Implications of New Government Health Insurance Policy in Chiang Mai

[Mapguy]

Chiang Mai has become somewhat of a Mecca for older (sometimes much older) people from richer countries, most, if not all, of which have national health policies. Chiang Mai is not a Viagra-driven Pattaya. It does attract others of both genders who aren't into "that" any more. It is not a high-energy urban scene like Bangkok, but it is not exactly a cultural gully by Western standards.

If anything, I personally regret people coming here to make Chiang Mai into something (hamburger heaven?) different than it is than to meet their expectations of what they left behind --- or were unable to cope with --- to come here. I do not mean to insult younger sorts looking for some adventure abroad. I wish them well. But I do wonder about older sods. Why so many (too many?) have landed here who can not provide for themselves? And then expect Thailand to take care of them !

The new Thai public health policy was designed to take care --- in consonance with other ASEAN countries --- of the healthcare needs of regional ASEAN partners. Thailand happens to be the more economically-advanced of its neighbors when it comes to health care. It was NOT designed to help people from more economically-developed countries to get a nominally "free ride" when it comes to health care!

At this point, I'll leave the question open as to the astonishing design and early implementation of the recently advertised healthcare changes to benefit expatriates in Chiang Mai.

Your thoughts ?!

[worgeordie]

I am sure all the old sods,have their pensions transfered to Thailand,which gives a year round

boost to the local economy,and most ,if not all have been able to provide for themselves before

the Government introduced their new health care policy, they live here,buy property (by proxy)

pay taxes if even just in the form of VAT.

So are you making the point that Chiang Mai would be a better place without all (too many)

old sods as you put it,just remember you will also be an old sod one day.

Really its none of your business,this is Thailand, the Thai Government make the policies,

some good ,some bad, this I feel is one of their better ones,not often you find a caring Govt.

regards Worgeordie one of the old sods.

[mccw]

I wonder how many of these farangs now queuing up at the Thai government hospitals were until recently moaning over their jars about all the immigrants using the health facilities in the home countries- especially those doing so with out contributing any taxes.

This is really an amazing development.

I can't say I agree with it all. Look how over burdened the British, Italian, etc health systems are because of the policies like this. It will cost a fortune and I see no moral reason got Thai tax payers to have to provide for retired farangs health care; especially those who live very unhealthy life styles, diabetics, obesity and alcohol related problems. Terrible.

At least there should be a minimum length of stay before being allowed to claim this for farang retires- 5 or 10years maybe. Perhapse an exemption for those married with children.

Obviously people are out for themselves- its understandable- but come let's have a bit of objectivity.

[Mapguy]

Well, I am not a young sod myself, but doing okay, thank you!

I suggest looking beyond personal concerns and needs. Let's be honest. In Chiang Mai, frankly, the "old sods" who might be most interested in this change of Public Health policy are those least invested in property beyond the rental of their 40sqm rooms and least able to contribute beyond a few beers, street food and the occasional "partner" for physical release.

Get real!

[mccw]

If all that's needed to sign up is a rental contract and no residency time limit then I expect we will see the scrounger type health tourists coming over from Europe and USA for a few months to skip the ques and or costs of back home. Probably many many countries would like to come for this deal- not just the richer ones.

[Mapguy]

If all that's needed to sign up is a rental contract and no residency time limit then I expect we will see the scrounger type health tourists coming over from Europe and USA for a few months to skip the ques and or costs of back home. Probably many many countries would like to come for this deal- not just the richer ones.

Brave soul! I think you will engender a few lively responses!

[mccw]

An implication of this could very well be a new hostility to the farang retirement community. Tolerated as an economic benefit this far quite happily; but how long until the lower class thai who are not directly benefiting from farang social or employment start to feel pissed off that half a day is spent servicing white foreigners while they are left with half the previous time slots to wye up in the afternoon (of something to this effect as previously already outlined in the other thread). Once these opinions start spreading in discussion it might not be long until some idiot political groups like rak Chiang Mai 51, or other extremists looking to capitalise on any hate based power, take advantage of this resentment and begin whipping up worse anti farang policies or protest or violent actions.

