Phuket Opinion: Health insurance for tourists at 7-Eleven

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Phuket Opinion: Health insurance for tourists at 7-Eleven
Phuket Gazette


Dr Sirichai Silpa-archa says it’s time to stop sticking hospitals with the bill for tourists’ medical care. Photo: Orawin Narabal

Dr Sirichai Silpa-archa has been the Director of Patong Hospital for six months and was Deputy Director of Vachira Phuket Hospital for 26 years. He has a medical degree from Chulalongkorn University with a specialty in Urology from Chiang Mai University, as well as an MBA.

Here, he discusses options for relieving the financial burden of uninsured foreign tourist and expat patients.

PHUKET: -- The cost of treating uninsured tourists at Patong Hospital totals about a million baht every year. At Vachira Phuket Hospital, the total is about 3 million baht.

In 2011, 15,000 tourists were treated at Patong Hospital. In 2012, the number increased to 17,000, and this year it is expected to hit the 20,000 mark. Only 400 to 500 of these tourists each year hold health insurance. The rest of them pay the medical fees out of pocket if they can. If they can’t, we are left holding the bill.

The way to solve this problem is to make travel insurance a requirement for entering Thailand or make it a lot easier to get.

The Public Health Ministry is considering making it a requirement for uninsured tourists to get travel insurance on arrival. In this case, the insurance would be available at the airport for the tourists to buy, according to the number of days they plan to stay.

However, this proposal is still under discussion with relevant organizations such as Immigration and the Ministry of Commerce.

In my opinion, insurance on arrival is probably not convenient for either tourists or officials because it would slow down the immigration process. I think it would be more practical to require tourists to get insurance before they arrive. If they come on a tour, the cost of travel insurance could be included in the package.

Another idea is to make insurance available at stores such as 7-Eleven. Tourists could just buy it the same way they buy prepaid phone cards. They would select a card based on the number of days they are staying here. That way they’d be covered while here.

The problem with this is that it’s impossible to make sure that every tourist would buy insurance. Once they’re in the country, what they do is out of our control.

The issue particularly affects Patong Hospital and Vachira Hospital since uninsured tourists are sent to us.

I’ll give you an extreme example. Two months ago we had a Filipino tourist who suffered a hip fracture. He had neither insurance nor the money to pay. He stayed with us for two months and his medical bills reached 200,000 baht. He couldn’t pay any of it.

At Patong Hospital, we treat all tourists the same, whether they have insurance or money to pay or not. In fact, until recently doctors weren’t aware until the day of discharge whether or not a patient could afford the medical fees.

Now we have a new system, and summarize the bill every two days. That way, if someone can’t pay, we know it sooner and have a chance to recuperate the costs.

The health of the patients comes first, of course, and if they are critical, we continue to treat them until they are better, regardless of their ability to pay.

But if, for example, we know on the second day that they are unable to pay, and they are recovering well and able to leave the hospital, we will discharge them.

In cases where they are not well enough to leave, we contact their embassy and report the problem. The embassy tries to get in touch with the family of the patient in their own country and ask them to help get the patient home.

Health insurance for tourists is a problem that needs a collective effort to solve effectively. Hopefully we’ll find a solution soon.

Source: http://www.phuketgazette.net/phuket_news/2013/Phuket-Opinion-Health-insurance-for-tourists-at-7-Eleven-21989.html


-- Phuket Gazette 2013-08-19

[LivinginKata]

Buy prepaid health insurance at a 7-11. I've heard it all now.

[madmitch]

"In 2011, 15,000 tourists were treated at Patong Hospital. In 2012, the number increased to 17,000, and this year it is expected to hit the 20,000 mark. Only 400 to 500 of these tourists each year hold health insurance. The rest of them pay the medical fees out of pocket if they can. If they can’t, we are left holding the bill."

I really do not believe these figures. My guess is that most of them have insurance but in view of the relatively low amounts involved (Patong Hospital is no good for major cases) tourists either don't bother with their insurance or they put in a claim with their insurers after they have paid the bills.

