Government concerned with foreigners being ripped off by Thai hospitals

[rijit]

So come on guys what does relatively Comp' private heath care cost a year ?

[Liquorice]

If you register at a Government hospital (only passport required) you can that get consultations, treatment and medication for the same cost as Thais. 20 baht. Not saying it's right, but it works for now.

Know one expat who goes 3 times a week for physio and pain killers for a shoulder injury.

Each visit he is charged 20baht for an hour of physio and medication.

I have only used it once. 20baht for consultation and medication.

This sounds interesting! Please tell us more about.

In post # 226 you admit that the Health Card for Foreigner had been a misinterpretation by most Thai hospitals. That scheme (now only for nationals of Laos, Cambodia & Myanmar) was the 30 Baht scheme.

Please tell us more. I am registered at several upcountry hospitals and was never told I would pay only 20 Baht for consultation, treatment and medication. Can you substantiate your claim with whatever makes your claim credible? I am sure that almost everyone on this forum without healh insurance wants to know about this.

It's known as the Universal Coverage Scheme and was introduced in 2002.

It is commonly known as the 30 baht scheme, but the scheme is run by taxations through capita per area.

Some pay 30 baht, some pay nothing dependant on the area. The local hospitals set the subsidy fee.

Although it may have been introduced specifically for Thais, it seems to be offered to anyone in Thailand who register at their local Government hospital.

http://healthmarketinnovations.org/program/universal-coverage-scheme-Thailand

You may also want to read this topic http://www.thaivisa.com/forum/topic/739396-health-cards-for-foreigners-ceased/ which also discusses the UCS scheme in Thailand.

I tried to register for the Health scheme for Foreigners, only to find it had just been stopped last year. As an alternative the hospital registered me, no fee, along with many other expats thereafter once they found out the HCFF scheme had stopped.

I think the fee was 30 baht last year, but recently they only charged 20 baht.

As I understand it you must register with your local Government hospital and attend there for treatment. They will transfer you if required for something more specialised.

For your convenience I've attached the old, now ceased, HCFF card and the new Government hospital registration card.

[Liquorice]

Dario, as I mentioned in a previous post I had a medical emergency 7 days after arriving in Thailand. (First in my life)

Not knowing the score, I had an operation at one of the local private hospitals. Cost 42,000 baht.

Later I found the same operation at the local Government hospital, if I'd been registered, would have cost 12,000 baht + an extra 600 baht a night for a private room.

Surprisingly it would have been the same surgeon as well.

One difference you must consider, apart from costs, is that private hospitals provide everything. Food, water, toiletries etc.

Government hospitals only provide the medical care, you need someone to bring in food, water, toiletries etc.

[Liquorice]

It's nonsense, that scheme was suspended/cancelled for anyone other than regional workers, Myanmar and the like..

If your answering to me, read my post #226.

I'm talking about the UCS scheme.

[Liquorice]

So come on guys what does relatively Comp' private heath care cost a year ?

If your talking about private healthcare policies, I've never asked for a quote, but I know it will be expensive.

Some who have been in BUPA for a long time seem to still get reasonable rates, but I've seen other expats over 70 years old quoted £500 per month. That's 300,000 baht a year.

[Liquorice]

If you register at a Government hospital (only passport required) you can that get consultations, treatment and medication for the same cost as Thais. 20 baht. Not saying it's right, but it works for now.

Know one expat who goes 3 times a week for physio and pain killers for a shoulder injury.

Each visit he is charged 20baht for an hour of physio and medication.

I have only used it once. 20baht for consultation and medication.

In post # 226 you admit that the Health Card for Foreigner had been a misinterpretation by most Thai hospitals. That scheme (now only for nationals of Laos, Cambodia & Myanmar) was the 30 Baht scheme.

That's where your getting confused Dario.

The Health Card for Foreigners required an upfront payment for a medical and medical coverage for 12 months.

