Aussies a drain on Phuket hospitals

[Estrada]

I spent 4 weeks in Robina Hospital on the Gold Coast Queensland, my travel insurance did not cover it. The medical bill including I.C.U. came to B1,000,000. They said I could pay it back over several years at 0% interest if I wanted, but I made B3.5 Million on the Thai Stock Exchange, whilst in I.C.U., thanks to my mobile phone internet trading program. In any case I keep B800,000+ for medical fees and unforeseen circumstances. Interesting enough, I discovered that BUPA and other medical insurance premiums cost B99,000 per year and which means that over the 20 years I have lived here I would have forked out up to B20 Million in premiums. However, although the coverage is B5 Million, it only covers a maximum of B1 Million in any one incident. Furthermore there is a limit on the amount that they will pay per cay for I.C.U. and normal bed, this meant that they would have paid only B82,000 out against the B99,000/year premium and a medical bill of B1 Million!

You are advised to keep an emergency fund, as you cannot rely on medical insurance to cover the full cost of treatment.

With regard to Australians, since many are covered by Australian Government Medicare, and hospital treatment in OZ is expensive, the Australian Government would save money if they were to cover their citizens medical treatment overseas.

[jollyman]

Well Oz and Brit people are really so unfit, so its not big a surprise is it. But it links up with another story about Tourists being charged health insurance at entry point! It will happen.

[F4UCorsair]

On a visit to the U.K. A few gears ago my Thai girlfriend needed hospital treatment. There was " no charge for foreign visitors" . Last week in Bangkok I had a day and a night in a regular hospital for a small problem which cost me 58,500 Baht. Not complaining, it was great service and I am very happy but hardly a reciprocal arrangement.

$2,000 for a SMALL problem?? I can't imagine what a large problem might cost.

Is that a misprint, not B 5,800??

[bigbamboo]

"It's just not fair. I mean the retirees are blocking up the hospital," Mr Cunningham told AAP."

Its possible because of the draconian laws in Australia---Mr Cunnningham--- when leaving Oz to retire in somewhere like Thailand, if pensioner age--you are striped of your rights for free medical care in Australia, Unlike the UK & other countries where there citizens routinely return home for the medical treatment that they have paid in for all their working life----An Australian government health care card is stopped after being away form the country more then 13 weeks---even though he may have been working & contributing there for more then 50 years. Now on returning he must make a stat declaration that he is back in the country to stay----& you can not do that to many times.

And by the sound of that last statement from Bob Carr---the situation for Australians abroad will get worse.

That's no longer the case in the UK I'm afraid.

[stevenl]

Simple solution - no insurance no Visa, like Europe

Not so simple.

What about the expats over 65 or 70 years of age, and those expats with a pre-existing condition? No insurance for them, means no visa for them, means no money into the Thai economy from them.

An idea might be that those without insurance, pay an extra levy attached to their visa. This levy, or medical fee, goes to the Thai Government to ensure older uninsured expats receive medical care, should they need it.

The system you're describing is called insurance. And because private insurance companies don't want this risk, in other words, it will cost them more than it bring them, the Thai government should bear this risk, in other words it will cost them more than it brings them.

I'm sorry, but if you want to stay here as a foreigner you have to be self reliant, and not rely on the Thai government. Can't do that, go home and let your own government take care of you.

It was just an idea, off the top of my head. Read my other post - yes, it is insurance, but it's the Thai Government self insuring, on that basis, it can't lose.

There are many insurance companies and they may get a "few" customers. The customers are spread over the different companies, because they have choice.

This is a compulsory scheme. That means EVERY elderly expat who the insurance companies refuse to insure, due to age or pre-existing conditions, are forced into the scheme via visa qualification. That's millions of uninsured expats, all paying the compulsory fee/levy. Now, not all of them will have a heart attack that year, for example, but all of them have paid. A small "excess" of say, 50,000 baht would still ensure minor injuries or illnesses are still paid for by these uninsured expats.

As mentioned, if the Thai Governemnt had a bad year and lost a little, they raise the fee/levy for the next year, just like an insurance company rises premiums. This is why the scheme can not lose. The loss only has to be carried by the Thai Governemnt for a short time.

