Thai politics: Do private hospitals charge reasonable prices?

[webfact]

BURNING ISSUE
Do private hospitals charge reasonable prices?
CHULARAT SAENGPASSA

BANGKOK: -- WHAT would happen if you needed emergency medical services and were sent to a private hospital?

Are you ready to fork out whatever amount the hospital would charge you?

A surgery like a percutaneous coronary intervention can cost nearly Bt500,000 at a privately-run medical facility, many patients have warned.

Others have complained that medicine prices at private hospitals are much higher than the Public Health Ministry's standard prices.

A private hospital, for example, charges Bt117 per Ezetrol tablet, which helps to lower cholesterol levels, but patients can get the tablets for just Bt50 apiece at pharmacies.

The Thai Medical Error Network believes the pricing issue has now got to a point that Thailand needs to introduce the Price Control Committee for Private Hospitals.

"We understand that private hospitals are operating businesses and they need to make some profits. But still, we believe the prices should be reasonable," the network's president Preeyanan Lorsermvattana commented.

Her network has conducted an online signature campaign, via www.change.org, to garner support for its call for the establishment of the Price Control Committee for Private Hospitals. Launched on April 19, the campaign aims to gather 15,000 signatures. As of yesterday, more than 16,000 people had already signed their names in support of the campaign.

At present, the law requires that medical service providers display the prices of medical services clearly.

Dr Tares Krassanairawiwong, deputy director general of the Department of Health Service Support (DHSS), said people had the right to check the prices before receiving services. He also explained that his department had no power to control the prices charged by private hospitals as their services were optional.

The country offers free medical services to about 48 million Thais through the universal healthcare scheme. Most other Thais are covered by either the social-security scheme or the medical-benefit scheme for civil servants and family members.

Medical Council's deputy secretary-general Ittaporn Kanacharoen, meanwhile, said the prices at private hospitals were beyond his council's control.

"We oversee doctors' ethics and practice. Even though we have laid down the standard medical fees, our guideline here applies to doctors only. Prices collected by private hospitals cover medicines, medical equipment and hospital rooms too," he said.

Some private hospitals have explained they invest hugely in some medical machines. They have counted this as operating cost and have to charge patients for the expense.

At some hospitals, the expenses are shared by all patients. At others, the expenses are shared just among patients who need to use those specific medical machines.

Investment by private hospitals can save lives in so many cases. Yet, some patients lament that they or their children have to pay a huge amount of money to these hospitals following the treatment.

In some cases, they even have to go for payment plans so that they can pay the amount by installment because the fees charged by hospitals are so massive.

According to the Kasikorn Research Centre, Thailand-based private hospitals listed on the stock market are doing well, with their businesses expected to grow by at least 10 per cent this year. Their 2015 revenue will likely go beyond Bt100 billion.

Does this high amount of revenue come from reasonable pricing?

It is undeniable that many private hospitals offer excellent services, friendly staff, shorter queues, and greater convenience. It is undeniable that so many people believe that if patients wish to get these things, they should not mind paying some additional fees.

But everyone should realise that medical services are by no means a luxury. So even when patients turn up at private hospitals, they should not be charged beyond reasonable levels.

Source: http://www.nationmultimedia.com/politics/Do-private-hospitals-charge-reasonable-prices-30258888.html


-- The Nation 2015-04-28

[KhunAussie52]

"A private hospital, for example, charges Bt117 per Ezetrol tablet, which helps to lower cholesterol levels, but patients can get the tablets for just Bt50 apiece at pharmacies"

Interesting, I puchase my meds from a local pharmacy in Surin.The cholesterol lowering meds, i use, "Zimva" 40mg,Costs 250 Baht for 100 tablets

Ezetrol is prescribed to those who cannot use Statins

Edited April 27, 2015 by KhunAussie52

[clockman]

They think they are not third world! So they charge first world prices. Nurses get a pittance. Doctors a fortune. And even some doctors do not have license. But use the hospitals license. Yes T.I.T.

[smutcakes]

I use Samitivej Sukhumvit hospital and it knocks spots of any hospital (Private or Public) in the west in all respects. The speed, cleanliness, convenience, professionalism of the staff is first rate, and i dont give a monkeys ass if i have to pay 300% over the odds, i happily pay it for the service.