[dcutman]

There was 7,400,000 tourist in Phukett last year (2012) and Bt 1.4 billion generated from those tourists. From an earlier thread local hospitals in Phukett where on the hook for Bt 5 million of unpaid hospital bills.

That is 67 Satang per tourist. Get over it!!!!

[NamKangMan]

"In 2011, 15,000 tourists were treated at Patong Hospital. In 2012, the number increased to 17,000, and this year it is expected to hit the 20,000 mark. Only 400 to 500 of these tourists each year hold health insurance. The rest of them pay the medical fees out of pocket if they can. If they can’t, we are left holding the bill."

I really do not believe these figures. My guess is that most of them have insurance but in view of the relatively low amounts involved (Patong Hospital is no good for major cases) tourists either don't bother with their insurance or they put in a claim with their insurers after they have paid the bills.

I also do not believe these figures.

Many travel agents sell the holiday, and then they sell the travel insurance. I think a lot more than 400 to 500 are insured. How would he come up with this figure anyway????

Travel insurance policies have an excess - usually somewhere between $100 to $300. If you only require minor medical treatment, you would pay cash and not bother to claim.

I would really like to know the stats for tourists presenting to the hospitals here for motorbike accident injuries.

If the health department here want to cut down on unpaid medical bills, it's simple, Phuket just needs baht buses. :) :)

[aguy30]

"In 2011, 15,000 tourists were treated at Patong Hospital. In 2012, the number increased to 17,000, and this year it is expected to hit the 20,000 mark. Only 400 to 500 of these tourists each year hold health insurance. The rest of them pay the medical fees out of pocket if they can. If they can’t, we are left holding the bill."

I really do not believe these figures. My guess is that most of them have insurance but in view of the relatively low amounts involved (Patong Hospital is no good for major cases) tourists either don't bother with their insurance or they put in a claim with their insurers after they have paid the bills.

The most important numbers and info is missing. How many didn't pay their bills, the average unpaid bill and where are they from?

Why should all tourists be made to pay for the few that don't? The Thai government should cover the hospial costs. It is part of the cost of bringing the lower class of people to increase the tourist count. The total unpaid bills are trivial in comparison to the money tourist spend.

Why not set up a government supported indigent ward in the hospital, a medical school, or a military or prison hospital for those that don't pay and provide only the absolute minimun care. Charge then with fraud when they are well and then give them jail time equal to their unpaid bill.

It is difficult for most senior expats as well as Thais to obtain health insurance because of advanced age. The Thai government should support reasonable and good health insurance plans that expats can purchase at affordable prices. Force the insurance companies to provide cover just like auto insurance.

[Ianatlarge]

As discussed before: the amount uninsured tourists cost the Thai medical system is miniscule compared to the profits both the Thai medical system (med tourism) and the Kingdom as a whole make. The issue is one more made up piece of fluff designed to get people excited over nothing so that they will overlook more important issues and allow politicians to be seen to be doing something (taming those Bad Farang).

By all means, encourage 7s to sell insurance, but don't believe that this is an important issue. As for the hospitals holding the bag? How about some small percentage of that visa money being used to plug the gap?

[tingtongfarang]

Buy prepaid health insurance at a 7-11. I've heard it all now.

No proplem kha, want slurpy with that?

[chrisbacke]

There was 7,400,000 tourist in Phukett last year (2012) and Bt 1.4 billion generated from those tourists. From an earlier thread local hospitals in Phukett where on the hook for Bt 5 million of unpaid hospital bills.

That is 67 Satang per tourist. Get over it!!!!

So, 67 satang per tourist times how many hospitals across the country?

There's a lot of numbers missing, to be sure. Take this article as one hospital's opinion in a country where the rest are probably watching to see how hard the hammer falls on the nail.

[dcutman]

There was 7,400,000 tourist in Phukett last year (2012) and Bt 1.4 billion generated from those tourists. From an earlier thread local hospitals in Phukett where on the hook for Bt 5 million of unpaid hospital bills.

