An American in Bangkok's heart event/"J.C.'s" scooter accident

[Craig krup]

There are a couple of youtubers who have posted their experiences regarding health care in Thailand. Scott Mallon - the eponymous "American in Bangkok" - took a funny turn which could have been a heart attack. "J.C" (who produces the retirecheapasia channel, which is good, but he needs to stop deleting all comments that aren't simply happy-clappy) came off his scooter recently, and ended up in the hospital. Now these are the kinds of accidents and events that I think you can reasonably fear and have to anticipate. In both cases they ended up paying treatment costs which seemed very reasonable - so low, in fact, that it makes you wonder about the wisdom of health insurance.

But here's the rub. In both cases they i) speak fluent Thai, ii) have Thai wives or girlfriends, and iii) were able to "participate" in the process. JC was knocked out, but not for long.

But if you're seriously ill and you don't have anyone to intervene on your behalf who is to say what anything costs? If you spent a week in hospital, received £100 worth of drugs, an hour of doctor care and nursing support - and were a Thai, and part of a large family - you would pay sum "x". What multiple of sum "x" would you pay if you were a seriously ill Brit? What (precisely) stops, "Think of a number and move the decimal point"?) Would the consulate intervene? Would the tourist police?

If you had a large and established European community would it be possible to employ your own pitbull? In other words, might it make sense for Brits, Aussies and Americans in Pattaya to club together and create a friendly society with no other objective than to supply representation for sick members? If 500 people paid £2 a month to a lawyer who only had one objective - secure Thai prices for sick members, even if that means making enemies - would that work? Would the lawyer instantly be made a separate (secret) counter offer?

[Soutpeel]

Or of course you pay for your own private medical insurance and the cost becomes their problem not yours

And no the consulate wouldnt intervene nor the tourist police, stop putting reasonability on other people and start being responsible for yourself by securing proper medical insurance, your not in the nanny state now with recourse to "free " medical services

Edited April 18, 2015 by Soutpeel

[loppylugs1]

No insurance after 65. Go down to Malaysia/India after stabilisation

[Craig krup]

Or of course you pay for your own private medical insurance and the cost becomes their problem not yours

And no the consulate wouldnt intervene nor the tourist police, stop putting reasonability on other people and start being responsible for yourself by securing proper medical insurance, your not in the nanny state now with recourse to "free " medical services

Well....!

From an economist's point of view the concern is that all you're really buying - or much that you are buying - when you buy health insurance in Thailand is precisely the "advocate" that I suggested in the first opening post. An insurance company will have a Thai speaker who will (in effect) say to the hospital, "**** off, he had a heart attack and he's up and walking in five days, take the 80,000 baht or you'll wish you had". Dis-intermediation - taking the middle man out of the loop, is generally a good idea, so if the insurance company is basically just a Thai advocate you'd be better off employing a Thai advocate, and keeping one on a retainer through a friendly society is a good idea.

My opening post drew attention to what seems an evident fact - people who can represent themselves, or have someone to represent them, seem able to buy medical services at prices which suggest that health insurance is very expensive. The World Bank reckons that Thailand is spending $264 per head per year on health cover. You can argue that westerners buying cover in their fifties are more expensive to provide for, but then again, having been the recipients of first world care for their entire lives they might be cheaper.

You say that asking whether the consulate or police would intervene to prevent the exploitation of a vulnerable and seriously ill person - through overcharging - is an example of "nanny state" mentality. Well, in the West for hundreds of years we've believed that stopping predatory behaviour is a core function of the state. That's after all why we have people directing their efforts into useful economic activity, and why we became seriously wealthy. You're right that in many parts of the world that still isn't understood, which is why some countries (like Thailand) have GDP a quarter of that of otherwise comparable nations.

The British NHS costs £2000 per head. Health insurance for many westerners in Thailand - certainly as they head into their late fifties - is almost as expensive. British nurses get paid £30,000 year (give or take) and have massive index-linked pensions. Consultants get paid £110,000 a year, with bonuses on top. British GPs - primary care physicians - get paid £125,000 a year.

