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Thai Govt Urged To Rein In Prices Of Private Hospitals


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EMERGENCY CARE
Govt urged to rein in prices of private hospitals

Pongphon Sarnsamak
The Nation

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Malpractice network cites complaints about unnecessarily high charges

BANGKOK: -- The Medical Malpractice Victims' network yesterday called for Prime Minister Yingluck Shinawatra to set up a panel to control the cost of medical treatment at private hospitals.


This is after the network discovered that many patients end up having to pay huge amounts, especially for emergency care, even though some of them are eligible for the government's free emergency scheme.

The network's chairperson, Preeyanant Lorsermwattana, said she had received many complaints about the high prices at private hospitals over the past few years.

"There is no national agency to control the pricing strategy at private hospitals," she said, adding that controlling the way private hospitals charge for treatment would make things fair for everyone.

Preyanant yesterday submitted her petition to Yingluck, who was chairing a meeting at Government House with representatives of three national healthcare agencies to help improve the free emergency medical scheme.

Separately, Preeyanant also asked Yingluck to help Supakkini Achineethongkham, 53, who is in a critical condition after being hit by a car last year. After she was taken to a nearby hospital for emergency care, her husband Prasert was made to sign a bond to cover the bills even though the patient was eligible for the government's free emergency care scheme. "We were asked to sign a bond saying that we would pay Bt500,000 for medical bills even before my wife received immediate attention for a brain haemorrhage," Prasert noted in the letter. "I was frightened and had no choice but to sign the bond, because I wanted to save my wife's life."

Prasert ended up having to borrow Bt631,000 from the bank to cover the medical bills, and is now at home taking care of his wife and four young kids.

"The hospital told me that I would get the money back if it was reimbursed by the National Health Security Office [NHSO]," he added.

Since the scheme began on April 1, 2012, many private hospitals have been charging patients and getting them to sign a bond before providing emergency care. Of the 353 private hospitals across the nation, 241 signed up for the scheme last year.

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-- The Nation 2013-04-27

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For a foreigner it might look like the cost of medical treatment in Thailand is very cheap but the truth is that for the common Thai people is very, very expensive, specially when you go to a private hospital and buy ur medicine ther, the prices of something so simple as an antibiotic very often is 30 times more expensive than if you go to a normal drugstore and buy it for yourself, so hope the goverment improve this situation because this is something that is a very important issue for must of the people, amenwai2.gif

Edited by Om85
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There is also the issue medicine is a business as are hospitals. A recent op on a mate and 168,000 later and results of the lab tests showed only 20% of 'bits' removed was necessary. Insurance did not cover this 'type' of surgery according to the 'private' hospital. Misdiagnosis and over zealous surgeons making money. However, having said that, if entrepreneurs have the capital to set up a hospital they should be able to expect a ROI based on pricing etc. So the rates they charge are really at their behest. I don't think the govt has any say in this.

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I went to a private hospital in Feb, from falling 5 meters thru a roof. Broke both wrists and an ankle. They started off saying they would charge me an arm and a leg (pun intended), but wound up charging a bit less, due to pleading by some Thai friends. The final tally came down from nearly Bt.200k to around Bt.80k. I had accident insurance which took Bt.30k off that. Yet, when I mentioned the 80k to Thai friends, they all were aghast at the high price. They said that a Thai would have paid considerably less at the same private hospital. That's not counting the 30 baht public hospital, where a person with a broken limb might have to wait several days before getting it set in plaster.

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Review of Emergency treatment in Private Thai Hospitals

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BANGKOK: -- Private hospitals are to be brought into line with the government national health plan, which covers all Thai nationals for emergency treatment anywhere in the nation and in any hospital.

The health ministry has been reviewing claims that some private hospitals who receive emergency patients, many from motor accidents, demand pledges to be signed or money to be paid before emergency treatment is given, despite the regulations which assure them that the government plan will cover emergency treatment costs.

The Health service is concerned that delays in treatment could occur due to form filing and paperwork which is against their contract with the hospitals and a new pre-authorisation process is to be established whereby anyone from the richest to the poorest will be assured of emergency treatment without delay at any hospital in the kingdom.

Of particular interest to Foreigners with Thai families here, the National Health plan is designed to ensure that all Thai nationals, rich or poor, have the right to basic medical treatment from cradle to grave.