No fees were requested for consultation, treatment or medication.

The UCS scheme is the one often referred to as the 30 baht scheme.

No medical or upfront payments, just registration.

[xylophone]

If you're a foreigner, and in Chiang Mai, and want to be seriously overcharged for anything medical, simply go to Ram Hospital. You can go to Rajavaj, or McCormick for the same - if not better - treatment, for about half the price. Trust me, I've had the experience and know all about it.

You are spot on with your observation. I was treated negligently and with a highly toxic drug in intensive care at the Ram Hospital which could have cost me my life and for which I was seriously overcharged. A few months later I was treated at the Rajavej for exactly the same allergic reaction to MSG in restaurant food and given one tablet which did the trick with no side effects whatsoever. I am still being treated in England for the after effects of my "treatment" at the Ram. The attached photo was taken after a canular was "shoved" through a vein in my hand. The Ram wanted to charge me for some cream to apply to my hand which turned out to be utterly useless! The charges for one overnight stay and tests I didn't require were unbelievable.

An interesting anecdote...but there is one problem..

"'Chinese restaurant syndrome' has been thoroughly debunked (virtually all studies since then confirm that monosodium glutamate in normal concentrations has no effect on the overwhelming majority of people)". - the Guardian.

As with so many stories by laypersons there is often a gap between the story and science.

i would also recommend that this poster gets a second opinion about his condition.....it would seem all his practitioners might be barking up the wrong tree. and he may be getting pointless treatments......all of which cost money.

There is no problem because there is much information available which will point to the fact that in some individuals, higher than normal intake of MSG can cause problems (double-blind, placebo-controlled studies).

If you look at the quote above regarding the "Chinese restaurant syndrome" please notice that, "Chinese restaurant syndrome has been thoroughly debunked (virtually all studies since then confirm that monosodium glutamate in normal concentrations has no effect on the overwhelming majority of people".

Fair to say in light of the above (my italics and underlining) that MSG can cause problems in some people, as it does (me included).

And before there are huge volumes of people screaming that it doesn't, remember that there are things that people are "allergic to"/"affected by" which don't affect many others. For example; bee pollen, milk, wheat, peanuts, mussels and other shellfish, to name but a few.

[lianajohn]

Agree with most of what has been said here and these are actual personal examples, not anecdotal:–

– My g/fs Brother had a growth in his neck which was getting larger (was about the size of a tennis ball in the end) and nothing the local hospitals could do, other than to give him iodine pills, seemed to help and his family was just about resigned to the fact that he was going to die. So we took him to Bangkok Phuket hospital, because I could not stand by and watch him die and we needed to get another opinion.

So my g/f accompanied him in to see the specialist, and to cut a long story short, after a couple visits and tests, he was found to have a benign tumour of the thyroid and an operation was suggested and the price given to her was around 80,000 to 100,000 baht.

When I accompanied them on the last visit and the nursing staff saw that a farang was going to foot the bill, it suddenly increased to 160,000 baht and when I queried this, the nurse said that it was because the surgeon had forgot to put their fee on the original quote. However we had the original quote and the surgeon’s fee was certainly on it. It was no more than a rip-off so I demanded the X-rays we had already paid for and went to another hospital and the whole procedure was done for just over 100,000 baht, this because there were unexpected complications.

That was about three years ago and he has been fine ever since.

-- At the opening of the Bangkok Phuket hospital colonoscopy unit, I enquired as to the cost of a colonoscopy and was told as an opening "offer" it could be done for 13,000 baht, this after I told them that I would foot the bill. When I turned up for the colonoscopy and the nurse asked if I had insurance, I said that I did and she said she would check to see if they would pay the bill, and this was confirmed. However a new bill was produced for me which exceeded 20,000 baht and after some embarrassing questions, I ascertained that it was loaded because the insurance company was paying.