I think Thai nurses and doctors are quite a bit cheaper, so if you don't think there's something to explain here permit me to disagree.

Edited April 18, 2015 by Craig krup

[Matej]

Why should tourist police care about that? It's not their problem at all.

If you can't take care of yourself than rather go back home.

[Craig krup]

Why should tourist police care about that? It's not their problem at all.

If you can't take care of yourself than rather go back home.

Well, I asked a question - would they? You say it's not their problem "at all". Why have tourist police? I mean, are they there principally to police the tourists or to protect a group who might be especially vulnerable - er, for example, the tourists?

"If you can't take care of yourself".....Mmmmm. Isn't the point rather, er, obvious from the original post - we're talking about a group of people who can't take care of themselves, a group called, "People who've been pole-axed by a serious illness in a foreign country". Harold Shipman killed about 300 pensioners. They, presumably, should have taken better care of themselves.

In the UK if a service provider - a hospital or anyone else - tried to dramatically overcharge a vulnerable foreigner the cops might say "civil matter", but far more likely someone would get lifted for "obtaining a pecuniary advantage by deception", "fraud" or "whatever else I can think of to get your obviously guilty and predatory a**e into a cell". Should the tourists getting off the planes at Heathrow - most of whom were not unconscious from an in-flight stroke - have been left to "take care of themselves", or should what actually happened have happened - a war on the touts and illegal cabs?

Don't get me wrong, not everybody understands the big trick of the West - "Why thinking carefully and implementing good rules will make us all rich". People who settle long-term in countries where nobody understands that are likely to be a self-selected group who have the same blind spot.

[Soutpeel]

No insurance after 65. Go down to Malaysia/India after stabilisation

Where you get this urban myth from ? There are companies who are sponsors on TV who will get you medical insurance, big difference between not bring able to get it and not wanting to pay for it

Although not thsiland, my parents are in their 80,s and still have medical insurance

[Soutpeel]

Why should tourist police care about that? It's not their problem at all.

If you can't take care of yourself than rather go back home.

Why should a consulate care its not their problem either, the op is showing the typical attitude that come with large numbers of people from the UK these days as regards of not taking responsibility for themselves and expecting other people to take care of them when the sh*t hits the fan Edited April 19, 2015 by Soutpeel

[loppylugs1]

No insurance after 65. Go down to Malaysia/India after stabilisation

Where you get this urban myth from ? There are companies who are sponsors on TV who will get you medical insurance, big difference between not bring able to get it and not wanting to pay for it

Although not thsiland, my parents are in their 80,s and still have medical insurance

Try it after 65 its not worth having, pays a fortune delivers a little

[Soutpeel]

No insurance after 65. Go down to Malaysia/India after stabilisation

Where you get this urban myth from ? There are companies who are sponsors on TV who will get you medical insurance, big difference between not bring able to get it and not wanting to pay for it

Although not thsiland, my parents are in their 80,s and still have medical insurance

Try it after 65 its not worth having, pays a fortune delivers a little

You said no insurance after 65, now your back peddling and saying something else, make your mind up

[loppylugs1]

No insurance after 65. Go down to Malaysia/India after stabilisation

Where you get this urban myth from ? There are companies who are sponsors on TV who will get you medical insurance, big difference between not bring able to get it and not wanting to pay for it

Although not thsiland, my parents are in their 80,s and still have medical insurance

Try it after 65 its not worth having, pays a fortune delivers a little

You said no insurance after 65, now your back peddling and saying something else, make your mind up

I said try it no new business after 65

[Sheryl]

There are international policies which will newly enroll people past age 65. Of course, pre-existing conditions are excluded, at any age.

OP is making a number of incorrect assumptions, starting with taking the amounts paid by 2 specific individuals in 2 specific cases as indicative of health care costs in Thailand .

Some private hospitals do have double tiered pricing, but not all, and most government hospitals do not. (However, most Thais do not have to pay anything since there is universal coverage in Thailand).

