Aussies a drain on Phuket hospitals

[hansnl]

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.

One might ask why you received the first part of your treatment in a private hospital?

[hansnl]

When i got Pneumonia recently,i went to three hospitals to make deals with them, McCormick in Chiang mai gave me the best quote so i took it, 5days 17000B, including medication and xrays,, the warning bells rang, get insurance!!

Or go to a state hospital?

[IrishIvan]

Australian man ..........spent several months in hospital ............ the cost of his hospital stay............ which

 

amounted to about $A10,000.???????

Thats cheaper than most hotels! There would be a bit of change left over for some whisky and a few ladies to be delivered to the hospital

[Thai at Heart]

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.

Well why can't they apply exactly the same logic to ALL long term expats in the country. If you work on a work permit, your salary is deducted a pittance, and you can go to the local hospital essentially for free. If they insist on 800k in the bank, why can't they deduct an equivalent amount assuming you have a salary of 70k per month?

For all long stayers, job done.

As for tourists, I think it is virtually impossible to quickly levy on all arrivals. Some have credit card insurance etc. But, why not be able to take out 1000 baht at the airport if you want, and your covered for government hospital. 22,000,000 visitors. Lets say, 5mn take it out, ranging from all ages, shapes and sizes. What percentage need to go to hospital? 5% at maximum during their 2 week holiday. 250,000 people visit across the year.

5mn x 1000 = 5,000,000,000,000 baht/ 250,000 = 20,000 per person. Probably covers most. Then put in an excess of up to 15,000 baht, and so nothing to pay out on the first 15,000 baht. I think that should cover just about major open heart surgery for an awful lot of people. Bear in mind, that a huge percentage of visitors are caused by things such as vehicle accidents and stuff which should have insurance.

[NamKangMan]

@ stevenl

Obviously, the 500,000 baht figure was an example.

I agree that a larger pool also carries a larger risk, but, 60 year olds will no doubt be subsidising the 80 year olds.

You didn't address the use of an excess for small injuries and illness, and the fact many paying for the scheme would actually just die, thus, not requiring to use the scheme at all.

Like I said, this idea was just off the top of my head.

Do you have an alternative?

Yes, as I said in my first answer: can't afford self insurance and don't have insurance: go home and let your own government take care of you in stead of the Thai government.

You can talk about excess etc., does not matter: if the risk were acceptable insurance companies would accept it with additional conditions. If a 60 year old would be an acceptable risk insurance companies would accept it, leaving you with the even worse risks.

The problem with self insuring is the Thai Government can't enforce it. Sure, they can say you need 800,000 baht in a bank account to get your 1 year visa, and they can possibly say you will now need 1 million baht in a bank account that has not been touched for the last year - calling this, basically, your "medical bond" or "medical deposit" etc. This woud also knock out a lot of expats.

Another problem with self insurance is, how much is enough? It's an unknown quanity. Some may be happy with 2 million baht at call, others happy with 5 million baht at call, but nobody can predict the future and the seriousness of their injury or illness.

I have a scenario for you. If you were riding along and hit by a drunk Thai and ended up a quadraplegic, do you currently have enough money to cover a devastating injury like that? Who can self insure against that.

Basically, Thailand wants all the expat money in their economy, but without any expenses.

Once again, they are going to have to realise the money comes along with the foreigner, and the Thai Government either insure the foreigners themselves, or accept a loss on some that are treated but can not pay.

In relation to going home to have your own Government treat you, this is becoming a thing of the past.

If you are out of many countries for a period of time, I believe for some it's as low as 2 years, you lose the right to do this. Also, a "medi vac" is very expensive. If you can afford one, you could probably afford treatment in Thailand.

[stevenl]

Of course your own country will help you, they have no choice. Getting there may be an issue though.

Or; insurance required, no insurance back home (so before illness/accident).

Edited August 9, 2013 by stevenl

[hanno]

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

Spent 8K for 4 days in a BKK hospital a few years back, so it sounds plausible (I had insurance). That's what you pay when the hospital has a piano player in the lobby......

