Friend In Hospital... Massive Bill Building Up

[WoopyDoo]

I have a friend in hospital in Korat.

He had a problem with not being able to digest food and it seemed like it was just staying in his upper stomach.

He went to the local Bangkok Hospital, and when he explained what his problem was, they instantly told him he had cancer.

They whipped him straight into surgery, and sliced him in 2 places and removed what i believe to be a few inches of his esophagus, then stitched him up and put him in ICU where he has now been for over 3 weeks. They have also told him he needs to stay in ICU for a further month.... (at least).

I have seen a few cancer victims.... he looks actually quite healthy to me and just like someone recovering from a standard surgical procedure.... even though he has been told he has 50/50 chance of survival.

Up until the beginning of this week, the bill is 1.8 million baht.... that is just the ICU bill, there is the surgery bill and a few other things as well, but they have quoted around 6 million in total.

I have known quite a few people with cancer in the past..... Even some family..... Not once were they told instantly with no tests that they had cancer.... they had to have biopsies and waited for the test results. They needed to use hospital facilities when needed, but most of the time they were treated as out patients.... certainly NOT 2 months ICU at 80,000+ a day plus extras.... In fact, none of them spent a single day in ICU.

It is my opinion that this guy is being blatantly ripped off. This is not the first time I have heard of a farang being needlessly shoved into ICU in this hospital.

I have visited the guy a few times, and as you can probably imagine he is pretty miserable, not only is his entire life savings being sucked out of him at a fast rate, but also not overly happy having to consider his condition (alleged condition). He does have insurance, but only covers 19,000 a day and only for 30 days.

Up until now, I have not said anything to him... But I just don't feel comfortable about the entire set up. There are a lot of things that just don't seem right.

I will be seeing him tomorrow and I am tempted to advise him to move himself to a new hospital, there are some very good ones here and I have had nothing but bad stories from the Bangkok Hospital..... It is not the first story I have heard of a farang being held in ICU rather than being treated as an out patient or put in a regular room to convalesce.

I know there are quite a few members here who are actively working in the medical industry..... what do you think?..... just mind my own business till they suck all his money up and boot him into the street?

Edited May 14, 2014 by WoopyDoo

[Satcommlee]

Sounds like they are taking the mickey... 80K a day.. come on!!

If he feels well enough to get up and walk out, then he probably is..

He needs tell them he has no money left, then his health may take a turn for the better...

edit: If he was on deaths door and needed ICU, then this money would all need to paid up front... is this the case?

Edited May 14, 2014 by Satcommlee

[speedtripler]

in thailand ,if it sounds like a scam it probably is ......

get him to another hospital for a 2nd opinion although

he really should have done this himself before agreeing to

go under the knife .......

if it isnt life threatening emergency id have flown to the uk or wherever he lived to have real tests done

if that was an option but it probably wasnt feasible for him

[MJP]

I went to the doctor, he said I got six months to live. Couldn't pay the bill, gave me another six months.

Sent from my SM-N9005 using Thaivisa Connect Thailand mobile app

[farang000999]

I believe my wife's C-Section and private hospital stay cost 40-50k baht but could be wrong.

80k baht a day to sleep in a hospital bed seems very high.

[WoopyDoo]

Sounds like they are taking the mickey... 80K a day.. come on!!

If he feels well enough to get up and walk out, then he probably is..

He needs tell them he has no money left, then his health may take a turn for the better...

edit: If he was on deaths door and needed ICU, then this money would all need to paid up front... is this the case?

I am not sure what the payment setup is, but I have heard of an earlier case where a farang's wife had to show a print out of her husband's bank statement, and pay every couple of days by direct bank transfer to the hospital's bank account.

The whole thing stinks if you ask me, and I am really tempted to convince him to get transported out to another hospital for a second opinion.

They claim he is gravely ill with not a good chance of survival..... He looks fine to me.... miserable at his situation, but still full of jokes when you can take his mind away from it.

At the very worst, he should be in a regular room at about 9,000 a night.... his insurance would easily cover it.

My Thai niece last year stuck a rubber band up her nose and it was lodged at the top of her sinus tract... her parents took her to the same place and they actually gave her an anesthetic and put some tweezers up her nose and pulled it out in literally seconds, then they insisted she stayed in overnight. They bowled in a bunch of impressive looking machines into her room (never hooked her up). Then handed over a 20,000 bill the next morning.... I was protesting all the way.... I knew it was just set up to make money.