The only problem I can see is with the long term overtayers who have not paid their fee/levy for the year. These are in the minority and will always be a problem, but the majority of expats doing the right thing will have some medical coverage that will at least save them from financial ruin.

Insurance companies refuse them for a reason, too big a risk. So yes, the Thai government would lose money on this, big pool or small pool, the bigger the pool the bigger the losses.

So no, they won't lose a little but will lose big time.

So from an insurance, pure financial point of view this will cost the Thai government lots of money. On top of that they will have to come up with the people to organise it, collect the money, evict the people who are not paying from the scheme, maybe even from Thailand, etc.

Many problems and an idea that is a very bad idea for many reasons. Sop yes, it will probably be implemented, after all politics never listens to reason.

[Ianatlarge]

So it was $10k for a few months in hospital. I am scared to imaging what that figure would be for a comparable stay in an Australian hospital. Possibly the Thai gov could dip into the money it receives for visas (for all that work involved in stamping pages), and put it to good use?

The reasonable thing to do would be for the Australian public health care system to pay these bills. Simply extend the coverage to all Australian citizens, irrespective of where they are located. In fact, this would save money. I believe Norway has this enlightened approach to public health. As would mentioned, medical insurance is all well and good, and tourists should take out this insurance, but insurance companies don't like paying out money. If they can they avoid, and if you are an older person, or have a long standing medical condition, you will experience difficulty in obtaining private insurance.

[simon43]

Wow! 58,500 seems like a lot for one day and night in a hospital. That's nearly $2,000 US.

Gender reassignment surgery can be quite expensive

Simon

(only joking!!)

[Sayonarax]

Oh yes it must be the Australians causing a burden to the Thai healthcare system.

I got one simple answer to solve all the problems in phuket, pattaya and the deep south.

- MOAB

(I didn't know paying for a PRIVATE healthcare services in foreign country was a problem)

Edited August 9, 2013 by Sayonarax

[MaxYakov]

Possibly because Australians enjoy a good free health care system at home they don't think about insurance.

It's also possible that they are a bunch of knuckleheads that end up hurting themselves all the time as well.....

That's right. A "good[sic] free health care system" and even Wiki describes it as "free universal access":

"The public health system is called Medicare, which funds free universal access to hospital treatment and subsidised[sic] out-of-hospital medical treatment. It is funded by a 1.5% tax levy on taxpayers with incomes above a threshold amount, an extra 1% levy on high income earners without private health insurance, as well as general revenue."

http://en.wikipedia.org/wiki/Health_care_in_Australia

That's right it's free to non-taxpayers and low income citizens. Ask the others if it's free. Ask the Thais if it is free. Someone is going to have to pay or be indebted for given freebies, hence the reason behind the article.

Edited August 9, 2013 by MaxYakov

[morpho]

In Chiang Mai, they have a unique way of insuring payment or at least some modicum of restitution. I had a solo motorbike accident here and was bang up pretty good. I was transported to a local hospital but before that, the license tag on my motorbike (which I own and was pick up by some friends) was taken off and provided to hospital staff when I was checked in. It was given back to me when I paid my bill in cash later.

[NamKangMan]

@ stevenl

It's a simple maths.

There is a monetary figure where the scheme pays for itself. If a fee/levy of 10,000 baht every visa renewal doesn't cover it, then next year it is raised to 20,000 baht, or whatever figure does cover the running of the scheme.

The "pool" and compulsory payment ensures it can not lose. What they lose this year, they make up the next year with a fee/levy rise and the possibility of not many getting sick. Remember, it's also coupled with an "excess" to stop minor claims.

[oldsailor35]

The Australian government save themselves millions of dollars by not having to provide medical services to Australians living overseas. So why can they not invest this money in an insurance to cover retired expats living in countries such as Thailand, after all, these retirees have paid taxes all their working lives to cover their health. Another point, why are insurance companies allowed to discriminate against perfectly healthy older citizens because of their age, to the point where it is just about impossible for many to pay the premiums if they are over 60.