Full story: http://www.pattaya103.com/review-of-emergency-treatment-in-private-thai-hospitals/

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--Pattaya 103 FM 2013-04-27

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I went to a private hospital in Feb, from falling 5 meters thru a roof. Broke both wrists and an ankle. They started off saying they would charge me an arm and a leg (pun intended), but wound up charging a bit less, due to pleading by some Thai friends. The final tally came down from nearly Bt.200k to around Bt.80k. I had accident insurance which took Bt.30k off that. Yet, when I mentioned the 80k to Thai friends, they all were aghast at the high price. They said that a Thai would have paid considerably less at the same private hospital. That's not counting the 30 baht public hospital, where a person with a broken limb might have to wait several days before getting it set in plaster.

Different prices for non-Thais should be stamped out. Surely there is a Thai anti-discrimination law that covers this.

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A good law to pass would be to "allow" patients to purchase medicines outside the hospital, because many hospitals force you to buy it there at 4-5 times the normal price.

I've tried, asked doctor to only prescribe me the medicine and I will buy at 1/4 of the price at the a big drugstore very cheap. Doctor said "no cannot".

for example, I know that a anti-acid milk bottle costs only 60 baht at the drugstore, but I had to pay 300 baht for it at the hospital for the exact same brand and size. total rip-off.

Edited by brfsa2
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In some countries, i.e. Brazil, hospitals are not allowed to sell or use their drugs and medicine, except for surgeries and emergencies.

The doctor will only prescribe you the medicines, you have to go buy it by yourself on your favorite drugstrore and pick the brand of your choice.

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It seems like the article is confusing a couple of things which, to me, makes it feel like propaganda instead of unbiased reporting.

- private hospitals are private businesses who can set their own prices. If people do not want to pay those prices they should not go there. So complaining that you went to a private hospital and paid a lot does not make any sense to me; its like buying a Porsche and complaining it costs more than a Honda Jazz.

- when a private hospital signed a contract with the government that they would treat emergency patients, free emergency medical scheme, they should just do so. Hospitals trying to force patients to sign things first should be prosecuted and possible be closed down by the government (breach of contract). This has nothing to do with the prices they charge other patients for medical treatments though.

- hospital staff misinforming patients (telling them treatment is not covered by the free emergency medical scheme while it is, talking people into medical treatments they do not need, or misinforming people about medical treatments and their options) should be dealt with by the Thai medical board (if something like that exists) which might result in fines or closing down of the hospital. Again, this has nothing to do with the prices a private hospital charges a patient.

So I can see nowhere a link to the prices private hospitals charge and the problems mentioned in the article.

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The prices for Farangs has at least quadrupled in the last 10 years. I had an operation 10 years ago, and was in for 5 days at the BP Hospital, and paid only 110,000 Baht for every thing. My father rescently had to go in and have a tube put down his throat, stayed in one night, and they charge me 68,000 Baht. It is in the cases of emergency treatment that they really do rip us off. Again my father had to to the same hospital just over a year ago for respitory problems, and they started quoting 800,000 before they even knew what was wrong. It is a really hard descision when you don't have that sort of money to hand, and yet you have to take the wellbeing of family. I ended up paying just under 500,000 Baht for him to be monitored for 9 days, but no surgery was done. I really struggled to get the cash together, but what choice do we have once they are in there and under the clutches of these businessmen. Trying to save some money now for any future problems, but will also look at alternative hospitals.

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...

I've tried, asked doctor to only prescribe me the medicine and I will buy at 1/4 of the price at the a big drugstore very cheap. Doctor said "no cannot".

...

I have trouble understanding how they can force you to buy it. You give the prescription to the pharmacist in the hospital, and he would come back with 10 items. How exactly does he make you take all 10 items instead of you just picking up one bag and saying you don't want the rest and not paying for it?

I heard this of many people before in private hospitals where they prescribe you one medicine and also try to sell you stuff against all possible side-effects of your prescribed drugs. But everybody I know just turns that down and only pays for the drug they really need.

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First of all private hospitals in Thailand are a big rip off and they really are not that much better then the public ones in some case they can actually be worse but just look good. And as far as the Doctors in hospitals over prescribing the 2 main reasons they do it is one to make money and two the Thais actually want to go home with a lot of medication according to my Thai friends.