[Thaiberius]

Second opinion required without a doubt. Two issues here, diagnosis and cost. They both need sorting out sooner rather than later.

[ALFREDO]

If the insurance does not cover the high costs in a hospital same style Bangkok-Korat hospital

and you finances do not allow to stay there, you should check that out beforehand

and possibly go to the big Thai Public hospital every Thai Province capital has.

Much less prices and as you are a paying customer, not same the nearly free of charge Thai regular patients,

you get also there privileges, as a early, immediately operation date, without waiting time and private room if you pay for it, but much cheaper than in a

private clinic.

I was in Jan. in Udon Thani Public hospital after an accident

and a 1hour20 min full narcotic OP, was necessary, same night,

than, some days more in shared, normal, more persons room, 23.000 Baht.

[speedtripler]

he walked in off the street and they said you have cancer ,we need to operate immediately ad he said ok and let them start ??

[Satcommlee]

This very same hospital kept my son in ICU...

He had found some sleeping pills (that were well hidden by the way) and we caught him with them in his hands, we panicked and rushed into the hospital in case he had taken any...

We got to the hospital within 10 minutes and they gave him a stomach pump..

2 hours later my boy was running round like a mad man!! (hardly sedated!!)

But they said they wanted to keep him in ICU, I didn't have a problem with this because BUPA paid for it all (despite some daft Thai trying to suggest that drug abuse was not covered which was quickly rectified by a phone call to the proper BUPA in UK, he was 3 year old <deleted>!!!)

Still they pray on fear and emotion!! This is how they make their money.. I am convinced of it

[Pralaad]

It does sound like a rip off and a huge medical malpractice(is that the correct term?)

If they did indeed believe it was cancer, they had to do CT scans to determine size and if it has spread.

If it has spread, surgery is not an option.

Not sure what to suggest, but i would PM Sheryl or wait for her to see the thread.

[WoopyDoo]

Second opinion required without a doubt. Two issues here, diagnosis and cost. They both need sorting out sooner rather than later.

I am thinking about suggesting he pay for a doctor from another hospital to come and visit him, take some samples and also interview the doctor who made the diagnosis and ordered the treatment.... Then get a lawyer to liase with the doctor doing the checking.

It is always going to be a bit political no matter what I suggest, and I am not sure his wife is going to like my interfering... I have to admit, it is not a straightforward situation for me... If he were to end up checking out, and then something happens to him, I really don't want people to point the finger at me.... Bloody nightmare scenario.

I feel like I am in a 'toss a coin' situation.

[Pralaad]

Second opinion required without a doubt. Two issues here, diagnosis and cost. They both need sorting out sooner rather than later.

I am thinking about suggesting he pay for a doctor from another hospital to come and visit him, take some samples and also interview the doctor who made the diagnosis and ordered the treatment.... Then get a lawyer to liase with the doctor doing the checking.

It is always going to be a bit political no matter what I suggest, and I am not sure his wife is going to like my interfering... I have to admit, it is not a straightforward situation for me... If he were to end up checking out, and then something happens to him, I really don't want people to point the finger at me.... Bloody nightmare scenario.

I feel like I am in a 'toss a coin' situation.

This is not a good idea.

Thai doctor will never take away "the face" of another Thai doctor

Also the new doctor may not be allowed to visit, as he is not a resident at that hospital.

[speedtripler]

Second opinion required without a doubt. Two issues here, diagnosis and cost. They both need sorting out sooner rather than later.

I am thinking about suggesting he pay for a doctor from another hospital to come and visit him, take some samples and also interview the doctor who made the diagnosis and ordered the treatment.... Then get a lawyer to liase with the doctor doing the checking.

It is always going to be a bit political no matter what I suggest, and I am not sure his wife is going to like my interfering... I have to admit, it is not a straightforward situation for me... If he were to end up checking out, and then something happens to him, I really don't want people to point the finger at me.... Bloody nightmare scenario.

I feel like I am in a 'toss a coin' situation.

if hes feeling ok a taxi / ambulance to the nearest govt hospital wont kill him ?

one doctor might not like to over step the boundaries and discredit another in his respective field

think of the loss of face factor ........

[NeverSure]

This is why I keep a residence and insurance in the US. If someone told me I had throat cancer I would board the first flight "home" and the minute I set foot on US soil all of my medical bills would be covered, 100%. It would even pay for an ambulance from the airport which could be waiting for me.