It is certainly important to have someone who can advocate on your behalf if you are incapacitated, and not only (or even primarily) for cost reasons.

But don't make the mistake of assuming that health care costs will not exceed what you can afford. Even in a government hospital, at the "Thai" rate (though as mentioned few Thais would have to pay it), costs can reach millions of baht if you require prolonged ICU care, multiple specialized surgeries etc. All of which cna and do happen, and have happened to many farangs here.

[loppylugs1]

There are international policies which will newly enroll people past age 65. Of course, pre-existing conditions are excluded, at any age.

OP is making a number of incorrect assumptions, starting with taking the amounts paid by 2 specific individuals in 2 specific cases as indicative of health care costs in Thailand .

Some private hospitals do have double tiered pricing, but not all, and most government hospitals do not. (However, most Thais do not have to pay anything since there is universal coverage in Thailand).

It is certainly important to have someone who can advocate on your behalf if you are incapacitated, and not only (or even primarily) for cost reasons.

But don't make the mistake of assuming that health care costs will not exceed what you can afford. Even in a government hospital, at the "Thai" rate (though as mentioned few Thais would have to pay it), costs can reach millions of baht if you require prolonged ICU care, multiple specialized surgeries etc. All of which cna and do happen, and have happened to many farangs here.

Hello Sheryl.

Yes looked at these "international" so called policies,would say not worth the paper they are written on,and as for "per-existing" for a 65 plus I would say you were pretty well excluded for everything.,and those terms,right

Being a great advocate of medical care a couple of hours south or east of Thailand give me choices far beyond anything here in Thailand.

Anyway have (free) medical evacuation plan from previous employment to the age I snuff it

[Soutpeel]

There are international policies which will newly enroll people past age 65. Of course, pre-existing conditions are excluded, at any age.

OP is making a number of incorrect assumptions, starting with taking the amounts paid by 2 specific individuals in 2 specific cases as indicative of health care costs in Thailand .

Some private hospitals do have double tiered pricing, but not all, and most government hospitals do not. (However, most Thais do not have to pay anything since there is universal coverage in Thailand).

It is certainly important to have someone who can advocate on your behalf if you are incapacitated, and not only (or even primarily) for cost reasons.

But don't make the mistake of assuming that health care costs will not exceed what you can afford. Even in a government hospital, at the "Thai" rate (though as mentioned few Thais would have to pay it), costs can reach millions of baht if you require prolonged ICU care, multiple specialized surgeries etc. All of which cna and do happen, and have happened to many farangs here.

Well said Sheryl

[Soutpeel]

There are international policies which will newly enroll people past age 65. Of course, pre-existing conditions are excluded, at any age.

OP is making a number of incorrect assumptions, starting with taking the amounts paid by 2 specific individuals in 2 specific cases as indicative of health care costs in Thailand .

Some private hospitals do have double tiered pricing, but not all, and most government hospitals do not. (However, most Thais do not have to pay anything since there is universal coverage in Thailand).

It is certainly important to have someone who can advocate on your behalf if you are incapacitated, and not only (or even primarily) for cost reasons.

But don't make the mistake of assuming that health care costs will not exceed what you can afford. Even in a government hospital, at the "Thai" rate (though as mentioned few Thais would have to pay it), costs can reach millions of baht if you require prolonged ICU care, multiple specialized surgeries etc. All of which cna and do happen, and have happened to many farangs here.

Hello Sheryl.

Yes looked at these "international" so called policies,would say not worth the paper they are written on,and as for "per-existing" for a 65 plus I would say you were pretty well excluded for everything.,and those terms,right

Being a great advocate of medical care a couple of hours south or east of Thailand give me choices far beyond anything here in Thailand.

Anyway have (free) medical evacuation plan from previous employment to the age I snuff it

A couple of hours south or east provided they can put you on a plane or transport you of course certain things could happen which could prevent this happening on medical grounds

[loppylugs1]

There are international policies which will newly enroll people past age 65. Of course, pre-existing conditions are excluded, at any age.