– Being fair-haired, I am prone to skin cancers, several of which I have had removed over the years and I had one particular "growth" of some description growing in the corner of my eye so I went to Bangkok Phuket hospital and saw the skin specialist who said that she would surgically remove it and I would probably need to see the cosmetic surgeon to get it fixed without scarring and just the initial cost would be 11,000 baht plus the additional for the cosmetic surgeon.

I wasn't satisfied with this so I saw the skin specialist at Phuket International hospital who recommended I use Aldara cream for a period of about a month. So I did and the growth completely disappeared.

Total cost for the visit, inspection and advice, plus a couple of solar keratosis burnt off was 1600 baht.

It seems that all private hospitals will try to rip you off, some more than others.

Where is Phuket International Hospital? Is it next to Index close to Central Festivals?

[xylophone]

Agree with most of what has been said here and these are actual personal examples, not anecdotal:–

– My g/fs Brother had a growth in his neck which was getting larger (was about the size of a tennis ball in the end) and nothing the local hospitals could do, other than to give him iodine pills, seemed to help and his family was just about resigned to the fact that he was going to die. So we took him to Bangkok Phuket hospital, because I could not stand by and watch him die and we needed to get another opinion.

So my g/f accompanied him in to see the specialist, and to cut a long story short, after a couple visits and tests, he was found to have a benign tumour of the thyroid and an operation was suggested and the price given to her was around 80,000 to 100,000 baht.

When I accompanied them on the last visit and the nursing staff saw that a farang was going to foot the bill, it suddenly increased to 160,000 baht and when I queried this, the nurse said that it was because the surgeon had forgot to put their fee on the original quote. However we had the original quote and the surgeon’s fee was certainly on it. It was no more than a rip-off so I demanded the X-rays we had already paid for and went to another hospital and the whole procedure was done for just over 100,000 baht, this because there were unexpected complications.

That was about three years ago and he has been fine ever since.

-- At the opening of the Bangkok Phuket hospital colonoscopy unit, I enquired as to the cost of a colonoscopy and was told as an opening "offer" it could be done for 13,000 baht, this after I told them that I would foot the bill. When I turned up for the colonoscopy and the nurse asked if I had insurance, I said that I did and she said she would check to see if they would pay the bill, and this was confirmed. However a new bill was produced for me which exceeded 20,000 baht and after some embarrassing questions, I ascertained that it was loaded because the insurance company was paying.

– Being fair-haired, I am prone to skin cancers, several of which I have had removed over the years and I had one particular "growth" of some description growing in the corner of my eye so I went to Bangkok Phuket hospital and saw the skin specialist who said that she would surgically remove it and I would probably need to see the cosmetic surgeon to get it fixed without scarring and just the initial cost would be 11,000 baht plus the additional for the cosmetic surgeon.

I wasn't satisfied with this so I saw the skin specialist at Phuket International hospital who recommended I use Aldara cream for a period of about a month. So I did and the growth completely disappeared.

Total cost for the visit, inspection and advice, plus a couple of solar keratosis burnt off was 1600 baht.

It seems that all private hospitals will try to rip you off, some more than others.

Where is Phuket International Hospital? Is it next to Index close to Central Festivals?

Yes, just down the bypass road a little way from Central. If you are considering seeing a skin specialist then please send me a PM to get a name as there are two specialists there and one is very good, the other.........????

[cumgranosalum]

(double-blind, placebo-controlled studies)....these studies show there is no evidence to support the theory of allergy to MSG........if there was any truth in it, the population of Asia would have been suffering for years...it also occurs in so many foods naturally, anyone who I had an allergy would not be able to eat them either....

Personal stories ARE anecdotes!

The plural of anecdote is not data....you need to understand what data is and how it is so important to medical science

People who pay money to practitioners for treatments for perceived ailments like these are indeed being taken for a ride by hospitals and wasting their money. However there is virtually no legislation in Thailand to prevent or espose this kind of stuff.

