Do Poor Thais Have Free Medical?

[TallGuyJohninBKK]

The plastic surgeon I use also works as a consultant in a govt hospital, the dematologist I use is a teaching professor at Chula when not in his clinic, A heart surgeon I know who worked at a St louis also worked at chula hospital, The list goes on. Most but not all of the medical professionals among my wifes collegues work for the govt during the day then operate private clinics or work in private hospitals after hours.

This also mirrors my experience here, based on my ex being a nurse's aide at one of the larger private hospitals here in BKK... Very often, when I'd meet a Thai doctor in our socializing, I'd find out they're working days at one place and nights at the other, or 3 days at one place and 2 or 3 days at another place, splitting time among government and private hospitals. It does seem to be a very common thing among doctors you'll find at the various private hospitals.

[lemoncake]

"If employed and pay social security , medical is free and medicine is 30 baht."

Under social security, most medicines are free.

"However there is a caveat and they can only use hospitals in the province they are registered for the 30 baht scheme."

Normally true, but if they need some special treatment they can be referred to another hospital, even to one not in the same province.

"I am sure he does encourage you to see him in public , it's only human nature to get paid less "

Sarcasm aside, I don't think you thought this one through. Doctors will normally get the same money at the hospitals whether they see you or not. They will however, get additional funds if they see you at their clinic. That can save you time and money.

Terry

This is not the Western System, Doctors do not get paid the same in private and public, this is why doctors fee for surgery at Bangkok Hospital Bangkok is 130 000 baht, while the same surgery doctor fees at BNH Hospital is half that., i am sure at public hospital it will be even less.

Their fees vary on education as well as other things such as experience, place of fellowship etc

Even in the West, doctors do not get paid the same, in Australia people even with the highest insurance cover always get hit up with a "gap" payment, ie the difference between what insurance pays and what doctor charges.

Those who work in public hospital, get paid the government rebate, HOWEVER do not perform any surgery themselves, but have their "students" or whatever the name is for them do the surgery "under their supervision"

For just a visit, they also always charge the difference between what the government pays and fee they want to charge.

Are you writing (in bold) about Thailand or Australia?

i did not write anything in bold, you did

[chiangmaikelly]

"If employed and pay social security , medical is free and medicine is 30 baht."

Under social security, most medicines are free.

"However there is a caveat and they can only use hospitals in the province they are registered for the 30 baht scheme."

Normally true, but if they need some special treatment they can be referred to another hospital, even to one not in the same province.

"I am sure he does encourage you to see him in public , it's only human nature to get paid less "

Sarcasm aside, I don't think you thought this one through. Doctors will normally get the same money at the hospitals whether they see you or not. They will however, get additional funds if they see you at their clinic. That can save you time and money.

Terry

This is not the Western System, Doctors do not get paid the same in private and public, this is why doctors fee for surgery at Bangkok Hospital Bangkok is 130 000 baht, while the same surgery doctor fees at BNH Hospital is half that., i am sure at public hospital it will be even less.

Their fees vary on education as well as other things such as experience, place of fellowship etc

Even in the West, doctors do not get paid the same, in Australia people even with the highest insurance cover always get hit up with a "gap" payment, ie the difference between what insurance pays and what doctor charges.

Those who work in public hospital, get paid the government rebate, HOWEVER do not perform any surgery themselves, but have their "students" or whatever the name is for them do the surgery "under their supervision"

For just a visit, they also always charge the difference between what the government pays and fee they want to charge.

Are you writing (in bold) about Thailand or Australia?

i did not write anything in bold, you did

Ya that was the question. Was the part I put in bold referencing Thailand as per the topic of the thread or about Australia. Sorry but anyone reading the post could have seen that I put it in bold. To those I confused I profusely apologize. But my question is..., "you wrote, "Those who work in public hospital, get paid the government rebate, HOWEVER do not perform any surgery themselves, but have their "students" or whatever the name is for them do the surgery "under their supervision" For just a visit, they also always charge the difference between what the government pays and fee they want to charge."

Edited January 13, 2013 by chiangmaikelly

[samran]

Have to say for all the bickering, that for a 3 rd world country Thailand makes many western countries look bad. Not only do they have free medical [ think the 30 Baht payment has gone'] but they have free dental and optical.