[does]

You lucky son of a gun... I have a dream. That one day, all God's children can happily pay 300% over the odds for their medical bills. Because then there will be no need for empathy with those who can't.

I use Samitivej Sukhumvit hospital and it knocks spots of any hospital (Private or Public) in the west in all respects. The speed, cleanliness, convenience, professionalism of the staff is first rate, and i dont give a monkeys ass if i have to pay 300% over the odds, i happily pay it for the service.

Edited April 28, 2015 by does

[malt25]

"Do private hospitals charge reasonable prices?" In who's eyes ? theirs or the patients ?

[shaurene]

I was in private hospital with Bronchitis when left the Doc prescribed an inhaler 2500bt went to my local pharmacy to check the price, 800 bt. They also check you temp, blood press every 4 hrs out of 24 hrs and charge you good. My last visit for a few nights I told them not to come and do those checks after 10pm until 8am next morning.

[Farang99]

I use a private hospital for medical care and check ups, but buy all the prescribed drugs at a pharmacy in town.

[ChrisY1]

Private hospitals do charge above the Government hospitals....but....if the treatment is good and achieves the desired results, then the cost is justified IMO....

I use a private hospital in Hua Hin should the need arise.

However, I had a shoulder reconstruction recently at Rama...(wife is a civil servant)...the cost was 1/2 that of treatment in Australia......no waiting time and an excellent result.....

I do have private health insurance, which I think it vital for an expat living here.

[Laughing Gravy]

I would say comparative to the west they are good value. What I don't like is the huge bag of meds you get for everything. I always throw back the paracetamol, Ibuprofen and the amoxicillin that you get even for a chipped finger nail. The hospitals should all work on reducing the amount of antibiotics they give out. It is ludicrous and not good for the people in the long run.

[skildpadden]

The price of medicine is not the whole issue here, it is also room, doctor's fees, nursing, laboratory and imaging, etc. etc. As for medicine prices, please bear in mind the huge import taxes on medicine - chemotherapy medicine is a good examle - so a high price is not always due to the private hospitals' charges.

Question is, if your relative needs a percutaneous coronary intervention, would you send them to a private or public hospital? The problem is that there can be long waiting at the public hospital whereas at the private hospital there is basically no waiting, the equipment at the public hospitals is in many places not very advanced, so diagnostics in e.g. cardiology is difficult. At the private you have all the specialist teams standing ready, which is likely not the case at the public hospital.

Could it be better in the public system? Sure, but that means everybody needs to start paying their taxes to fund and develop the system, but the latest big outcry on a proposed land tax, does not indicate that there will be any added funds to the public hopsital system anytime soon. Perhaps introduction of something similiar to the Affordable Care Act & Medicare would provide more Thais with access to prime medical facilities?

[cyborgx]

I recently got quoted THB400,000 for an operation by one of the big Bangkok hospitals. Going to a government hospital where the treatment in my opinion was just as good, quoted THB20,000 for EXACTLY the same operation!

If the laws say that prices for services should be clearly displayed, I have NEVER seen in in Bumrungrad, or any of the other major hospitals here. The doctors just make up a number between THB500 and THB2000 for a consultancy, and there is no consitstancy!

Yes, the shopping bag full of pills has always been a problem here. Ridiculous prices for a bag of paracetamol which they don't ask you if you want or need! Anit inflamatory drugs (as if they ever do anything useful), and of course the obligatory antibiotics which we all know the over perscription of which is reducing the effectiveness of antibiotics wordwide. You can undertand it a little from the small clinics who sometimes don't even charge a doctors fee and just make their money on medicines, but you expect better from large hospitals!

I always refuse the height, weight and blood pressure tests unless my problem requires it, but I don't remember hearing about anybody with a nasal problem being caused by symptoms of them getting shorter!!!!

But they always add some nurse/room/facilites or similar nondescript fee of a few hundred baht, as if you are responsible for paying their office expenses too!

We are frequently made to sit around waiting 45-60 minutes later than our appointment, even though WE get there on time. And god forbid you ask for an explanation of why you have been kept waiting 45 minutes after the time of the appointment! I once asked, and the doctor literally came at me and assaulted me!