There are outfits that will give you a physical address and mail forwarding without you living there. Then with US bank accounts etc. there is no hassle of being an expat.

It is true that a good oncologist would probably recognize cancer by looking down the throat, but there is no excuse for not doing a biopsy.

These bills sound outrageous.

Edited May 14, 2014 by NeverSure

[WoopyDoo]

Second opinion required without a doubt. Two issues here, diagnosis and cost. They both need sorting out sooner rather than later.

I am thinking about suggesting he pay for a doctor from another hospital to come and visit him, take some samples and also interview the doctor who made the diagnosis and ordered the treatment.... Then get a lawyer to liase with the doctor doing the checking.

It is always going to be a bit political no matter what I suggest, and I am not sure his wife is going to like my interfering... I have to admit, it is not a straightforward situation for me... If he were to end up checking out, and then something happens to him, I really don't want people to point the finger at me.... Bloody nightmare scenario.

I feel like I am in a 'toss a coin' situation.

This is not a good idea.

Thai doctor will never take away "the face" of another Thai doctor

Also the new doctor may not be allowed to visit, as he is not a resident at that hospital.

Probably right about the face...

Maybe a quick consultation to establish if he can be moved and the whole treatment history can be handed over to the next doctor much in the same way as anywhere else in the world a hospital has to hand over patient records if requested by a qualified doctor taking over the case at the request of the patient.

It is not a situation where he can just get up, get dressed and walk out.... he is in the ICU with loads of monitors plugged into him and also on a drip and also a tube inserted into him to feed him.

It all just looks way over the top and excessive.

I think they have him by the balls.

[Jessi]

Perhaps one of the mods might like to move this to the medical forum.

[benalibina]

I have had dealings with hospitals in Thailand as a patient and as a father. Overall they are positive because they saved my life many years ago and when my twindaughters were born and a complication occurred with the 2nd 1 to be delivered, they acted swiftly. I need to mention though that it was supervised by an elderly doctor.

There is a need at many private hospitals to make money so, not saying they are scamming, they try for the extra night to make money. Had this couple of times and i refused it, as well for my son.

1 occassion i remember that my daughter of 7 months had an inside sort of cyste. We went to phuket International hosp and a female doctor suggested to make a cut, the cyste was right on top of a breast, and do testing for cancer. I looked up on internet what the exact problem was, a lesion she said, and called a hospital in my own country. They told me not to worry that much and that it would soon disappear but also suggested to do a 2nd opinion. Which we did. No problem the doctor there said.

By thinking more about an above poster stated...yes some bring fear into a patient and the patient just follows what the doctor orders. In my opinion doctors everywhere in the world are not the most emphatic people and being in thailand with a different culture of handling things, one must be very critical to them. U need to ask questions and if something not feels right u are obliged to be critical for urself or for ur child.

Story of OP is though quite extreme and obviously the shock of his friend by hearing he has cancer made him loose his thinking abilities, understandably ofcourse. I wish him all the best.

[speedtripler]

Second opinion required without a doubt. Two issues here, diagnosis and cost. They both need sorting out sooner rather than later.

I am thinking about suggesting he pay for a doctor from another hospital to come and visit him, take some samples and also interview the doctor who made the diagnosis and ordered the treatment.... Then get a lawyer to liase with the doctor doing the checking.

It is always going to be a bit political no matter what I suggest, and I am not sure his wife is going to like my interfering... I have to admit, it is not a straightforward situation for me... If he were to end up checking out, and then something happens to him, I really don't want people to point the finger at me.... Bloody nightmare scenario.

I feel like I am in a 'toss a coin' situation.

This is not a good idea.

Thai doctor will never take away "the face" of another Thai doctor

Also the new doctor may not be allowed to visit, as he is not a resident at that hospital.

Probably right about the face...

Maybe a quick consultation to establish if he can be moved and the whole treatment history can be handed over to the next doctor much in the same way as anywhere else in the world a hospital has to hand over patient records if requested by a qualified doctor taking over the case at the request of the patient.

It is not a situation where he can just get up, get dressed and walk out.... he is in the ICU with loads of monitors plugged into him and also on a drip and also a tube inserted into him to feed him.

It all just looks way over the top and excessive.