That is 67 Satang per tourist. Get over it!!!!

So, 67 satang per tourist times how many hospitals across the country?

There's a lot of numbers missing, to be sure. Take this article as one hospital's opinion in a country where the rest are probably watching to see how hard the hammer falls on the nail.

Missing numbers? How hard the hammer falls on the nail? Huh.

21 mill tourist to Thailand last year State hospitals claim thy lost Bt 200 million for non payment.

Thailands revenue was Bt 1.14 trillion. You dont even need a calculator to figure out how stupid that would be to implement this idea..

[Cyclist]

There was 7,400,000 tourist in Phukett last year (2012) and Bt 1.4 billion generated from those tourists. From an earlier thread local hospitals in Phukett where on the hook for Bt 5 million of unpaid hospital bills.

That is 67 Satang per tourist. Get over it!!!!

That money you're talking about goes to resorts, hotels, restaurants, bars, nightclubs, tour guides, jet ski operators, hookers, etc. None of it goes to hospitals.

Think about it.

[Jimi007]

As I have said before and will say again: TAT had a budget of 6 BILLION Baht in 2012, but they can't contribute a measly few million Baht to the public hospitals to cover the few unlucky tourists? What a joke... So now tourists should buy health insurance at 7-11! This government has it's priorities a bit out of line, IMHO!

[dcutman]

There was 7,400,000 tourist in Phukett last year (2012) and Bt 1.4 billion generated from those tourists. From an earlier thread local hospitals in Phukett where on the hook for Bt 5 million of unpaid hospital bills.

That is 67 Satang per tourist. Get over it!!!!

That money you're talking about goes to resorts, hotels, restaurants, bars, nightclubs, tour guides, jet ski operators, hookers, etc. None of it goes to hospitals.

Think about it.

Last I heard, tourism in Thailand accounted for 14% of GDP.

Think about it.

[Cyclist]

There was 7,400,000 tourist in Phukett last year (2012) and Bt 1.4 billion generated from those tourists. From an earlier thread local hospitals in Phukett where on the hook for Bt 5 million of unpaid hospital bills.

That is 67 Satang per tourist. Get over it!!!!

That money you're talking about goes to resorts, hotels, restaurants, bars, nightclubs, tour guides, jet ski operators, hookers, etc. None of it goes to hospitals.

Think about it.

Last I heard, tourism in Thailand accounted for 14% of GDP.

Think about it.

But how much of that goes to hospitals?

[RedQualia]

This guy's a doctor, AND a professional bean counter (MBA)? Alas... Once a bean counter, that supersedes any other abilities, however great they may have once been.

Does the hospital earn a profit? Most assuredly. All hospital costs are allocated across all patients (including the paying "government patient" as necessary), so that the hospital earns a profit overall. This guy has simply found a bean to be singled out for special attention. And he's PROUD of having found that bean. Just have a look at his photo.

"The cost of treating uninsured tourists at Patong Hospital totals about a million baht every year." Wow... $32,500US per year. How many patients is that? "At Vachira Phuket Hospital, the total is about 3 million baht." -- $97,000US per year.

However slight, of course, the costs do add up across several hospitals. Even so, there's this idea in hospitals of "product line costing," in which the cost of providing each and every service is allocated across the patient population. Take that $32,500US per year and allocate it across the entire hospital population. How many patients, per year? Maybe 32,500? Would that be $1US per patient? 30 Baht? I must assume that Vachira Phuket Hospital is quite a bit larger, and so sees many, many more patients. So that the larger cost is allocated across many more patients. How many? Can you say "bean counting?"

The good doctor has nonetheless seen this bean, and merely wishes to transfer its cost to external agencies. Note smile.

A proper bean counter must address the issue of implementing this change across all government agencies, including immigration, embassies, etc. It must also be considered in light of its effect on tourism. How many lost tourists will there be each year? What is the cost to Thailand of each lost tourist? Has this "doctor cum bean counter" analyzed those costs? Is it less expensive to force external government agencies and those who service tourists to deal with the problem? For the hospitals, I'm quite sure. For the external agencies, much less clear.