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The prices for Farangs has at least quadrupled in the last 10 years. I had an operation 10 years ago, and was in for 5 days at the BP Hospital, and paid only 110,000 Baht for every thing. My father rescently had to go in and have a tube put down his throat, stayed in one night, and they charge me 68,000 Baht. It is in the cases of emergency treatment that they really do rip us off. Again my father had to to the same hospital just over a year ago for respitory problems, and they started quoting 800,000 before they even knew what was wrong. It is a really hard descision when you don't have that sort of money to hand, and yet you have to take the wellbeing of family. I ended up paying just under 500,000 Baht for him to be monitored for 9 days, but no surgery was done. I really struggled to get the cash together, but what choice do we have once they are in there and under the clutches of these businessmen. Trying to save some money now for any future problems, but will also look at alternative hospitals.

I understand your frustration and how difficult making a decision like that can be, but how can you compare the costs of medical treatments based on the number of days in the hospital? That does not make any sense to me.

And you might want to consider going to a public hospital next time instead of a private one, that can make a huge difference in costs. Medical insurance might also be a good idea.

Bob. My dad is 86 and we can't get medical insurance for him. I know we can choose to go back to the UK, and all that, but we are happy here and just don't want to get ripped off. I also know it's not just about number of days, but if you look at the fact that there was no surgery, and basically just monitoring him, and charging neary a 1,000 GBP per day, it is a bit much. We were scared and not being medically minded, had to take them on evereything they said, so we were too scared to even try and move him to a cheaper hospital. There are alternatives, which I think we will follow in future.

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A good law to pass would be to "allow" patients to purchase medicines outside the hospital, because many hospitals force you to buy it there at 4-5 times the normal price.

I've tried, asked doctor to only prescribe me the medicine and I will buy at 1/4 of the price at the a big drugstore very cheap. Doctor said "no cannot".

for example, I know that a anti-acid milk bottle costs only 60 baht at the drugstore, but I had to pay 300 baht for it at the hospital for the exact same brand and size. total rip-off.

Private hospitals are no doubt ripping people off with what they charge for medicines. I think that's pretty clear when you can get the same items for a fifth of the price or less at local pharmacies.

I don't understand your statement above. If you knew what was being prescribed then why didn't you just not turn in the prescription and go buy the medicine outside the hospital. No hospital can force you to buy their medicine. I can understand if the prescription was mixed with controlled medicines that can only be purchased at a hospital by prescription. It would then be awkward or difficult to tell them, "OK, I want this item and this items, but not these". I usually get the hospital medicine because I just don't want to hassle with getting an explanation of exactly what's being prescribed so I can get the same thing at a local pharmacy, but maybe next time I should bother.

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I understand your frustration and how difficult making a decision like that can be, but how can you compare the costs of medical treatments based on the number of days in the hospital? That does not make any sense to me.

And you might want to consider going to a public hospital next time instead of a private one, that can make a huge difference in costs. Medical insurance might also be a good idea.

So I know there are Private Hospitals and Government Hospitals. Government Hospitals can be fine if it's not life threatening or an emergency and in certain cases they don't have good options for treatment whereas Private Hospitals are equipped with all the latest medical gadgets...they better be with what they charge these days.

So what Public Hospitals exist in Pattaya, if you know.

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First of all private hospitals in Thailand are a big rip off and they really are not that much better then the public ones in some case they can actually be worse but just look good. And as far as the Doctors in hospitals over prescribing the 2 main reasons they do it is one to make money and two the Thais actually want to go home with a lot of medication according to my Thai friends.

I'll agree with that. It has been my observation that if you aren't prescribed lots of different prescriptions then you aren't getting treated well...for Thais anyway. I feel the less medicine the better. They prescribe anti-biotics for every single tiny sore in this country. I'm surprised this country isn't crawling with anti-biotic resistance super-bugs yet.

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A good law to pass would be to "allow" patients to purchase medicines outside the hospital, because many hospitals force you to buy it there at 4-5 times the normal price.

I've tried, asked doctor to only prescribe me the medicine and I will buy at 1/4 of the price at the a big drugstore very cheap. Doctor said "no cannot".

for example, I know that a anti-acid milk bottle costs only 60 baht at the drugstore, but I had to pay 300 baht for it at the hospital for the exact same brand and size. total rip-off.