Go to Australia and go on the dentist list for free care, 5 years if you are lucky.

Most Doctors work in the public system because the Government paid for their education and they have to pay it back by working in the public system.

Being poor anywhere in the world will not get you the best medical care, but at least here you will get care.

Jim

Indeed what you say is true.

A bit off topic, in OZ it is inexplicable as to why Medicare stops at the mouth. I'm a big fan of it having seen family members have to go through some pretty tough stuff over the past 3 years (down in OZ) and can't complement the system enough now.

As for Thailand - you are right, the care is there and available. Not always great, but at least passable. Now if we can only get preventative medicine as a priority here...

[chiangmaikelly]

Have to say for all the bickering, that for a 3 rd world country Thailand makes many western countries look bad. Not only do they have free medical [ think the 30 Baht payment has gone'] but they have free dental and optical.

Go to Australia and go on the dentist list for free care, 5 years if you are lucky.

Most Doctors work in the public system because the Government paid for their education and they have to pay it back by working in the public system.

Being poor anywhere in the world will not get you the best medical care, but at least here you will get care.

Jim

Indeed what you say is true.

A bit off topic, in OZ it is inexplicable as to why Medicare stops at the mouth. I'm a big fan of it having seen family members have to go through some pretty tough stuff over the past 3 years (down in OZ) and can't complement the system enough now.

As for Thailand - you are right, the care is there and available. Not always great, but at least passable. Now if we can only get preventative medicine as a priority here...

I think I get it. Both you and Lemon are talking about health care in Australia right? A five year wait at the dentist and students doing surgery in Australia makes Thailand look pretty good is that the connection?

Edited January 13, 2013 by chiangmaikelly

[harrry]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

[chiangmaikelly]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

I didn't bring it up. I was trying to find the connection to Poor Thais having free medical.

[lemoncake]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

[lemoncake]

Ya that was the question. Was the part I put in bold referencing Thailand as per the topic of the thread or about Australia. Sorry but anyone reading the post could have seen that I put it in bold. To those I confused I profusely apologize. But my question is..., "you wrote, "Those who work in public hospital, get paid the government rebate, HOWEVER do not perform any surgery themselves, but have their "students" or whatever the name is for them do the surgery "under their supervision" For just a visit, they also always charge the difference between what the government pays and fee they want to charge."

I am sorry if you can not express yourself, do not start to point fingers

Your question was and i quote "Are you writing (in bold) about Thailand or Australia?"

If you had posted "the bold part of the post is about Thailand or Australia?" then it would have been appropriate question.

Yes that part WAS about Australia and i have a feeling it is no different to any other country.

Surgeons or doctors working in public hospital do not get anywhere near the same as working in private hospital, there is a reason why everything cost crazy money when going private compared to public, not to mention level of qualified surgeons and level of their qualifications.

From personal experience few years ago in Thailand, i had to have shoulder surgery and naturally wanted to save some money, so the first stop was a public hospital where shoulder surgeon poked my shoulder with the dumbest expression on his face and stated he would do it for 120 000 baht, though english fluency was very poor so as was the confidence.

Next stop was Bangkok Hospital Bangkok, where price was 330 000 baht, surgeon was fluent in English, Masters from USA, fellowship from USA, member of Asian shoulder group etc etc etc.

I went private and paid 330 000, a friend of mine had the same injury and had the same surgery public for 120 000.

I have tiny, hardly visible scars, his body looks like a butcher had a party.

I recovered and gained mobility after 1 year, he took 3.5 years and still some pain.

[simple1]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

I've had three hand surgery operations via private medical insurance in Oz - all no gap & operation carried out by the same consulting orthopaedic surgeon. Two year waiting period if under Medicare, private care within two weeks of initial appointment

Edited January 13, 2013 by simple1

[harrry]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

What is your evidence for this assertation. Are you Australian as this refers to surgery in Australia?

My statement is based on at least four cases in which I have been awake through the procedure as I am a high risk patient for anaesthesia. THe operations were ..cateract, Removal of a lump inide the chest wall. Removal of wiring following severe compound arm fracture repair.

added......I see you now based it on a feeling you have....great evidence...