I kid you not, I just asked why since the appointment was only the first or second, how come I was kept waiting nearly an hour? The first time he ignored the question, the second time I asked, he came at me! It was so ridiculous, I held him down until some staff could drag him away, but the man was a nutter! He even tried to come back for more a little later with a weapon and had to be dragged away again! All that for asking why I had been kept waiting nearly an hour. It's as if they think they are some kind of superior species, and should never be questioned!

My final moan about doctors is their extremely frequent inability to diagnose what is wrong with you, and just prescribe a load of pills including the always present "general antibiotics". I can do that myself! without wasting an hour in traffic to and from the hospital,and another hour in the hospital!

BUT they still charge you a doctors fee every time.

Now change the situation to your phone is broken. You put it in for repair. they can't fix it. do you pay for the repair? of course not!

90% of the time you might as well just ask the pharmacist for some medicine to match your symptoms, there's no service charge and the medicine is cheaper too! 2 issues with that though 1) the person behind the pharmacist counter may give you advice, but usually if you ask them if they a re a pharmacist they will say no, the pharmacist is not there 2) I'm not sure of the current percentage of fake medicine in Thailand, but last time I saw, I believe it was may be as much as 20-30% fake!

[cyborgx]

Considering the 2000% markup, who is being ripped off here? It's the rich Thai's, Tourists, Expats living here, and middle class Thais who end up signing up for massive loans which will take them years to pay back.......

This obvioulsy effects Health Insurance prices, but I've not had one here for a long time. Perhaps some one else can give a perspective on how they are effected by these exorbitant medical fees?

Edited April 28, 2015 by cyborgx

[yardrunner]

I have recently come home after emergency surgery for appendix at Sinanagrind hospital Khon Kaen, the university hospital the care and treatment were excellent and four nights as an inpatient 29000 Baht

[zyphodb]

I think it largely depends on which private hospital you go to, One nameless chain which ambulances take you to by default in a lot of tourist areas have completely insane prices which are obviously set at rates to fleece health insurance companies, wobetide the uninsured who wake up at one of these hospitals, I've known people who've woken up to bills of 50000 + bahts just for being stabilised & spending 12 hours unconscious there... & they take your passport until you pay the bill if you were unfortunate enough to have it with you at the time, although this is illegal T.I.T

[jackanapes]

I am of the opinion that private hospitals charge extortionate fees simply because they are private I was quoted 400,000 baht going upwards for an operation re a fractured femur the end result was an operation in a red cross hospital that cost 49.000 baht and satisfaction .

[maderaroja]

An oilman once was quoted as saying, "Excess profit? There is no such thing as an excess profit!"

[jamie2009]

I normally return to the UK for my 3 monthly check up for Prostate Cancer, it's a PSA Blood Test and a DRE, (digital rectum examination) this time I will have it done here in Pattaya, I have been recommended by some members a Uroligist who works at the International Hospital on Fridays. Before I go I will pay a visit and ask the cost of the consultation so I know what to expect, hopefully cheaper than an air fare to the UK. I used the place for some thing else before but what I didn't like was they always seemed to be 'touting' for business.

[maderaroja]

Try the government hospital, for a change of pace. See what they charge for the same services.

[enufsaid]

Bumrungrad hospital out patient visits are as expensive as Australian GPS, so is medication

[razer]

Saving lives and giving aid to badly injured people and children, for monetary profit, somehow does not make sense in my moral-logic thinking.

[abrahamzvi]

They think they are not third world! So they charge first world prices. Nurses get a pittance. Doctors a fortune. And even some doctors do not have license. But use the hospitals license. Yes T.I.T.

All I can say is UTTER NONSENSE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Each doctor has to use his own licence number! Thailand is neither a third world country nor are its private hospitals "third class"nor do they charge first world prices. Admittedly, medicines are more expensive in hospitals than in pharmacies, I assume that their margin of profit is higher, but in most countries, including first world countries this is the case.

May I suggest that clockman compare the costs of visiting a doctor in a hospital in the USA, UK, most European countries and Australia, NZ. to the costs here in the most expensive private hospitals in Thailand, which afford first class service and are staffed by highly qualified staff. I am sure that he will be most surprised. The costs here would be at least 50 to 75% lower.

I think that people should be careful before making such false and misleading statements.

Just for the records - I am neither an employee nor a shareholder of any private hospitals.My experience with 3-4 of them in the last few years has been absolutely excellent compared to the USA and Europe (including the UK).