Well you are a bit weak then.

I usually get the list of medication prior to paying for it, usually at the same time the high price is delivered.

Then I tell them no medication and keep the list.

If they bitch about it, I tell them I will not pay for the doctor then as I came here to see a doctor and get his recommendation for treatment, not to be forced to take whatever I do not think is necessary or over priced.

Has not failed me yet.

Mind you, they still hit you up for the nurse care, the treatments and medicines and equipment used in the room if required.

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The prices for Farangs has at least quadrupled in the last 10 years. I had an operation 10 years ago, and was in for 5 days at the BP Hospital, and paid only 110,000 Baht for every thing. My father rescently had to go in and have a tube put down his throat, stayed in one night, and they charge me 68,000 Baht. It is in the cases of emergency treatment that they really do rip us off. Again my father had to to the same hospital just over a year ago for respitory problems, and they started quoting 800,000 before they even knew what was wrong. It is a really hard descision when you don't have that sort of money to hand, and yet you have to take the wellbeing of family. I ended up paying just under 500,000 Baht for him to be monitored for 9 days, but no surgery was done. I really struggled to get the cash together, but what choice do we have once they are in there and under the clutches of these businessmen. Trying to save some money now for any future problems, but will also look at alternative hospitals.

I understand your frustration and how difficult making a decision like that can be, but how can you compare the costs of medical treatments based on the number of days in the hospital? That does not make any sense to me.

And you might want to consider going to a public hospital next time instead of a private one, that can make a huge difference in costs. Medical insurance might also be a good idea.

Bob. My dad is 86 and we can't get medical insurance for him. I know we can choose to go back to the UK, and all that, but we are happy here and just don't want to get ripped off. I also know it's not just about number of days, but if you look at the fact that there was no surgery, and basically just monitoring him, and charging neary a 1,000 GBP per day, it is a bit much. We were scared and not being medically minded, had to take them on evereything they said, so we were too scared to even try and move him to a cheaper hospital. There are alternatives, which I think we will follow in future.

I have no doubt these private hospitals count on the fear people feel and their general lack of knowledge about medicine, to squeeze every baht they can out of people in desperate medical need. I agree that 500,000 baht for 9 days with no surgery is outrageous. Here's a question: Did they ever tell you what he had and do you know that they actually cured him or did they hymn and haw, give him anti-biotics and then sit back and pray. They probably could have done all of that as an outpatient and saved you a ton of money. They love to have people stay overnight for as many days as they can get you.

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Only read a few of the comments so excuse me if I'm repeating what someone else has already said. Medicine & healthcare as a business, Students studying medicine not to make a difference but to get rich, pharmaceutical companies being the end of the line for all those endless funnels, called Charities of which the Board &/or Chair persons have Corporate salaries.

Welcome to American medicine.

About time, Thailand got with the rest of the world.

I've had many medical procedures done in Bangkok, would say Phuket is the most expensive however. Though very expensive, still a fraction or at most 2/3 of what it would cost in America and that's Thailand's private network of specialists versus America's middle shelf. Inquired about a hand specialist in Los Angeles, just to talk to him (consultation, no tests) was quoted $1000 to $1400. At a prime private orthopedic hospital in Bangkok, the consultation, examination, X-ray & treatment (extremely painful, Thailand painkillers are absolutely ineffective) totaled roughly $200. After a week, my hand was fine.

In this world, as now, recessions will stay; falling currencies will continue & the raising baht...up to them. I would still prefer Thailand over my country anytime of any given year.

Didn't spell or grammar check, so please excuse any "simple English" - bionics.

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A good law to pass would be to "allow" patients to purchase medicines outside the hospital, because many hospitals force you to buy it there at 4-5 times the normal price.

I've tried, asked doctor to only prescribe me the medicine and I will buy at 1/4 of the price at the a big drugstore very cheap. Doctor said "no cannot".

for example, I know that a anti-acid milk bottle costs only 60 baht at the drugstore, but I had to pay 300 baht for it at the hospital for the exact same brand and size. total rip-off.

When I see my doc, and after the consultation is done and he write the prescription, I just go over

to the paying station and pay my doc bill and all other sundries I had incurred at that visit,

I than go out to my off hospital pharmacy and buy my medicine there, as no law prohibit you

from doing so, and no doctor can tell you where to purchase your meds, it's entirely up to you

and you are responsible to the outcome of those meds.