Maybe maybe not. Worth baring in mind before u go and join the que due to an ache back or what ever.

Never mind the enevitable grumpy gits and cultural insensitivity too many already display in the private hospitals. Like not talking at the top of your voice while others are trying to rest and such.

[muchogra]

I did not have a good impression of you when you 'talked too much' when a friend of Nancy needed help cos she was not able to help herself on her own in an accident due to financial difficulties. In other words, she's not prepared being in a foreign country! Well, that could certainly happen to many people unknowingly. But, I certainly do not want to see peope of advanced age coming here thinking they can be covered as some posts elsewhere may suggest!

[Mapguy]

Interesting. mccw.

I do not understand how this recent change in public health policy can be perceived as "hostility" to foreigners of any stripe! Indeed, considering the original purpose of the program --- to be in conformance with, monitor and assist ASEAN partner populations --- it is astonishingly generous !!

In a large sense, don't you wonder at how extravagant the "investment" so many farang on this site tend to make their contributions to Thailand's GNP?! GET REAL!!!

Otherwise, I find it difficult to characterize the modi operandi of various Thai political groups too handily. There are some very serious sociopolitical changes going on in Thailand --- and they can not be measured in a few months or a few years, let alone within the common knee-jerk timeframe of Western journalism.

[muchogra]

you, in my last post refers to the OP! In other words, I quite agree with the OP on his inferences.

[mccw]

Interesting. mccw.

I do not understand how this recent change in public health policy can be perceived as "hostility" to foreigners of any stripe! Indeed, considering the original purpose of the program --- to be in conformance with, monitor and assist ASEAN partner populations --- it is astonishingly generous !!

In a large sense, don't you wonder at how extravagant the "investment" so many farang on this site tend to make their contributions to Thailand's GNP?! GET REAL!!!

Otherwise, I find it difficult to characterize the modi operandi of various Thai political groups too handily. There are some very serious sociopolitical changes going on in Thailand --- and they can not be measured in a few months or a few years, let alone within the common knee-jerk timeframe of Western journalism.

Perhapse you miss understood.

I don't mean the 30bht health care policy is hostile.

I mean how long until the enevitanle increased waiting times / lack of rescources left for the poor Thai citizenry, how long till this festers resentment of those foreigners taking up these rescourses by those now left with a worsened standard of care?

That resentment is what politicians can turn to advantage just as they have done along class lines successfully in many other countries far and not so far away.

The Thai people are extraordinarily patient and good hearted by and large so hopefully such circumstances will not develop. Just theorising as to a possible implication of this new policy.

[mccw]

One can see the resulting hostility to immigrants in the west when they on mass are taking away needed services from the locals.

Just saying.

Not like there isn't examples all over the west of racial hostility and economic problems because of people taking advantage (perfectly legally) of generous provisions.

Just think its worth considering.

[Chiengmaijoe]

Absolute drivel. And what a condescending, stereo- typical view you have of older expats, even though you are one yourself.

First of all you think they come here to turn chiang Mai into burger heaven, then you think that too many have landed here, unable to take care of themselves and expect Thailand to take care of them. Does anyone really come here with those intentions? I doubt it.

Some old expats may well continue to prefer to eat there national food , as most expats worldwide do, be they American, Mexican, Turkish or Greek, but I doubt if they collectively have any noticeable effect on local habits. Do they come here intending to get a free ride on the local health care? I very much doubt it. Most will have there own personal health plans, and will continue to do so, but a small few may find themselves unable to care for themselves, so the fact that there is a safety net for those less fortunate than you is something to be happy about, not resentful.

The new Thai public health care probably wasn't designed purely for Thais or members of the ASEAN countries, it was probably designed for all people living here. All people living here pay tax via VAT, and a fair few old expats will either have a small business or job so also pay income tax and/ or company tax. Should they not have the benefit of a system they contributed to, possibly more than the average Thai? Again, most of those people will probably have personal health cover, so probably won't use it anyway, preferring the better, quicker private hospitals.