OP is making a number of incorrect assumptions, starting with taking the amounts paid by 2 specific individuals in 2 specific cases as indicative of health care costs in Thailand .

Some private hospitals do have double tiered pricing, but not all, and most government hospitals do not. (However, most Thais do not have to pay anything since there is universal coverage in Thailand).

It is certainly important to have someone who can advocate on your behalf if you are incapacitated, and not only (or even primarily) for cost reasons.

But don't make the mistake of assuming that health care costs will not exceed what you can afford. Even in a government hospital, at the "Thai" rate (though as mentioned few Thais would have to pay it), costs can reach millions of baht if you require prolonged ICU care, multiple specialized surgeries etc. All of which cna and do happen, and have happened to many farangs here.

Hello Sheryl.

Yes looked at these "international" so called policies,would say not worth the paper they are written on,and as for "per-existing" for a 65 plus I would say you were pretty well excluded for everything.,and those terms,right

Being a great advocate of medical care a couple of hours south or east of Thailand give me choices far beyond anything here in Thailand.

Anyway have (free) medical evacuation plan from previous employment to the age I snuff it

A couple of hours south or east provided they can put you on a plane or transport you of course certain things could happen which could prevent this happening on medical grounds

Erm no but then look on the bright side broken bones ,spleen whatever If your dying your dying end of

[Loptr]

Not sure where the OP is getting his info, but Scott recently had hip replacement surgery... No mention of a "heart event" unless this is something new...

As far as being rendered unconscious and not being able to communicate with rescue / health care workers, that's what an insurance card is for in your wallet... As for the assertion that not everyone can get or afford health insurance, have a card in your wallet with a contact name and telephone number in case of emergency... Someone you know who can instruct medical staff what your intentions are... This person could be a friend, relative or possibly an attorney you put on retainer for this purpose... Those who fail to plan, plan to fail...

[Craig krup]

...the op is showing the typical attitude that come with large numbers of people from the UK these days as regards of not taking responsibility for themselves and expecting other people to take care of them when the sh*t hits the fan

Well, I explore (above), in quite a lot of detail why you aren't entitle to infer that from what I've actually said. The reason you don't address that, it seems, is because you already have a preconception in place which means that you can't see what is actually being said. I'll make it even clearer.

1) It seems that fairly serious medical emergencies can be treated at surprisingly low cost.

2) The people who seem able to secure these low prices may have characteristics which make this possible.

3) Specifically they might be Thai speakers with Thai spouses/girlfriends.

4) The prices for emergency medical treatments aren't posted in the way that the prices of scooters are posted.

5) It could be difficult or impossible to establish exactly what treatment you had when you were seriously ill.

6) You might be in a very weak position to pursue a civil action if you have been seriously ill.

7) It seems that there is little or nothing preventing a hospital charging a seriously ill farang, who doesn't have locals to help him out, five, ten or twenty times what they would charge a local.

8) If there is something that prevents this please tell me what it is.

9) The cost of health insurance seems high next to the established cost of treatment.

10) Specifically, if a suspected heart attack, an angiogram, a scooter accident with a concussion and a total time in hospital of over a week comes to less than a year's policy for a fifty something it seems that someone somewhere is taking the p***.

Now if you can't, or won't, read the above, and address the issue - what stops the incapacitated being overcharged? - then please don't reply.

[The internet: where inattentive people have been learning to type since 1990].

Edited April 19, 2015 by Craig krup

[Craig krup]

Some private hospitals do have double tiered pricing, but not all, and most government hospitals do not. (However, most Thais do not have to pay anything since there is universal coverage in Thailand).

It is certainly important to have someone who can advocate on your behalf if you are incapacitated, and not only (or even primarily) for cost reasons.

But don't make the mistake of assuming that health care costs will not exceed what you can afford. Even in a government hospital, at the "Thai" rate (though as mentioned few Thais would have to pay it), costs can reach millions of baht if you require prolonged ICU care, multiple specialized surgeries etc. All of which cna and do happen, and have happened to many farangs here.