[Sayonarax]

I spent 4 weeks in Robina Hospital on the Gold Coast Queensland, my travel insurance did not cover it. The medical bill including I.C.U. came to B1,000,000. They said I could pay it back over several years at 0% interest if I wanted, but I made B3.5 Million on the Thai Stock Exchange, whilst in I.C.U., thanks to my mobile phone internet trading program. In any case I keep B800,000+ for medical fees and unforeseen circumstances. Interesting enough, I discovered that BUPA and other medical insurance premiums cost B99,000 per year and which means that over the 20 years I have lived here I would have forked out up to B20 Million in premiums. However, although the coverage is B5 Million, it only covers a maximum of B1 Million in any one incident. Furthermore there is a limit on the amount that they will pay per cay for I.C.U. and normal bed, this meant that they would have paid only B82,000 out against the B99,000/year premium and a medical bill of B1 Million!

You are advised to keep an emergency fund, as you cannot rely on medical insurance to cover the full cost of treatment.

With regard to Australians, since many are covered by Australian Government Medicare, and hospital treatment in OZ is expensive, the Australian Government would save money if they were to cover their citizens medical treatment overseas.

No, it would only create loopholes and black market medical treatments in a border they have no control over.

A one night stay in our government hospital is $1,400 per bed

ICU would be more since it requires more than a heart monitor and 24hr nurse care.

[monkey4u]

I will hazard a guess and say that most of these hospital visits from Aussies are a result of vehicle accidents. Why not have compulsory hospital insurance on vehicles/motorbikes/cars?

Secondly the Aussies could try ringing isaarn and let future the in laws know that they are in hospitan and need baht quickly

IrishIvan why do you take the piss out of us Aussies.

We all know money only goes out from ATM not into it.

Secondly only half of us have motor vehicle accidents.

The rest are just piss heads who dont know when to say enough Im drunk

Oops I fell off my roof / balcony

[oldsailor35]

I have a bill owing to a Thai private hospital for emergency treatment that saved my life. It was in the region of 1.4 million Baht when I left the hospital to transfer to a local hospital which covered me under the Thai social system as I work and pay tax here. Every month 50K from my salary goes to the hospital having been guaranteed by my employer. This leaves me with a very tight budget to live on BUT there is no way I could consider not paying this back.

Maybe the leading tourist nations could each pay an amount each year into the Thai system (accessible by Private and Govt Hospitals) and with the full details of each of their citizens (that don't have full travel insurance) being recorded at each admission simply add the cost onto their future tax bills?

Admittedly there way be certain elements that might profit from this locally however the threat of tax impositions may well encourage people to arrange insurance cover prior to travelling which then benefits that govt through taxes on the companies doing normal business.

My my! you are a good boy, give yourself another pat on the back !

Edited August 9, 2013 by oldsailor35

[Thai at Heart]

I spent 4 weeks in Robina Hospital on the Gold Coast Queensland, my travel insurance did not cover it. The medical bill including I.C.U. came to B1,000,000. They said I could pay it back over several years at 0% interest if I wanted, but I made B3.5 Million on the Thai Stock Exchange, whilst in I.C.U., thanks to my mobile phone internet trading program. In any case I keep B800,000+ for medical fees and unforeseen circumstances. Interesting enough, I discovered that BUPA and other medical insurance premiums cost B99,000 per year and which means that over the 20 years I have lived here I would have forked out up to B20 Million in premiums. However, although the coverage is B5 Million, it only covers a maximum of B1 Million in any one incident. Furthermore there is a limit on the amount that they will pay per cay for I.C.U. and normal bed, this meant that they would have paid only B82,000 out against the B99,000/year premium and a medical bill of B1 Million!

You are advised to keep an emergency fund, as you cannot rely on medical insurance to cover the full cost of treatment.

With regard to Australians, since many are covered by Australian Government Medicare, and hospital treatment in OZ is expensive, the Australian Government would save money if they were to cover their citizens medical treatment overseas.

Indeed, the coverage afforded by BUPA for the cost is very very bad, and I would suggest that it is more a scheme to boost business for private hospitals. People go to private hospitals for all sorts of small scrapes and bumps, and the hospital charges what I would consider to be a small fortune to put it right, but if you really need something very serious, the insurance isn't likely to cover it.