Your views come across as smug, self righteous and uncaring. Have you considered contributing to the columns of The Daily Mail?

[Chiengmaijoe]

One can see the resulting hostility to immigrants in the west when they on mass are taking away needed services from the locals.

Just saying.

Not like there isn't examples all over the west of racial hostility and economic problems because of people taking advantage (perfectly legally) of generous provisions.

Just think its worth considering.

Another Daily Mail reader!

Immigrants on mass taking away needed services from the locals! I hate to shatter your illusions but the vast majority of immigrants work hard to support a family back home and take jobs that locals are unwilling to do.

Just saying. Worth considering.

[Chiengmaijoe]

If all that's needed to sign up is a rental contract and no residency time limit then I expect we will see the scrounger type health tourists coming over from Europe and USA for a few months to skip the ques and or costs of back home. Probably many many countries would like to come for this deal- not just the richer ones.

I very much doubt that the only requirement is a rental agreement. Do you really believe that? Also, I think you'll find that most, if not all, Americans/Europeans will have an extremely low opinion of Thai public hospitals. No one is going to pay for a flight to Thailand and accommodation here to take advantage of basic health care, I can assure you.

It's always best to take a little bit of time to ponder before you post on topics such as this. Just saying.

[Mapguy]

Your criticisms, Chiengmaijoe, seem very harsh to me.

You are correct. There are many responsible people among "Westerners" (to introduce a new expression here rather than farang (with apologies to those "Down Under" or nearby ).

You are correct. A lot of foreigners do indeed take personal responsibility for health care through insurance or personal income. But I wonder how much you have looked around !!

The program was NOT designed for other than ASEAN. It was extended to include foreigners of seemingly better means (perhaps) because of the increasing problem for medical care costs absorbed by practitioners and hospitals in Chiang Mai --- a retirement haven --- as well as elsewhere in Thailand --- for such people. Many of these people exist in Chiangmai with no extended family whatsoever. Indeed, some have basically divorced themselves from their "roots," and some, when they are in need, are not even "claimed" by their families in their "home" country!

Edited October 22, 2013 by Mapguy

[Chiengmaijoe]

Your criticisms, Chiengmaijoe, seem very harsh to me.

You are correct. There are many responsible people among "Westerners" (to introduce a new expression here rather than farang (with apologies to those "Down Under" or nearby ).

You are correct. A lot of foreigners do indeed take personal responsibility for health care through insurance or personal income. But I wonder how much you have looked around !!

The program was NOT designed for other than ASEAN. It was extended to include foreigners of seemingly better means (perhaps) because of the increasing problem for medical care costs absorbed by practitioners and hospitals in Chiang Mai --- a retirement haven --- as well as elsewhere in Thailand --- for such people. Many of these people exist in Chiangmai with no extended family whatsoever. Indeed, some have basically divorced themselves from their "roots," and some, when they are in need, are not even "claimed" by their families in their "home" country!

If it came across as harsh, then I got it right.

You say it was extended to include foreigners of seemingly better means, then go on to say that it will benefit people with no extended family and who , when in need, have no connections with their families back home. Let's hope so.

You say 'many of these people exist' but how many are you talking about? Roughly speaking, what percent of the number of people using the Thai public hospitals do you think will be westerners? To the nearest hundredth of a percent will suffice.

[NancyL]

Normally I don't reply to threads started by Mapguy, because I, too, find him "smug, self righteous and uncaring" as suggested by Chiengmaijoe. Plus, I have no sense that he actually does anything to help elderly expats in need, except to harp at them in his posts. But he did us all a favor this time, by moving these "editorial" comments away from the other informative thread about the inclusion of foreigners in the Thai UC scheme.