Interesting. But can you rely on getting a bill that hasn't been padded?

[Craig krup]

Not sure where the OP is getting his info, but Scott recently had hip replacement surgery... No mention of a "heart event" unless this is something new...

I think it was about a year ago - it should be available. He says he didn't feel good, he's a little bit heavy, gets taken in and has an angiogram, gets a bill which has been padded a bit, has a little argument and ends up paying about a tenth of the square root of what he would have paid in the US.

[Soutpeel]

...the op is showing the typical attitude that come with large numbers of people from the UK these days as regards of not taking responsibility for themselves and expecting other people to take care of them when the sh*t hits the fan

Well, I explore (above), in quite a lot of detail why you aren't entitle to infer that from what I've actually said. The reason you don't address that, it seems, is because you already have a preconception in place which means that you can't see what is actually being said. I'll make it even clearer.

1) It seems that fairly serious medical emergencies can be treated at surprisingly low cost.

2) The people who seem able to secure these low prices may have characteristics which make this possible.

3) Specifically they might be Thai speakers with Thai spouses/girlfriends.

4) The prices for emergency medical treatments aren't posted in the way that the prices of scooters are posted.

5) It could be difficult or impossible to establish exactly what treatment you had when you were seriously ill.

6) You might be in a very weak position to pursue a civil action if you have been seriously ill.

7) It seems that there is little or nothing preventing a hospital charging a seriously ill farang, who doesn't have locals to help him out, five, ten or twenty times what they would charge a local.

8) If there is something that prevents this please tell me what it is.

9) The cost of health insurance seems high next to the established cost of treatment.

10) Specifically, if a suspected heart attack, an angiogram, a scooter accident with a concussion and a total time in hospital of over a week comes to less than a year's policy for a fifty something it seems that someone somewhere is taking the p***.

Now if you can't, or won't, read the above, and address the issue - what stops the incapacitated being overcharged? - then please don't reply.

[The internet: where inattentive people have been learning to type since 1990].

What prevents this ? Having proper medical insurance

Funny thing is having worked here for 14 years and having proper medical insurance and having used said insurance on numerous occasions at various private hospitals in Thailand I have yet to experience any of the circumstances you are suggesting are common problems here,

I see and sign all the bills and my medical insurance which is based out of the UK has never had an issue with inflated or padded costs and in fact commented one time that they couldn't believe it was so cheap to get a hernia repaired in Thailand

Seems to me all your trying to do is justify in your own mind not talking out insurance, which if your living in a country with no recourse to "free" medical treatment is a very irresponsible thing to do and one hopes you don't end up in an ICU somewhere and your relatives are having to appeal for money to pay the the hospital bill and the money to fly you home, just because you couldn't be bothered to get proper insurance

[Craig krup]

1) What prevents this ? Having proper medical insurance

2) Funny thing is having worked here for 14 years and having proper medical insurance and having used said insurance on numerous occasions at various private hospitals in Thailand I have yet to experience any of the circumstances you are suggesting are common problems here,

3) I see and sign all the bills and my medical insurance which is based out of the UK has never had an issue with inflated or padded costs and in fact commented one time that they couldn't believe it was so cheap to get a hernia repaired in Thailand

4) Seems to me all your trying to do is justify in your own mind not talking out insurance, which if your living in a country with no recourse to "free" medical treatment is a very irresponsible thing to do and one hopes you don't end up in an ICU somewhere and your relatives are having to appeal for money to pay the the hospital bill and the money to fly you home, just because you couldn't be bothered to get proper insurance

I've numbered your remarks to make this clearer.

Your "1" - You say "prevents this". It is entirely unclear what the "this" is that you are referring to. Are you saying that there is a problem of overcharging, but this doesn't happen if providers are dealing with insurance companies? If you are saying this you concede my point.

2) Your "2" - "..having worked here and having proper medical insurance....". Read what you've written. If you've only ever been looking at bills prepared for someone who does have a hard-faced insurance company with local reps standing behind them that that wouldn't tell us much about what would happen to other people, would it?