[technologybytes]

One of the problems going into hospital in Thailand without insurance is that most hospitals try and sell you more services, more tests and keep you in longer then they would if you were insured. They know that every bill charged to an insurance company will be scrutinised where private paying customers bills are not.

It's happened to me, I've been in Hospital for a minor illness and they try and tell me I'd be better in ICU so they can keep and eye on me, or that I should have loads of tests.

I'm sure they are sometime a victim of their own greed. If the bills were realistic they would have a far higher chance of being paid.

I paid my bills, but I have it on good authority that they can't force any forigener to pay a bill, the police will not officially get involved in unpaid hospital bills.

[stevenl]

@ stevenl

It's a simple maths.

There is a monetary figure where the scheme pays for itself. If a fee/levy of 10,000 baht every visa renewal doesn't cover it, then next year it is raised to 20,000 baht, or whatever figure does cover the running of the scheme.

The "pool" and compulsory payment ensures it can not lose. What they lose this year, they make up the next year with a fee/levy rise and the possibility of not many getting sick. Remember, it's also coupled with an "excess" to stop minor claims.

Yes, simply monetary figure, which is why insurance companies don't cover this. It would cost them money, and it would be the same for the government. And no, 'pool' and compulsory payment' don't ensure it can not lose. To ensure it can not lose the premiums have to increase, to the level of the private insurance companies (that is why they are asking these premiums).

[oldsailor35]

I have a bill owing to a Thai private hospital for emergency treatment that saved my life. It was in the region of 1.4 million Baht when I left the hospital to transfer to a local hospital which covered me under the Thai social system as I work and pay tax here. Every month 50K from my salary goes to the hospital having been guaranteed by my employer. This leaves me with a very tight budget to live on BUT there is no way I could consider not paying this back.

Maybe the leading tourist nations could each pay an amount each year into the Thai system (accessible by Private and Govt Hospitals) and with the full details of each of their citizens (that don't have full travel insurance) being recorded at each admission simply add the cost onto their future tax bills?

Admittedly there way be certain elements that might profit from this locally however the threat of tax impositions may well encourage people to arrange insurance cover prior to travelling which then benefits that govt through taxes on the companies doing normal business.

I would have thought that any intelligent person working in Thailand, for what obviously must be a foreign company, would have negotiated for health insurance in his salary package .

Edited August 9, 2013 by oldsailor35

[market trader]

Interesting to see the sky diver walked (or more likely wheeled) out of hospital. Luckiest guy alive. He now needs to do everything he can to pay his bills!

And wallabies will grow wings.

Some hope.

In NZ everybody from anywhere is covered ny 'no fault' accident insurance.

Would falling from the 9th floor of a building be considered an accident?

[technologybytes]

but I made B3.5 Million on the Thai Stock Exchange, whilst in I.C.U., thanks to my mobile phone internet trading program.

Shame you couldn't have stayed longer.... and earned more..

Edited August 9, 2013 by technologybytes

[andreandre]

It's probably been covered on other threads..if so a link would be appreciated,or first hand knowledge of a basic accident and illness insurance available to over 60 yo expats at a not too ridiculous cost.

Anyone have such a policy recently?

Thanks

[oldsailor35]

Always assuming that the government in question were competent to run such a scheme without losing the payments somewhere along the way and that certainly leaves this government out.

Or any Thai government come to that.

[technologybytes]

Maybe the leading tourist nations could each pay an amount each year into the Thai system (accessible by Private and Govt Hospitals) and with the full details of each of their citizens (that don't have full travel insurance) being recorded at each admission simply add the cost onto their future tax bills?

Hmmm.... excuse me but what planet are you from ???

[stevenl]

I have a bill owing to a Thai private hospital for emergency treatment that saved my life. It was in the region of 1.4 million Baht when I left the hospital to transfer to a local hospital which covered me under the Thai social system as I work and pay tax here. Every month 50K from my salary goes to the hospital having been guaranteed by my employer. This leaves me with a very tight budget to live on BUT there is no way I could consider not paying this back.

Maybe the leading tourist nations could each pay an amount each year into the Thai system (accessible by Private and Govt Hospitals) and with the full details of each of their citizens (that don't have full travel insurance) being recorded at each admission simply add the cost onto their future tax bills?