I think they have him by the balls.

not necessarily ,he can still be moved by ambulance

if anyone tells them this bill is already more than he can possibly pay they will unhook the machines

and arrange trafer to a govt facilty themselves .........

it happened to me in phatathai 2 (private Fccking expensive) hospital in bkk when my credit card maxxed out

ad i was transferred to siriraj hospital in another part of bkk barely conscious in a taxi and bleeding after a bad accidet

years ago

[Tywais]

Perhaps one of the mods might like to move this to the medical forum.

Agree that will be a better place for it and certain Sheryl/FBN will see it. So moved to Health forum, link kept here though.

[Satcommlee]

If he was in the UK, he would have been referred to an Oncologist or whatever... and that appointment would have been up to a month away!

In the UK it is very hard to get a bed in a hospital and they still rate the healthcare system as one of the best in the world.

He's being taken for a ride! as the previous poster said, he walked in off the street and they operated immediately???? something sounds fishy... slow month in the surgical department perhaps?? Month end targets to be met???

[WoopyDoo]

If he was in the UK, he would have been referred to an Oncologist or whatever... and that appointment would have been up to a month away!

In the UK it is very hard to get a bed in a hospital and they still rate the healthcare system as one of the best in the world.

He's being taken for a ride! as the previous poster said, he walked in off the street and they operated immediately???? something sounds fishy... slow month in the surgical department perhaps?? Month end targets to be met???

I appreciate your input.

Maybe I should have corrected the poster who said he walked in off the street.

He didn't, he was unable to swallow any food or liquids and felt very uncomfortable (not painful). So his wife called an ambulance and he was taken to the BKK hospital... He was quickly checked over after explaining the problem and was told immediately that he had cancer and they had to cut it out right away. He was wheeled straight into emergency surgery.

Came around next day in the ICU and was told had to stay in ICU for up to 2 months and has 50% chance of survival.... I just don't believe it.... he doesn't look anything like any cancer patient I have ever seen, and I have seen a few.

I actually swallowed all this at first, the alarm bells rang when they said ICU for up to 2 months and probably up to 6 million baht.... He does have the money.... But that's just about all he does have.

They have also seen his bank statement..... very fishy indeed.. I can see a possible lawsuit coming on.

[WoopyDoo]

Anyway... bedtime. I will catch up with this tomorrow... I am going to visit him again in the afternoon... Hopefully will get enough advice before leaving. As much as I hate to interfere... I am not the type of person to sit idly by while my friend gets shafted.

[Thaiberius]

I am certainly no medical expert but surely a follow up treatment of chemo or similar is required. Sounds very fishy.

[David48]

I believe my wife's C-Section and private hospital stay cost 40-50k baht but could be wrong.

80k baht a day to sleep in a hospital bed seems very high.

That what we paid ... 4 days / 3 nights Bt 42,000 from memory

Edited May 14, 2014 by David48

[Satcommlee]

I believe my wife's C-Section and private hospital stay cost 40-50k baht but could be wrong.

80k baht a day to sleep in a hospital bed seems very high.

That what we paid ... 4 days / 3 nights Bt 42,000 from memory

That's about right I paid 40K for wifes C-S in BPH Pattaya, but you had the choice to shop around so the hospitals are competitive!! Seems like this unfortunate bloke didn't have the chance to shop around and that's when they sting you!

[I Like Thai]

He went to the local Bangkok Hospital, and when he explained what his problem was, they instantly told him he had cancer.

They whipped him straight into surgery, and sliced him in 2 places and removed what i believe to be a few inches of his esophagus, then stitched him up and put him in ICU where he has now been for over 3 weeks. They have also told him he needs to stay in ICU for a further month.... (at least).

When I read something like this, it doesn't make sense to me. No matter how bad people sometimes like to portray Thai hospitals. This kind of behaviour as depicted just can't be right.

Not wanting to doubt the ops version of events, I wonder if this could be plausible.

Maybe the patient had been to the hospital previously, had tests, treatments and advised of his issues and what the remedial action necessary was. For whatever reason he didn't tell his friends about it. Then when he went to the hospital with the OP, whilst they were providing details to the staff. They were pulling his records on their system.

Maybe that's why they said, you have cancer and took him away for an operation. They knew it from the records, not what from what they were talking about at the desk.

Has the OP gone to the hospital to "sort things out"

Edited May 14, 2014 by I Like Thai

[CharlieH]

Sounds all very suspicious, especially AFTER they saw his bank statement.

I would tell them his insurance has requested a second opinion at another hospital due to rising costs and get him the hell out of there.