3) Your "3" - Your insurance "is based out of the UK". Yeah. If you think they don't have metrics in place, and locals to pursue funny figures, then .......whatever. I'm sure they're as ill-organised, thoughtless and open to scams as you imagine.

4) Your "4" - "Seems to me all your [you mean "you're"] trying to do is justify in your own mind.....blah, blah, blah". Exactly. It seems to you. You don't know me, you don't know anything about me, you haven't read what I've actually written, you don't feel obliged to take it at face value and actually address any of the content.

If we're in the business of characterising one another on the basis of slim evidence you strike me as like an old woman at a bus stop chuntering on regardless of what the other person says. At some level you must know that you've chosen to leap to a conclusion about my "real" motives, my "probable" character and status. At some level you know that it's possible that I'm a university graduate with four degrees, a big pension and substantial independent means. I might not be, but then again, at some level you know I might be. So at some level you must know that ignoring what I've actually said, in order to engage in yet one more exercise in sub-literate stick-missing must be unwise. It hasn't stopped you though, has it?

[Sheryl]

Please keep it civil.

[Craig krup]

Please keep it civil.

I know, I know.....but hell's teeth, almost every single internet bulletin board is made completely unusable be frequent posters who impute intentions rather than read what's written. Hume (and others) said that nobody can ever imagine anyone doing anything for a motive that they themselves couldn't hold. So thugs always interpret reasonableness as weakness, and fools always imagine that a critique of their ideas is an attempt to belittle and bully them. The thug can't imagine what it would to be reasonable, and the fool can't imagine why anyone would care that an idea was coherent. They don't have a taste for it, don't have access to those sentiments, don't have any experience of dealing with people or ideas in this way, so they proceed for decades on that basis.

An educational theorist called Olson suggested that it was writing that made the West rich by forcing people to look at precisely what they have said - so called "literate scientific thinking". Of course the reality is that people are perfectly happy ignoring what they've said and what you've said, whether you type it or not.

[loppylugs1]

Seems to me all your trying to do is justify in your own mind not talking out insurance, which if your living in a country with no recourse to "free" medical treatment is a very irresponsible thing to do and one hopes you don't end up in an ICU somewhere and your relatives are having to appeal for money to pay the the hospital bill and the money to fly you home, just because you couldn't be bothered to get proper insurance

As someone who relates having used insurance to pay for medical treatment in Thailand,you may well know the way around the block,and the authorities may well know you. Padding or inflating the bill is common practice,have experienced it and complained (bill reduced 50%) (changing half used oxygen bottles for full ones etc.) just a gang of robbers Medical Mafia of Thailand.

Come 60 or even 65 impossible to obtain insurance,do not care what is offered after that date,but if ,a big if, will go something like £500 per month capped at max of 1 mil. Some countries insist on medical insurance up to 65 then drop the requirement after that age of 65 because they know its impossible.

As for that suggestion of "proper insurance" yeah right LOL ps you may get to 65 but then you may not, so no insurance worries

[Sheryl]

It is not impossible to get insurance at 60 or 65 (or even 70, 75) and at levels well over 1 million. The big problem is that by that age most people have acquired one or more pre-existing conditions, which will be excluded from the coverage. And of course the premiums are higher (but so is the risk that you'll have a major illness).

[loppylugs1]

It is not impossible to get insurance at 60 or 65 (or even 70, 75) and at levels well over 1 million. The big problem is that by that age most people have acquired one or more pre-existing conditions, which will be excluded from the coverage. And of course the premiums are higher (but so is the risk that you'll have a major illness).

..and no emergency evacuation tacked on either

[NancyL]

It's much easier to get personal accident insurance than comprehensive health insurance once over age 65 and considering that the personal accident rate here is about 20 times higher than in the west, it would seem prudent to at least purchase a personal accident policy. Some cover up to age 100 and they don't seem to inquire about pre-existing conditions when you purchase a PA policy.