Edited January 13, 2013 by harrry

[lemoncake]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

I've had three hand surgery operations via private medical insurance in Oz - all no gap & operation carried out by the same consulting orthopaedic surgeon. Two year waiting period if under Medicare, private care within two weeks of initial appointment

Those are the "insurance doctors" a large majority do not work under the same scheme

[simple1]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

I've had three hand surgery operations via private medical insurance in Oz - all no gap & operation carried out by the same consulting orthopaedic surgeon. Two year waiting period if under Medicare, private care within two weeks of initial appointment

Those are the "insurance doctors" a large majority do not work under the same scheme

Not this guy, he also worked at the local government hospital, mostly A&E

Edited January 13, 2013 by simple1

[lemoncake]

It is not true that only students do surgery in Public Hospitals in Australia. There are some teaching hospitals and in some cases students do do surgery under supervision as in most countries but there are many cases in which the surgery is performed by the surgeons themselves.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

What is your evidence for this assertation. Are you Australian as this refers to surgery in Australia?

My statement is based on at least four cases in which I have been awake through the procedure as I am a high risk patient for anaesthesia. THe operations were ..cateract, Removal of a lump inide the chest wall. Removal of wiring following severe compound arm fracture repair.

added......I see you now based it on a feeling you have....great evidence...

Yes i am and my mother just had cancer surgery, and i can tell you if you interested the chain of events which you would not normally know, but i had lawyers involved so learned a few things.

When i lived in Oz, i had a few surgery's myself in private and public, the same surgery and can tell you the next day the difference was huge, when asked why it was different, the surgeon advised that when private he did it personally when public he was present at all times but was one of his team, not him personally

[lemoncake]

Not this guy, he also worked at the local government hospital, mostly A&E

All doctors in Oz work in public hospitals but not all accept fees determined by the insurance and government. Example

Some charge $180 for visit, medicare or insurance rebate is $120. Some will accept the $120 and some will want the $60 extra

[Sheryl]

In teaching hospitals everywhere and regardless of whether the patient is private pay/private insurance or under a government scheme, it is standard practice for interns and residents to assist during surgeries and to perform elements of it themselves at the discretion of (and under the direct observation of) the attending surgeon.

How much is delegated to them varies with the attending surgeon and his/her degree of confidence in them.

In a public hospital one usually cannot choose one's doctor and thus will not know -- at least not unless you specifically ask -- who the attending surgeon will be..it will not necessarily be the head of the department.

[simple1]

Not this guy, he also worked at the local government hospital, mostly A&E

All doctors in Oz work in public hospitals but not all accept fees determined by the insurance and government. Example

Some charge $180 for visit, medicare or insurance rebate is $120. Some will accept the $120 and some will want the $60 extra

// Off topic comments removed //

Getting back on topic Thai government hospitals have varying levels of quality of service. Poor Thais I know in the Pattaya area have a fear of Bunglamung Hospital under the 30 baht scheme & if they can borrow the money to go to the likes of the "Red Cross" government hospital in Sri Racha that is better equipped and have to pay for medicines.

Edited January 13, 2013 by metisdead

[lemoncake]

In teaching hospitals everywhere and regardless of whether the patient is private pay/private insurance or under a government scheme, it is standard practice for interns and residents to assist during surgeries and to perform elements of it themselves at the discretion of (and under the direct observation of) the attending surgeon.

How much is delegated to them varies with the attending surgeon and his/her degree of confidence in them.

In a public hospital one usually cannot choose one's doctor and thus will not know -- at least not unless you specifically ask -- who the attending surgeon will be..it will not necessarily be the head of the department.

Agree 100%, though i think you will find when its private, the residents assist the surgeon, when public, its vice versa the surgeon assists residents.

Does not mean residents do a bad job, but just like with anything else, a more skilled professional gets the job done faster, cleaner and nicer looking result.

Little things like steady hand(less chance of internal cuts), smaller stich, etc etc etc

Edited January 13, 2013 by lemoncake

[metisdead]

An off topic post has been removed.

[simple1]

In teaching hospitals everywhere and regardless of whether the patient is private pay/private insurance or under a government scheme, it is standard practice for interns and residents to assist during surgeries and to perform elements of it themselves at the discretion of (and under the direct observation of) the attending surgeon.

How much is delegated to them varies with the attending surgeon and his/her degree of confidence in them.