[mikemac]

Australian man ..........spent several months in hospital ............ the cost of his hospital stay............ which

amounted to about $A10,000.???????

Lucky he spent that time in a Thai hospital and not an Australian hospital. Would have cost him 10 times that at home.

And the Thai nurses are divine.

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.

Don't make statements like that in an Aussie or English pub. You may regret it.

There is no excuse not to have enough medical insurance to cover the average holiday in Thailand, say a month or so. The average Aussie drinker would spill that much on a good night out.

[Krataiboy]

"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.

As I understand it, UK citizens who become resident in Thailand are NOT entitled to free medical or dental treatment under the NHS, even if they paid into it all their lives. In addition, their pensions are "frozen" at the rate they were when they left the UK and they are not entitled to any further uplifts while overseas. Oh, and UK tax has to be paid on state and company pensions earned in Britain, irrespective of how long one has lived abroad (15 years in my case).

The only way to re-qualify, I gather, is to return to the UK to live, in which case you still have to wait six months to re-qualify for NHS treatment. If you need to see a doctor, dentist or visit a clinic or hospital in the meantime you must pay as if you were a foreigner. Under recent immigration rule changes If you have a Thai wife not only will she have to pass a British Knowledge test that most Brits who have tried cannot pass but you must prove an income of 18,000 from a UK source. Otherwise, wave her (and any kids you may have in Thailand who don't have a UK passport) goodbye.

Fort Knox has got nothing on Britain under Cameron and Co - unless of course you are an illegal immigrant (slipping in undetected is easier than ever now the Tories have cut back on the staff manning our borders}. An illegal immigrant would probably also find it easier to get free medical treatment and other State help than a Brit like me who paid his taxes and his National Insurance (which is supposed to cover health care and state pension) for 45 years and whose only sin is that he chose to retire with his wife and family in her country instead of his.

Never mind Oz - there's not much great about Britain these days, either!

[mikemac]

Never mind Oz - there's not much great about Britain these days, either!

Who said there was not much great about Australia ?

[Mousehound]

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.....

Unless you are on a social security card heath cover is not free in Australia.

[amykat]

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?

This isn't meant as an insult to you, it is a nice thought. But come on, a cost of 4 million baht in total ...I have seen this number twice now in the news so it probably is correct. And today, I believe, I read that Phuket gets over 10 million tourists per year, (on the airport thread), so that would be a cost of .40 baht per person! Tourism can cost money somewhere, it isn't all 100% profit. We drive on the roads, wear out tires on cars, sit on furniture, use the sewage system, drink water, help fill up trash landfills, leave our cigarette butts on the road, or in the sand, whatever.

This is such a small amount in comparison. Every country also has some costs involved with hosting tourists, some of those tourists are also Thais going to other countries, for real tourism, for illegal working, and as one poster pointed out above, in the UK they also get free medical care if needed. Do we really think that Thais are also not using free medical care in other countries or walking out on bills, escaping because they cannot pay?

To have "other" countries attempt to PAY Thailand for the cost of these few tourists or expats who can't pay for their medical bills, is simply ridiculous in my opinion, as it would cost so much more to adminster such a program, and what about all the other countries we visit? Should every first world nation do the same for every country? Will Thailand reimburse us for their illegal fake tourists that come to our countries and take advantage of whatever is available to them, as well as real tourists, who also use our roads, sit on furniture, use the sewer system, etc.?

Should we bill people who get in trouble and use the legal systems of various countries, that for sure isn't cost free. Can we Western people get a big credit in this area, because we are mostly victims of crimes, because of the jet-ski scams and other things? Can our insurance companies get paid back from Thailand, for having so much crime against farangs?

My own home country won't pay a dime for my medical care, of any sort! But they should get a government program together to pay Thailand for their "lost" medical costs for a few of my fellow countrymen who might not pay a bill here?? Should a restaurant association get together and agree to pay for those same people who walk out on their food/bar bills??