A few comments -- most of the people I've assisted to join have no intention to run up to Nakorn Ping hospital and wait many hours to see a doctor for every little problem. No, they'll continue to pay for the convenience of access at CM Ram, Sripat, Rajavej, etc. Instead, they see this UC coverage as a sort of "catastrophic insurance" for a serious major injury or illness. This is coverage they can't buy in the marketplace above a certain age.

Without this insurance, these people probably could end up at Suan Dok for a major problem, where they'd have to work out payment over time, on a payment contract, from their monthly pension checks. Hopefully, they won't die, leave CM or become too senile to remember to make payments before the contract is paid. This UC scheme removes that burden to Thai society.

I think the inclusion of all foreigners in this scheme is the logical extension of calls by various Thai gov't officials for all tourists, visitors, resident foreigners, etc, to have health insurance. Note that this program isn't free for foreigners. Yes, the charge is very modest by western standards, but that charge can be adjusted as they gain experience and understand their true costs.

Edited October 22, 2013 by NancyL

[masuk]

Normally I don't reply to threads started by Mapguy, because I, too, find him "smug, self righteous and uncaring" as suggested by Chiengmaijoe. Plus, I have no sense that he actually does anything to help elderly expats in need, except to harp at them in his posts. But he did us all a favor this time, by moving these "editorial" comments away from the other informative thread about the inclusion of foreigners in the Thai UC scheme.

A few comments -- most of the people I've assisted to join have no intention to run up to Nakorn Ping hospital and wait many hours to see a doctor for every little problem. No, they'll continue to pay for the convenience of access at CM Ram, Sripat, Rajavej, etc. Instead, they see this UC coverage as a sort of "catastrophic insurance" for a serious major injury or illness. This is coverage they can't buy in the marketplace above a certain age.

Without this insurance, these people probably could end up at Suan Dok for a major problem, where they'd have to work out payment over time, on a payment contract, from their monthly pension checks. Hopefully, they won't die, leave CM or become too senile to remember to make payments before the contract is paid. This UC scheme removes that burden to Thai society.

I think the inclusion of all foreigners in this scheme is the logical extension of calls by various Thai gov't officials for all tourists, visitors, resident foreigners, etc, to have health insurance. Note that this program isn't free for foreigners. Yes, the charge is very modest by western standards, but that charge can be adjusted as they gain experience and understand their true costs.

Nice to see a responsible and well-stated viewpoint.

I'm one of the 'oldies', choosing to live in Chiang Mai for a number of reasons. My neighbours are delightful and helpful Thais, I have good friends here, the climate is reasonable, and I also use the great majority of my pension in Chiang Mai. It's not a fortune, but a few hundred dollars every week towards food, other shopping, rent, doctor, cleaning lady, travel, eating out, all contributes to the economy.

If there are as many 'oldies' as has been suggested, then this must have some impact on the quality of life.

[cloudhopper]

This plan is economically, actuarially and demographically doomed and the implications for all should be self evident.

Or I could be wrong and everyone will get all the free health care that 2500 baht can buy they want and live happily ever after. More Kool-aid anyone?

[Thailand]

Normally I don't reply to threads started by Mapguy, because I, too, find him "smug, self righteous and uncaring" as suggested by Chiengmaijoe. Plus, I have no sense that he actually does anything to help elderly expats in need, except to harp at them in his posts. But he did us all a favor this time, by moving these "editorial" comments away from the other informative thread about the inclusion of foreigners in the Thai UC scheme.

A few comments -- most of the people I've assisted to join have no intention to run up to Nakorn Ping hospital and wait many hours to see a doctor for every little problem. No, they'll continue to pay for the convenience of access at CM Ram, Sripat, Rajavej, etc. Instead, they see this UC coverage as a sort of "catastrophic insurance" for a serious major injury or illness. This is coverage they can't buy in the marketplace above a certain age.

Without this insurance, these people probably could end up at Suan Dok for a major problem, where they'd have to work out payment over time, on a payment contract, from their monthly pension checks. Hopefully, they won't die, leave CM or become too senile to remember to make payments before the contract is paid. This UC scheme removes that burden to Thai society.