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The prices for Farangs has at least quadrupled in the last 10 years. I had an operation 10 years ago, and was in for 5 days at the BP Hospital, and paid only 110,000 Baht for every thing. My father rescently had to go in and have a tube put down his throat, stayed in one night, and they charge me 68,000 Baht. It is in the cases of emergency treatment that they really do rip us off. Again my father had to to the same hospital just over a year ago for respitory problems, and they started quoting 800,000 before they even knew what was wrong. It is a really hard descision when you don't have that sort of money to hand, and yet you have to take the wellbeing of family. I ended up paying just under 500,000 Baht for him to be monitored for 9 days, but no surgery was done. I really struggled to get the cash together, but what choice do we have once they are in there and under the clutches of these businessmen. Trying to save some money now for any future problems, but will also look at alternative hospitals.

Not just hospitals, but for many things in Thailand - farang will pay whatever is asked, right away. Thais know this, so they jack prices up high for us. Partial solution is for farang to contest, at least a bit, when a high price is quoted. If nothing else, than to let Thais know that some of us aren't automatically going to pay every quoted price right away with no outwardly-expressed qualms.

No one mentioned drugs: but Thai hospitals, with no exceptions, prescribe profusion of un-needed drugs, and they rarely consult with patients beforehand. Thais would never dispute prescribed drugs, because Thais are brought up to respect everything a doctor utters. Farang, however, can dispute prescribed drugs. I've done it many times, at the check-out counter of a hospital, and it's surprising how quick the dispensing girls comply with my insistence on not buying the prescribed pills. Often the staff will grin, perhaps thinking, "oh, this guy can see the folly of these doctors prescribing loads of un-needed pills willy nilly."

However, when I checked out with my recent broken bones (which had been set in plaster) I wasn't able to screen the load of drugs they prescribed because I wasn't right there at the dispensary. When I got home, I saw bunches of Tylenol and dozens of anti-biotic pills, plus several other things I wouldn't need. The bulging knapsack sized bag is still sitting there, with all the pills still in their packages. Anybody reading this wants to buy 1,000 unused pills, send me 200 baht and I'll mail them to you. I don't want to toss them in the trash, because antibiotics, in particular, play havoc on other species in the environment. Of course, the hospital won't take them back. Plus, all the hospitals are directly tied in with drug companies - all making money like bandits.

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It seems like the article is confusing a couple of things which, to me, makes it feel like propaganda instead of unbiased reporting.

- private hospitals are private businesses who can set their own prices. If people do not want to pay those prices they should not go there. So complaining that you went to a private hospital and paid a lot does not make any sense to me; its like buying a Porsche and complaining it costs more than a Honda Jazz.

- when a private hospital signed a contract with the government that they would treat emergency patients, free emergency medical scheme, they should just do so. Hospitals trying to force patients to sign things first should be prosecuted and possible be closed down by the government (breach of contract). This has nothing to do with the prices they charge other patients for medical treatments though.

- hospital staff misinforming patients (telling them treatment is not covered by the free emergency medical scheme while it is, talking people into medical treatments they do not need, or misinforming people about medical treatments and their options) should be dealt with by the Thai medical board (if something like that exists) which might result in fines or closing down of the hospital. Again, this has nothing to do with the prices a private hospital charges a patient.

So I can see nowhere a link to the prices private hospitals charge and the problems mentioned in the article.

there is a regulation that obliges the hospitals to treat emergency cases free of charge . this really isnt a bias report, in fact it has been covered in greater depth this weekend by the nationals here.

the issue is that some have been charging EMERGENCY patients.

you are of course correct on elective on non emergency treatment, you choose the rolls royce or kia version depending on your pocket.

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It seems like the article is confusing a couple of things which, to me, makes it feel like propaganda instead of unbiased reporting.

- private hospitals are private businesses who can set their own prices. If people do not want to pay those prices they should not go there. So complaining that you went to a private hospital and paid a lot does not make any sense to me; its like buying a Porsche and complaining it costs more than a Honda Jazz.

- when a private hospital signed a contract with the government that they would treat emergency patients, free emergency medical scheme, they should just do so. Hospitals trying to force patients to sign things first should be prosecuted and possible be closed down by the government (breach of contract). This has nothing to do with the prices they charge other patients for medical treatments though.