Thailand is making plenty of money from tourists! This is a slippery slope, where this kind of thinking can lead to charging "us" for all sorts of other things as well. Why not charge us all a "trash surcharge" when we arrive? I realize the slippery slope argument can be a weak one ...my main point is simply that Thailand is making a huge amount of money on tourism and some small "loss" like this one, is just ridiculous to worry about. This is one of the costs of tourism. Shocking to Thais maybe ...they can't recoup and simply profit at 900% on every single tourist ...there will be some costs! I am really crying to think about poor Thailand in this situation.

[CBR250]

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.

The idea of forcing tourists into insurance is absurd. I personally don't want it because I hate insurance companies and prefer to pay my bills myself, however much they are.

But for others what actuary do you suggest is going to determine appropriate premiums for different ages, pre-existing conditions etc? Or should that be left to the totally trustworthy private sector of Thailand, whom we all know are totally ethical and rationale organizations? And perhaps the under-worked Immigration officials at Swampy will happily volunteer to check the fine print in every tourists' health insurance brochure, in whatever their native language may be, before they issue a visa?

[Jimi007]

Of course your own country will help you, they have no choice. Getting there may be an issue though.

Or; insurance required, no insurance back home (so before illness/accident).

As I said earlier on in this thread, TAT has a ridiculously huge budget, maybe they should give up a bit of their pork to feed the public hospitals here that take care of the wounded tourists. Or maybe influence builders and tour operators to adopt more international safety standards? I wonder why so many farangs keep falling off of balconies. Most likely it's because the railing are too short for taller people.I've seen some barely above my knees!

[geriatrickid]

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.

Insurance is available. The issue is that the people do not wish to pay for cost. The health insurance policies even on 30 year olds all include an exclusion of coverage for a pre-existing condition. The demographic group that you reference, who do not have insurance or the financial means with which to self finance their own health care are not likely to be contributing into the Thai economy in a positive manner. Sorry, but that's the reality. Purchasing a 100 baht meal or paying 15,000 for a room/month at a muay Thai camp is not a benefit. At best it is a contribution to the real costs of having such people around. Yes, they may purchase some services, but the reality is that the costs incurred to support that demographic (public services of water, electricity, transport, healthcare, waste disposal, carbon footprint etc.) are not covered by marginal visitors.

[geriatrickid]

Of course your own country will help you, they have no choice. Getting there may be an issue though.

Or; insurance required, no insurance back home (so before illness/accident).

As I said earlier on in this thread, TAT has a ridiculously huge budget, maybe they should give up a bit of their pork to feed the public hospitals here that take care of the wounded tourists. Or maybe influence builders and tour operators to adopt more international safety standards? I wonder why so many farangs keep falling off of balconies. Most likely it's because the railing are too short for taller people.I've seen some barely above my knees!

Because the people falling off the balconies are usually drunk or doped up?

A large number of "wounded" tourists are injured because of misadventure. The onus is on the visitor to take care of him/herself.

Most visitors are on trips of less than 30 days. It is not unreasonable to oblige them to have health insurance. Let the visitor take responsibility for his/her life.

[lemoncake]

I fully understand the concept of people without insurance and medical is not cheap, HOWEVER, Public hospitals are FREE for Thai's 30 baht or something.

So can the people really be all that burden when its free anyway.

Those who are supposedly a burden also spend more in 1 week than most Thais who use public hospitals in 1 year.

[dighambara]

I Guess thats why they want 800K in a bank account for retirement visa, something happens to you without insurance, at least some costs are covered, i could be wrong...

However, common sense would be nice. An acquaintence is now in Hospital. He has double insurance - primary guarantees to pay 100% and secondary guarantees to pay 75%. His hospital bill is estimated after treatment to be 500,000 Baht, so the Hospital is demanding 400,000 Baht up front, even though they know his insurance will cover everything. Meanwhile, he is on his back, drugged to stay alive, until an operation can be performed.