How does he know anything was actually done ? They may have opened him up, done an exploratory, removed a blockage and thats all.

Move him for sure !

[FBN]

From brief description of the symptoms, it certainly seem compatible with a diagnosis of esophageal cancer but there could also be other, non-malignant reasons. It certainly seems irregular to have emergency surgery without any prior investigative procedures (unless, as a previous poster mentioned, he had been seen at this facility before) but the actual condition of the patient in the ER at time of admission would have determined the immediate management.

You have a right to ask to be transferred to another facility; there are some examples on this forum where this had been accomplished once the correct (senior) people in the hospital admin are involved. This should be the way forward in this case.

Even an ambulance transfer from either this or the receiving hospital should be possible to arrange.

[Sheryl]

There are really 5 different issues here, 4in terms of whether he has/is receiving proper care and then the issue of cost.

In terms of his care, the issues are:

(1) did he in fact have cancer of the esophagus or stomach, necessitating the treatment given. I obviously can't say for sure but his symptoms were consistent with it and it would not have needed very complex tests to know enough to say that surgery was warranted - a physical examination of the throat may have sufficed to show a mass in which case whisking him into surgery ASAP was indeed the right thing to do, with biopsy afterwards on the mass(es) removed - they would need to come out in any event and these types of cancers are curable only when detected early and operated on immediately. Cancer patients do look perfectly healthy until the cancer has spread at which point it is inoperable .So his healthy appearance has no relevance. By now they have full biopsy reports on what they removed, if they are giving him a poor prognosis I would assume it confirmed cancer buy there is more information of relevance i.e. type of cancer, how extensive, whether any indications of metastasis to other organs (they would need to do scans for that, hopefully already have). I really doubt this hospital would go so far as to unnecessarily remove part of esophagus and stomach and deliver a poor prognosis if it were not in fact true. I have never seen any hospital in Thailand, even the most egregious profit-seekers, to do that.

(2) They are however capable of keeping people in ICU past the time needed. It was indicated for say the first 24 hours post-surgery but after that only if he was unstable. I do not have enough information to judge -- perhaps he is having cardiac arrhythmias or other problem that justified a continued stay in the ICU. But it would be good to insist on an explanation of why ICU level care is still needed. If he has no insurance he should make it clear that his funds are limited and hint that he will have trouble paying the bill, that often has a salutory effect.

(3) Assuming cancer has been confirmed on biopsy, whether or not adjunctive therapy, such as chemo and/or radiation, is indicated and would increase his chances. He should have had a consultation with an oncologist by now to explore that option. If he has not, then should insist in it.

(4) How well his doctors are communicating with him in terms of clear explanation of his condition and his options, and whether they are involving him in decisions about treatment. In something like cancer this is critical and if it is not happening (or happening to an unsatisfactory extent) a change of doctors is advisable.

Then cost - he is in the most expensive place possible and is likely going to need additional care such as chemo/radiation, follow up etc, scans to determine if the cancer has spread top the liver and elsewhere (if not already done) so plenty more cost looms ahead, though many of these things can be done on an outpatient basis. So depending in his financial capacity and how he feels about his current doctors he might want to think of going elsewhere.

While there are many other hospitals in Korat , which are fine for general medicine and surgery, I cannot recommend going to any of the other private ones th for this - it is something highly specialized. The only hospital in Korat itself that could be considered is the Maharat Nakhon Ratchasima Hospital (main government provincial hospital, which is a regional level facility and thus would have capacity to manage cancer). However, the best care in the region by far is up at Khon Kaen in the University teaching hospital . It is a government hospital and will cost a fraction of what Bkk Hospital does and has all the necessary facilities and specialists, though there will be some initial red tape, longer waits for outpatient services and of course traveling to and fro to consider.

Both on financial grounds and quality of care grounds, I would advise a transfer to KKU Hospital (Srinagarind). He has an absolute right to insist on that and it is the best facility in Issan for this.

In summary, your suspicions about a false diagnosis/unncessary surgery are almost surely wrong (and please do not hint them to your friend), your suspicions about unnecessary prolonged stay in ICU may be true (can't say due to insufficient info), and certainly he is in the most costly hospital around and it is also not the one with the highest medical capacity for his needs. A transfer to KKU would both improve the level of expertise provided and substantially reduce the remaining costs of treatment.

http://www.md.kku.ac.th/en/index.php?index_page=med_serv&page=hospital