In a public hospital one usually cannot choose one's doctor and thus will not know -- at least not unless you specifically ask -- who the attending surgeon will be..it will not necessarily be the head of the department.

Some months ago you posted an excellent overview, that I cannot locate, of how Thai government hospitals are structured in the Provinces and the quality of care according to the type of hospital.. Are you able to pin in the relevant topic forum as their are numerous debates on this matter. I believe it would be useful for forum members, especially those with Thai partners/families.

[Sheryl]

As in most countries, the Thai public health system has different tiers of hospitals. The lowest tier is the District Hospital (which is what Bunglamung is). These are very basic and have very limited facilities...sometimes only 1 physician (usually a new graduate) and liittle or nothing in terms of laboratory or Xray etc. Some district hospitals located in towns with unusually large populations are better equipped than average but still nothing like the next level up which is the:

Provincial Hospital - located only in provinical capitals (so for Pattaya this would be Chonburi). These are a very large step above District Hospitals; they can do a wide range of general surgery and have large inpatient capacities, full laboratory and imaging (though usually not CT or MRI, just sonogram and Xray).

Selected Provincial Hospitals are designated as Regional Hospitals, these offer specialized services like cancer chemotherapy to a group of provinces. They are usually affiliated with a medical school and have a wide range of specialists.

And then there are the National Hospitals in Bangkok which offer the highest level of care.

One disadvantage of the "30 baht" scheme is that people have to register at the nearest govt hospital and cannot self refer to a higher level than the one they are registered in, they have to be referred by the hospital. Thois who happen to live in an ampur muang will be registered at a provincial hospital to begin with so not as much problem as for those who live outside it.

We farangs, while not eligible for the free care, have the advantage of being able to go directly to whatever level/hospital we want. In almost all cases this will be at least a provincial hospitals. Unless it is a simple wound/tetanus shot or the like District Hospitals are best avoided.

(A Thai CAN also go straight to a higher level without referral but then they'd have to self pay).

[TerryLH]

“This is not the Western System, Doctors do not get paid the same in private and public…”

Didn’t say it was. My comment referred to the difference between a hospital and a clinic.

“Those who work in public hospital, get paid the government rebate, HOWEVER do not perform any surgery themselves, but have their "students" or whatever the name is for them do the surgery "under their supervision"”

In Thailand, where this topic was started for, not all doctors have ‘students’. That would be in the teaching hospitals. The same place all those very good doctors who are so much better than…, learned their skills.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

Is that referring to Aus or Thailand?

If Thailand, it doesn’t seem that you understand the system very well.

If Aus, I guess Thailand gets a gold star for transparency.

Terry

[lemoncake]

“This is not the Western System, Doctors do not get paid the same in private and public…”

Didn’t say it was. My comment referred to the difference between a hospital and a clinic.

“Those who work in public hospital, get paid the government rebate, HOWEVER do not perform any surgery themselves, but have their "students" or whatever the name is for them do the surgery "under their supervision"”

In Thailand, where this topic was started for, not all doctors have ‘students’. That would be in the teaching hospitals. The same place all those very good doctors who are so much better than…, learned their skills.

Surgeon himself will ONLY do the surgery himself if customer/patient pays his fees ie the full asking price not the insurance or government rebate.

It is not uni students who do the surgery under supervision, but doctors under his wing, ie the ones already out of uni.

If you believe the surgeon himself does it, you will be very mistaken, though no one would tell you who actually did the surgery.

Is that referring to Aus or Thailand?

If Thailand, it doesn’t seem that you understand the system very well.

If Aus, I guess Thailand gets a gold star for transparency.

Terry

When i said students, i also did say or "whatever you call them" meaning resident doctors or less experienced doctors

[ravip]

IMHO I think anywhere in this planet if you are poor you get the most rotten treatment. It does not matter where. Free medical treatment is available in certain countries, but...

Ironically, the super rich too get scammed with medical issues too. After spending millions, maybe billions they depart to meet their creator.

Sometimes I wonder, where would you be 100% safe and get a super deal when you are sick? Especially, when it is real serious.

e.g http://www.telegraph.co.uk/health/healthnews/9827116/Mid-Staffs-scandal-dummy-taped-to-babys-mouth.html