[aaacorp]

Private Hopital make a lot of money from drugs and minor services

Some exemples :

i had a tonsil operation and it was nice, the operation by itself cost 85,000thb and was covered by my insurence

However all the medicine i took aside from the operation costed a total of 10000thb at the hospital counter

I stopped the hospital medicine when i saw they charged me 250thb for a gargle medicine.

Few years ago i had a wound on my leg

Daily dressing change at the BNH : 600thb if made by a nurse, 1000thb if made by the doctor

The same thing at the public hospital :40thb

I went to the ENT two days ago and ended with 4500thb visit : 1000for the doctor (no isssue with that) 3000thb for antibiotique and some other medicine...

[AsiaCheese]

I normally return to the UK for my 3 monthly check up for Prostate Cancer, it's a PSA Blood Test and a DRE, (digital rectum examination) this time I will have it done here in Pattaya, I have been recommended by some members a Uroligist who works at the International Hospital on Fridays. Before I go I will pay a visit and ask the cost of the consultation so I know what to expect, hopefully cheaper than an air fare to the UK. I used the place for some thing else before but what I didn't like was they always seemed to be 'touting' for business.

Can you let us know the name of the doctor & the cost please? Thanx!

[abrahamzvi]

Bumrungrad hospital out patient visits are as expensive as Australian GPS, so is medication

I totally disagree. For a normal visit to a GPS in Bumrungrad hospital you would pay a total of BHT400 to 600. You would pay at least double that in Australia. Wouldn't you?

[jamie2009]

I normally return to the UK for my 3 monthly check up for Prostate Cancer, it's a PSA Blood Test and a DRE, (digital rectum examination) this time I will have it done here in Pattaya, I have been recommended by some members a Uroligist who works at the International Hospital on Fridays. Before I go I will pay a visit and ask the cost of the consultation so I know what to expect, hopefully cheaper than an air fare to the UK. I used the place for some thing else before but what I didn't like was they always seemed to be 'touting' for business.

Can you let us know the name of the doctor & the cost please? Thanx!

Dr Supanat Sirikulchayanonta Is the doctors name, will be calling round the hospital in the next couple of weeks for cost, will let you know

[abrahamzvi]

I normally return to the UK for my 3 monthly check up for Prostate Cancer, it's a PSA Blood Test and a DRE, (digital rectum examination) this time I will have it done here in Pattaya, I have been recommended by some members a Uroligist who works at the International Hospital on Fridays. Before I go I will pay a visit and ask the cost of the consultation so I know what to expect, hopefully cheaper than an air fare to the UK. I used the place for some thing else before but what I didn't like was they always seemed to be 'touting' for business.

From my own experience of the same examinations at a private very expensive hospital, referred to above without naming it, in Bangkok, which was followed by a biopsy,l can tell you the total was lower that the cheapest airfare to the UK. The total cost, including the usual hospital charges was around BHT20,000

[larsjohnsson]

Bumrungrad hospital out patient visits are as expensive as Australian GPS, so is medication

I totally disagree. For a normal visit to a GPS in Bumrungrad hospital you would pay a total of BHT400 to 600. You would pay at least double that in Australia. Wouldn't you?

I have been to Bumrungrad 3 times for "normal visits". Just smaller problems. Every time I have paid more than 4-600 baht

[harrry]

Bumrungrad hospital out patient visits are as expensive as Australian GPS, so is medication

I totally disagree. For a normal visit to a GPS in Bumrungrad hospital you would pay a total of BHT400 to 600. You would pay at least double that in Australia. Wouldn't you?

I think that would be 500 plus nursing charges. Round 800 baht or $33

Australia

$37.05 for patients who see their doctor for 10 minutes or less,

[new2here]

I don't dispute the rough cost comparisons, but I don't think this is a true like-for-like comparison in that many of the for-profit hospitals have much more extensive list of medical services they can do on-site and the facilities themselves tend to be of a better "quality" (quality here refers to the fit-and-finish if you will) and offers a wider range of patient support services.

I am not the biggest supporter of price-controls because I think it distorts true market force pricing which I think is the truest form of price controls there is.

I do think there needs to be proper supervision of of both government and private facilities to insure whatever is law, is met... But on the price side alone, I don't think the answer is price controls