I think the inclusion of all foreigners in this scheme is the logical extension of calls by various Thai gov't officials for all tourists, visitors, resident foreigners, etc, to have health insurance. Note that this program isn't free for foreigners. Yes, the charge is very modest by western standards, but that charge can be adjusted as they gain experience and understand their true costs.

On the nail Nancy. Agree 100 per cent.

And yes, we will be lining up with the wall to wall expats at our local government hospital in the near future to join the scheme.

Very welcome indeed,very innovative and well done Thailand.Hope it does what those in favour think it will.

,

And if you don't like, don't want to be a part of it then I guess you know what to do --------?

[worgeordie]

Xenophobia against old people ,there must be a word for it,?

thats what Mapguy ,seems to suffer from,he seems more against

old sods,than the fact they maybe able to subscribe to reasonable

priced health care.he forgets one day he also will be an old sod !

regards Worgeordie

[mccw]

One can see the resulting hostility to immigrants in the west when they on mass are taking away needed services from the locals.

Just saying.

Not like there isn't examples all over the west of racial hostility and economic problems because of people taking advantage (perfectly legally) of generous provisions.

Just think its worth considering.

Another Daily Mail reader!

Immigrants on mass taking away needed services from the locals! I hate to shatter your illusions but the vast majority of immigrants work hard to support a family back home and take jobs that locals are unwilling to do.

Just saying. Worth considering.

I know a majority of immigrants are hard working (in England - not talking retirees in Thailand here obviously) but despite this there does exist hostility due to strains on hospitals and school places. The fact that newspapers like the daily mail are decrying the situation proves my point. You think it will be a positive development of Thai farang relations to have thai tabloids starting to run daily weekly stories about how all these old farang have just overburdened the health service.

Reactions to problems are not always reasonable. Maybe this will result in it getting harder to obtain visas.

[harrry]

Normally I don't reply to threads started by Mapguy, because I, too, find him "smug, self righteous and uncaring" as suggested by Chiengmaijoe. Plus, I have no sense that he actually does anything to help elderly expats in need, except to harp at them in his posts. But he did us all a favor this time, by moving these "editorial" comments away from the other informative thread about the inclusion of foreigners in the Thai UC scheme.

A few comments -- most of the people I've assisted to join have no intention to run up to Nakorn Ping hospital and wait many hours to see a doctor for every little problem. No, they'll continue to pay for the convenience of access at CM Ram, Sripat, Rajavej, etc. Instead, they see this UC coverage as a sort of "catastrophic insurance" for a serious major injury or illness. This is coverage they can't buy in the marketplace above a certain age.

Without this insurance, these people probably could end up at Suan Dok for a major problem, where they'd have to work out payment over time, on a payment contract, from their monthly pension checks. Hopefully, they won't die, leave CM or become too senile to remember to make payments before the contract is paid. This UC scheme removes that burden to Thai society.

I think the inclusion of all foreigners in this scheme is the logical extension of calls by various Thai gov't officials for all tourists, visitors, resident foreigners, etc, to have health insurance. Note that this program isn't free for foreigners. Yes, the charge is very modest by western standards, but that charge can be adjusted as they gain experience and understand their true costs.

Sometimes I feel the same about NancyLs posts but I know she does much to help people in ChiangMai.

It is important to note that this scheme gives the hospital the same money as thy would recieve for a Thai Person. In fact the scheme is cost neutral as far as the Thai Government is concerned. My view though is that it should be compulsory for all resident foreigners to join....including those who consider they never will use it. That way the proper spread of people are in the scheme as they are with thais not just a skewed population. Yes it is possible that some of the people who use it are sicker than the norm..but not sicker than elderly thais. I think though that an even greater number of foreigners who join it will pay their day to day medical costs in private centres and only use it as a fall back unlike the thai people who recieve all their care through it and that is designed to include monthly monitoring and treatment of health for older people with problems such as high blood pressure.