[Jimi007]

Of course your own country will help you, they have no choice. Getting there may be an issue though.

Or; insurance required, no insurance back home (so before illness/accident).

As I said earlier on in this thread, TAT has a ridiculously huge budget, maybe they should give up a bit of their pork to feed the public hospitals here that take care of the wounded tourists. Or maybe influence builders and tour operators to adopt more international safety standards? I wonder why so many farangs keep falling off of balconies. Most likely it's because the railing are too short for taller people.I've seen some barely above my knees!

Because the people falling off the balconies are usually drunk or doped up?

A large number of "wounded" tourists are injured because of misadventure. The onus is on the visitor to take care of him/herself.

Most visitors are on trips of less than 30 days. It is not unreasonable to oblige them to have health insurance. Let the visitor take responsibility for his/her life.

Misadventures like getting hit by a speed boat propeller? "Ferries", speed boats and drive boats sinking? Tour buses and mini buses crashing? Train derailing? Come on... Really?

[ableguy]

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.

The problem is every person , business Hi Sos steal money, this scheme could never be governed, and dont tell me there are honest hospitals out there , agreed some of the private hospitals are superb BUT they are hre only to make money.

By way glad they saved you and you have the decency to pay them back , good luck /

[Sirius1935]

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

Yes but it would have been $5,000 back home in Australia. So I am very happy. I just had the stitches out today in my local hospital in Mae Chan, Chiang Rai. The surgeon in Bangkok had done an excellent job and the doctors here were all very impressed. As we're the nurses and I think the cleaner too. They think that the surgeon used super glue and only two tiny stitches for a 10 cm cut. It has been a great result despite a 100 item, four page ledger for only 24 hours in hospital!

[N47HAN]

58,500thb .mmmm what was your health issue they can clear in 24 hours and charge that ?

[transam]

I have read that Aussies there, or is it Pat's, are ''shooting'' themselves in the foot. Not literally but shooting none the less.

[N47HAN]

Guess i posted after your reply but 100 items ?

[transam]

Guess i posted after your reply but 100 items ?

Good stuff. .....

[NamKangMan]

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.

Insurance is available. The issue is that the people do not wish to pay for cost. The health insurance policies even on 30 year olds all include an exclusion of coverage for a pre-existing condition. The demographic group that you reference, who do not have insurance or the financial means with which to self finance their own health care are not likely to be contributing into the Thai economy in a positive manner. Sorry, but that's the reality. Purchasing a 100 baht meal or paying 15,000 for a room/month at a muay Thai camp is not a benefit. At best it is a contribution to the real costs of having such people around. Yes, they may purchase some services, but the reality is that the costs incurred to support that demographic (public services of water, electricity, transport, healthcare, waste disposal, carbon footprint etc.) are not covered by marginal visitors.

The "reality" is, that expat "purchasing a 100 baht meal or paying 15,000 for a room/month" is probably supporting a wife/girlfriend and sending money to Issan to also support her family.

Like I said, Thailand wants their money in their economy, but doesn't want to pay for any medical for them. They can't have one without the other.

[AloisAmrein]

Thailand should send the bills to the embassies, and if not paid, send back the people to their home country, refuse of further stay and visa, persona non grata. Europe does the same.

[transam]

Thailand should send the bills to the embassies, and if not paid, send back the people to their home country, refuse of further stay and visa, persona non grata. Europe does the same.

Europe (England) does eh.

[BwindiBoy]

Headline = 3 words too many, surely?? ;-)

[DogNo1]

Sirius1935: So your injury was just a cut requiring stitches? I had both cataracts removed at Bumrungrad this year for a little more than double what you paid: $4,000 (120,000 Baht.) Most doctor visits that I have paid for at Bumrungrad are in the neighborhood of $100 - $200 (3,000 - 6,000 Baht.) Do you think that you were overcharged?

Edited August 9, 2013 by DogNo1