Admittedly there way be certain elements that might profit from this locally however the threat of tax impositions may well encourage people to arrange insurance cover prior to travelling which then benefits that govt through taxes on the companies doing normal business.

I would have thought that any intelligent person working in Thailand, for what obviously must be a foreign company, would have negotiated for health insurance in his salary package .

Why would it 'obviously be a foreign company'?

[oldsailor35]

Interesting to see the sky diver walked (or more likely wheeled) out of hospital. Luckiest guy alive. He now needs to do everything he can to pay his bills!

And wallabies will grow wings.

Some hope.

In NZ everybody from anywhere is covered ny 'no fault' accident insurance.

Would falling from the 9th floor of a building be considered an accident?

I think it always is in Pattaya, either that or suicide.

[scorecard]

Simple solution - no insurance no Visa, like Europe

Not so simple.

What about the expats over 65 or 70 years of age, and those expats with a pre-existing condition? No insurance for them, means no visa for them, means no money into the Thai economy from them.

An idea might be that those without insurance, pay an extra levy attached to their visa. This levy, or medical fee, goes to the Thai Government to ensure older uninsured expats receive medical care, should they need it.

Seems to me this idea should be explored, and if managed properly (no corruption) my guess is that it would not be all that expensive:

- One quick calculation ... 30,000 Aussies in any given month X say a visa add-on of 1,000Baht per person = 30,000,000 (30million) Baht per month (just Aussies).

= A$35.00 per Aussie, IMHO quite attractive.

But of course it should be applied to all visitors or perhaps exempting those folks, from any country, who can prove they have independent health insurance.

And of course there would need to be some time limit (maximum of 60 days cover or something like that), etc.

[MickGC]

I would not call this a drain on the local hospital system. Going by the figures in the news article, over a 12 month period there are 360,000 Aussie visitors to Phuket. The total drain on the hospitals over one year is 4m baht. So even if it was only Aussies needing medical attention, that only equates to 110 baht per person. Include all the other foreign visitors http://www.phuketland.com/phuket_links/touristinfo.htm - 2.5 million in 2005 and we are looking at about 15 baht per person. Add a 20 baht levy onto every visa and the problem is solved with a tidy profit to the hospitals.

By the way, if each of those tourists only used the ATM once while on holiday the return to Thailand would be around 375 million baht. Go figure ...

[MickGC]

Simple solution - no insurance no Visa, like Europe

Not so simple.

What about the expats over 65 or 70 years of age, and those expats with a pre-existing condition? No insurance for them, means no visa for them, means no money into the Thai economy from them.

An idea might be that those without insurance, pay an extra levy attached to their visa. This levy, or medical fee, goes to the Thai Government to ensure older uninsured expats receive medical care, should they need it.

Seems to me this idea should be explored, and if managed properly (no corruption) my guess is that it would not be all that expensive:

- One quick calculation ... 30,000 Aussies in any given month X say a visa add-on of 1,000Baht per person = 30,000,000 (30million) Baht per month (just Aussies).

= A$35.00 per Aussie, IMHO quite attractive.

But of course it should be applied to all visitors or perhaps exempting those folks, from any country, who can prove they have independent health insurance.

And of course there would need to be some time limit (maximum of 60 days cover or something like that), etc.

You beat me to it

[Just1Voice]

Back in the States I didn't need insurance because I have a 100% disability from both the VA and SS, so all of my medical costs were covered. But when I moved to LOS, I knew that would not be the case, and the Foreign Medical Program of the VA only handles certain things, and since I was not that far from the 60 yr old cut off date, me and my wife quickly obtained policies for health/accident/hospital insurance, as well as life insurance. The premiums for health/accident/hospital are not that bad, easily affordable, and the policies have come in handy more than once.

There is no simple solution to this problem with foreigners. The "no insurance - no visa" stipulation might work for some, but as others have mentioned, what of the older retirees who can no longer get insurance? It's possible that one, or more, of the insurance companies here could set up special policies for this group, but if so, I have a feeling that the premiums would be very expensive, and perhaps more than could be paid without a serious bite into their fixed incomes.