There might be other options... The hospitals might try confiscating the patients' passports. If patient has an outstanding bill, the passport is retained. Have heard this works in some countries. Much simpler solution. Probably other solutions as well. There are surely many ways in which the good doctor might break into hospital management.

All in all, though, I'm thinking the patient population would be better served if this urologist paid more attention to urology, and less attention to beans.

[stoli]

Buy prepaid health insurance at a 7-11. I've heard it all now.

I think the idea has merit. There is no way possible that 7-11 could do any worse than Blue Cross. I would rather trust 7-11.

[Colabamumbai]

Some hospitals like to hold your passport until they are paid. There is the solution to the problem.

[fresnoboy]

"The health of the patients comes first, of course, and if they are critical, we continue to treat them until they are better, regardless of their ability to pay."

I don't know about Phuket but, in Pattaya the hospital wants to know if you have insurance/funds before the treatment.

My personal experience in dealing with another's injuries.

[eezergood]

A thinly veiled "BLAME THE FARANG/MAKE THE FARANG PAY" piece here from the Phuket GAzette - good work fellas, consistancy is the key!

[Chao Lao Beach]

The same hospitals make a small fortune out of inflated tourist prices as well.

Will he open up his books.

So how will some officier interpret my health insurance on the customs counter?

[pookiki]

Why doesn't Thailand just ban tourists from going to Phuket? Problem solved! And no one has answered my question from another post on this issue. What country requires medical insurance as a requirement to obtain a visa?

[laurentbkk]

Yeah blame the tourists , its always easier like this.

[laurentbkk]

Why doesn't Thailand just ban tourists from going to Phuket? Problem solved! And no one has answered my question from another post on this issue. What country requires medical insurance as a requirement to obtain a visa?

Russia for instance , European Shengen states also. If you want to go to France as Thai , you need an insurance which will cover your entire trip.

[stevenl]

A thinly veiled "BLAME THE FARANG/MAKE THE FARANG PAY" piece here from the Phuket GAzette - good work fellas, consistancy is the key!

He is talking foreigners, not farang.

[belg]

don't they alreadt first check

if you have a CC card

and if not, you can go on your merry way ?

Edited August 20, 2013 by belg

[abhaya]

What a smug little whiny pr**k. I dont believe this figure either and also he mentions that most of these tourists pay out of pocket rather than insurance, but does not say in reality how much the hospitals get stuck with unpaid bills and whether or not they are being charged local prices for emergency procedures or the welcome to Thailand, we will squeeze you til bleed to death falang price. I really dont have a problem with a modest increase in an air fare with an inclusive insurance add on when buying a ticket to Thailand as long as the bill is paid in Thailand by a Thai company. His 7/11 suggestion is ludicrous, he even admits its impossible to make sure that every tourist would buy insurance so why even bring it up unless you just want to appear stupid?

[GAZZPA]

I agree that people should make a provision for the possibility of urgent medical treatment whilst away, paying for medical insurance before you travel is sensible as long as you have a choice of who to insure with and it is not dictated to you.

I think that this should also apply for Thai people that visit my country, England. They should also have to have full medical insurance before entering the UK because at present it is free which of course it shouldn't be.

[tingtongteesood]

When a foreigner needs medical attention because they were assaulted by Thai citizens, the kingdom of Thailand should at least pay the medical expenses, that's the least they should do ! As for the rest, if Thai people stropped double pricing, price gouging and stealing from foreigners, maybe more of them could pay their medical bills. For the few per cent that are left, I agree they should be refused unless it is life threatening. I would refuse to pay for medical insurance, why should I pay an extra tax for everyone else ? I have money and WILL pay any legitimate bills that may come my way...

[Kananga]

With all the killings, muggings, bar fights, stabbed karaoke singers, shootings, balcony jumpers etc perhaps they would be better off selling life insurance instead.

[MobileContent]

I wouldn't be surprised if CP Allianz would get that deal to sell health insurance to foreigners at all 7/11 stores.