn't have free healthcare. They have certain things were certain people will qualify for certain care. Even the elderly in the US are not afforded free healthcare and need to pay out of pocket or pay extra for basic care.

Healthcare should be a basic human right. In my mind it should come before paying for police protection. I would much rather be responsible for protecting my proper, myself and my family than having to be responsible to perform surgery on a family member. However, free healthcare doesn't mean you should have world class care or private suites at the hospital just as you don't get an armed cop stationed at your front door when you sleep but those with the ability can pay for such security.

I think Thailand's healthcare system is great given this country's current place in growth.

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Thailand's class system is fairly rigidly enforced, but one cannot be blind to the fact that these government 'schemes' are completely unrealistic. The Thai government (over the last two decades), has chosen to pursue a dual private-public healthcare system that enables the wealthy to afford world-class healthcare. That quality cannot be offered for free, under any circumstances. The United States is an excellent example of this problem. Free healthcare models have significantly reduced quality and availability of care so that the society at-large can access them. It's a cost-benefit choice. The PTP initiative is quixotic at best. Thaksin's policies have already taxed an overburdened healthcare system. It reminds me of Thaksin's proposal, earnestly delivered, to the Swedish government that Thailand trade chicken meet for Saab fighter planes. Someone has checked out of reality.

What country with free healthcare also doesn't have private options available? And the US doesn't have free healthcare. They have certain things were certain people will qualify for certain care. Even the elderly in the US are not afforded free healthcare and need to pay out of pocket or pay extra for basic care.

Healthcare should be a basic human right. In my mind it should come before paying for police protection. I would much rather be responsible for protecting my proper, myself and my family than having to be responsible to perform surgery on a family member. However, free healthcare doesn't mean you should have world class care or private suites at the hospital just as you don't get an armed cop stationed at your front door when you sleep but those with the ability can pay for such security.

I think Thailand's healthcare system is great given this country's current place in growth.

Well, then, there isn't a problem, is there? I don't think I was suggesting that anything is free in the United States. I also don't think the argument that public-private healthcare models exist everywhere does any justice to the system that exists in Thailand. Compare Canada or Sweden to Thailand and then let's talk about the differences.

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Why a private hospital doesn't provide non-emergency care to patients isn't the question. It should be why didn't they arrange for transport to a government hospital? That and what is that blue crap on the floor.

The patient was most likely taken to the hospital because it was the designated reception center for the patient.

Has it occured to you that the public hospital may have been inadequately staffed, or suffering from crowding ?

You do realize that these private hospitals do benefit from government subsidies don't you? Despite the use of the term "private", this does not mean that these hospitals pay their way. They benefit from the government procurement program for drugs and the cost ceilings imposed on various drugs.

Feel free to go and mop the remnants of the slurpee up.

What are you talking about? This person was not dying. he was checked out and x-rayed. He has no insurance and no means to pay for a PRIVATE hospital and the way it is set-up in Thailand is one needs to go to their GOVERNMENT hospital unless it is an emergency.

Crowding?????????????????????? Where is there not crowding when somebody goes to a free hospital? Does that mean everyone has the right to go to a privately run for profit facility in non-emergency situations? Of course not. Not only that, the lines and wait times are not nearly generaly that long here at a public hospital than a private hospital in the US or those offering free care in the west.

The only thing this hospital should have done, if he didn't have his own means, was to arrange for him to get to a public hospital AFTER the determined it was not an emergency situation and he was stable.

It was a set up to make the hospital look bad by Sittipon Chuprajong of the Mirror Foundation they could just as easily taken him to a government hospital.

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I have had numerous opportunities to witness the care given at government hospitals under the universal care scheme. There is a long queue, and it is spartan, but it does provide a minimally effective service, and in life threatening situations even exceptional care at extremely low cost. In short, the existing system is working.

The universal health care scheme requires you to go to your designated hospital for treatment. All other hospitals, whether participating in the scheme or not, are only obliged to offer care as necessary in an emergency situation, and then only so far as is necessary to stabalize you and transport you to your designated hospital.

So there are 2 questions in this very poorly written article.

1. Was this Chukiat's designated hospital under the universal care scheme? It seems unlikely a hospital in Min Buri would be if the man typically lived in the lower Sukhumvit area. Gluay Nam Thai would have been a more likely choice.

2. Was there anything that should have been immediately obvious to a doctor examining him that his ailment was immediately life threatening? Since the article doesn't say that Chukiat died, my suspicion is that he was not in any danger of dying, and thus the doctor and the hospital were correct to reject treatment.

There are simple rules to follow, and while they can be frustrating at times, if you do follow them you get very basic care for free in Thailand. No, it is not top notch care at your convenience. That is never going to be available to everyone. But the point is that the universal care scheme in Thailand meets the "good enough" standard. Care beyond this is a want, not really a need.

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a number of years ago, I drove from California to southern Mexico. On my way back to the US, I had a festering staph infection on my hip. By the time I got Stateside, I went to an Arizona hospital. They wouldn't deal with me, even though I could barely walk at that time. I then went to a pharmacy and asked for antibiotics. They laughed. I then found two young girls at a fast food place and talked them in to going to their homes and bringing back some antibiotics. Surprisingly, they did that! I looked at the labels, and couldn't discern what was what, so didn't take any pills. I wound up driving the remaining several hundred miles to my home, nearly passing out several times on the hwy. When I got to my home town, the doctor told me that if I'd waited another day or two, I might have lost my leg at the hip, because the infection had gotten so bad. He injected some stuff in the wound, and I got healed. But it was a sobering glimpse at US health care attitudes at that time in Arizona. If I had gone in to shock on the floor of the hospital or the pharmacy, I doubt if anyone would have done anything to assist me. They'd probably just get a couple of Latinos to drag me outside - to get me out of the way.

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