- hospital staff misinforming patients (telling them treatment is not covered by the free emergency medical scheme while it is, talking people into medical treatments they do not need, or misinforming people about medical treatments and their options) should be dealt with by the Thai medical board (if something like that exists) which might result in fines or closing down of the hospital. Again, this has nothing to do with the prices a private hospital charges a patient.

So I can see nowhere a link to the prices private hospitals charge and the problems mentioned in the article.

This really is a question if you favor the USA system of "free for all" or you prefer a regulated system, it's really a political issue, what kind of a system do you prefer.

Companies have rules they must obey for the privilege of being allowed to run in our society. For factories these includes rules about pollution, labor, taxes etc. For hospitals this should include some maximum prices they are allowed to charge. I understand your argument that people can just go somewhere else, but what if there is no somewhere else to go? As in Pattaya where the only real option is a private hospital if you intend to get treatment this year.

A hospital should not just be a business with the sole purpose be to earn money, in the same way as nobody should become a doctor for the sole purpose of getting rich. Yes it's a side effect, but the main purpose for both should be the desire to help those in need. I think it's good the government takes this step. Unfortunately I think, as with so many things here, it's in the news today and forgotten tomorrow.

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Capitalism is probably superior to the command economy BUT not all capitalists are good people and things like cartels, monopolies, duopolies and monopsonies do exist.

Government is probably the best control, if it is well versed in the area and reasonably efficient.

See how hard it can get?

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my wife went trough her whole period of pregnancy to the same hospital and also give birth there,

I told her many times something was wrong there, other patients paid like 750 thb for consultation, we paid arround 4000 thb

the delivery inthe hospital without a plan is 32.000 thb ,when our son was born, l got a bill of almost 90.000 thb, ...l asked them what and why

this bill is so high and different from what agreed before, they answered me ..;" you are farang, you can afford it ! "

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The prices for Farangs has at least quadrupled in the last 10 years. I had an operation 10 years ago, and was in for 5 days at the BP Hospital, and paid only 110,000 Baht for every thing. My father rescently had to go in and have a tube put down his throat, stayed in one night, and they charge me 68,000 Baht. It is in the cases of emergency treatment that they really do rip us off. Again my father had to to the same hospital just over a year ago for respitory problems, and they started quoting 800,000 before they even knew what was wrong. It is a really hard descision when you don't have that sort of money to hand, and yet you have to take the wellbeing of family. I ended up paying just under 500,000 Baht for him to be monitored for 9 days, but no surgery was done. I really struggled to get the cash together, but what choice do we have once they are in there and under the clutches of these businessmen. Trying to save some money now for any future problems, but will also look at alternative hospitals.

I understand your frustration and how difficult making a decision like that can be, but how can you compare the costs of medical treatments based on the number of days in the hospital? That does not make any sense to me.

And you might want to consider going to a public hospital next time instead of a private one, that can make a huge difference in costs. Medical insurance might also be a good idea.

Bob. My dad is 86 and we can't get medical insurance for him. I know we can choose to go back to the UK, and all that, but we are happy here and just don't want to get ripped off. I also know it's not just about number of days, but if you look at the fact that there was no surgery, and basically just monitoring him, and charging neary a 1,000 GBP per day, it is a bit much. We were scared and not being medically minded, had to take them on evereything they said, so we were too scared to even try and move him to a cheaper hospital. There are alternatives, which I think we will follow in future.

Totally understand your quandray. Recently I had denge fever and (allegedly) pnumonia. I was in BKK Hospital on Koh Samui for 10 days and the bill reached nearly 200,000 baht for a couple of x-rays, accommodation and a drip - no food as I was not up to eating anything. I believed I was being over charged and asked my Thai Wife to book me into a private ward at the local Government Hospital. The Ward, which was ensuite, was absolutely fine and the treatment as good as BKK Hospital. The cost 1,900 baht per day including accommodation drip and an x-ray. Almost 10 times less than BKK Hospital. I will not be going there again and have advised all my friends to avoid it if they do not want a very big bill. I have also read on this Forum that many Government Hospitals are very good and would suggest to Members to check them out as a very cost effective alternative to the Private Hospitals.

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