If an adjustment of premiums is required we should only be talking of a maximum of double the existing ptemium. Any more is proffiting from the fact we are foreigners.

Comparrison wit Western prices is not relevant here.

[mccw]

If all that's needed to sign up is a rental contract and no residency time limit then I expect we will see the scrounger type health tourists coming over from Europe and USA for a few months to skip the ques and or costs of back home. Probably many many countries would like to come for this deal- not just the richer ones.

I very much doubt that the only requirement is a rental agreement. Do you really believe that? Also, I think you'll find that most, if not all, Americans/Europeans will have an extremely low opinion of Thai public hospitals. No one is going to pay for a flight to Thailand and accommodation here to take advantage of basic health care, I can assure you.

It's always best to take a little bit of time to ponder before you post on topics such as this. Just saying.

On the other thread some one reported that all they needed was a copy of rental contract , passport and 2 mug shot photos.

[mccw]

That Thai hospitals have been left out of pocket up until now by non paying foreigners/ farangs is not a reason to celebrate this scheme as a solution. What it is doing is moving that cost on to the Thai tax payers and multiplying it exponentially.

[harrry]

That Thai hospitals have been left out of pocket up until now by non paying foreigners/ farangs is not a reason to celebrate this scheme as a solution. What it is doing is moving that cost on to the Thai tax payers and multiplying it exponentially.

Thai taxpayers do not pay the hospital. THe government pays about 2000 baht per person in the area covered by the UC sceme that is not included in SS or Government Health Insurance. This contibution is the same. The hospital does not recieve other moneys from either taxpayers or the government.

Incidently the largest amount of taxes paid in thailand is VAT and exise and the average foreigner contributes greatly to that tax pool.

[rcjoop]

The capitation for the UCS in the current fiscal year is 2755 Baht, so this is not very far from the 2200/600 Baht we pay and even at 500 or 1000 baht per month it would help quite a few older farang without becoming a burden for the Thai state.

[mccw]

That Thai hospitals have been left out of pocket up until now by non paying foreigners/ farangs is not a reason to celebrate this scheme as a solution. What it is doing is moving that cost on to the Thai tax payers and multiplying it exponentially.

Thai taxpayers do not pay the hospital. THe government pays about 2000 baht per person in the area covered by the UC sceme that is not included in SS or Government Health Insurance. This contibution is the same. The hospital does not recieve other moneys from either taxpayers or the government.

Incidently the largest amount of taxes paid in thailand is VAT and exise and the average foreigner contributes greatly to that tax pool.

UC scheme will need funding from the tax payer- so your splitting hairs really.

A stay of 5 or more like 10years might be a fair contribution to the economy before entitlements are allowed. Definitely not for new arrivals.

[harrry]

That Thai hospitals have been left out of pocket up until now by non paying foreigners/ farangs is not a reason to celebrate this scheme as a solution. What it is doing is moving that cost on to the Thai tax payers and multiplying it exponentially.

Thai taxpayers do not pay the hospital. THe government pays about 2000 baht per person in the area covered by the UC sceme that is not included in SS or Government Health Insurance. This contibution is the same. The hospital does not recieve other moneys from either taxpayers or the government.

Incidently the largest amount of taxes paid in thailand is VAT and exise and the average foreigner contributes greatly to that tax pool.

UC scheme will need funding from the tax payer- so your splitting hairs really.

A stay of 5 or more like 10years might be a fair contribution to the economy before entitlements are allowed. Definitely not for new arrivals.

No I do not think I am splittting hairs. THe rate of the UC confribution of the government to the hospital is 2000baht (round figures). If this is not sufficient and should be raised it should be. It is not for foreigners to subsidise the Thai Health Scheme either with this or the other discussion going on,.

Yes I think the government should provide more than 2000 baht oer person. The hospitals could then provide everyone better care. The rate for others that we are talking about should be the same. In this case we are not talking about tourists.