Why do you think it is so much easier to find these "alternative" therapies in Thailand?...they are even availablenin hospitals...all this does is show how unethical some practitioners and hospitals can be in Thailand.

Sadlky I douybt if any government enquiry will be strong enough to engage the powerful medical / business hierarchy of the Thai healthcare industry.

[roamer]

I can recall a time in London when top private hospital charges were relatively reasonable. Then half the population of the Middle East started flocking there and prices rocketed.

I can recall a time in Bangkok when top private hospital charges were relatively reasonable. Then half the population of the Middle East started flocking there and prices rocketed.

[Whyamiandwhatamidoinghere]

A Thai girl I met through social media had a serious motorcycle accident and was taken to a public hospital. She had a fractured collarbone, a broken right leg and arm. They charged a total of 80,000 baht. Most of it was covered under her insurance but would have a balance of 10,000 baht. I went to visit her several times before she was released. She stayed only 5 days. Of course everyone thought I was her boyfriend. There was a counseltation before she was released. She told me that they asked her if they could add an extra 5,000 baht to her bill and for her to get me to pay it. For her part they would split that money with her and she would receive it before she was released. She told them I was just a backpacker friend she knew not her boyfriend. She said they just shook their heads and said "Mai pen ran ka" From then on I scrutinize every bill and dress down when I visit hospitals as visitor or patient. How you dress is how you are perceived.

[xylophone]

(double-blind, placebo-controlled studies)....these studies show there is no evidence to support the theory of allergy to MSG........if there was any truth in it, the population of Asia would have been suffering for years...it also occurs in so many foods naturally, anyone who I had an allergy would not be able to eat them either....

Personal stories ARE anecdotes!

The plural of anecdote is not data....you need to understand what data is and how it is so important to medical science

People who pay money to practitioners for treatments for perceived ailments like these are indeed being taken for a ride by hospitals and wasting their money. However there is virtually no legislation in Thailand to prevent or espose this kind of stuff.

Why do you think it is so much easier to find these "alternative" therapies in Thailand?...they are even availablenin hospitals...all this does is show how unethical some practitioners and hospitals can be in Thailand.

Sadlky I douybt if any government enquiry will be strong enough to engage the powerful medical / business hierarchy of the Thai healthcare industry.

Not wanting to deviate from the poster who reported his symptoms........

· Then in 2000, researchers conducted the largest double-blind, placebo-controlled study on MSG, consisting of 130 subjects who said they were sensitive to the additive. The researchers found that MSG produced short-lasting and minor reactions in a subset of people…….Clinical Correlations: The NYU Langone Online Journal of Medicine.)

· There are some people who may experience adverse effects after consuming MSG. In one study, people with self-reported MSG sensitivity consumed either 5 grams of MSG, or placebo (a dummy pill). 36.1% reported reactions with MSG, compared to 24.6% with placebo. Symptoms included headache, muscle tightness, numbness/tingling, weakness and flushing.

What this study indicates, is that MSG sensitivity is a real thing.

· However, researchers have found no definitive evidence of a link between MSG and these symptoms. Researchers acknowledge, though, that a small percentage of people may have short-term reactions to MSG. Symptoms are usually mild and don't require treatment.

So double blind studies do say that some people have symptoms related to MSG, and you will notice this "rider" in many of the controlled studies.

[roamer]

(double-blind, placebo-controlled studies)....these studies show there is no evidence to support the theory of allergy to MSG........if there was any truth in it, the population of Asia would have been suffering for years...it also occurs in so many foods naturally, anyone who I had an allergy would not be able to eat them either....

Personal stories ARE anecdotes!

The plural of anecdote is not data....you need to understand what data is and how it is so important to medical science

People who pay money to practitioners for treatments for perceived ailments like these are indeed being taken for a ride by hospitals and wasting their money. However there is virtually no legislation in Thailand to prevent or espose this kind of stuff.

Why do you think it is so much easier to find these "alternative" therapies in Thailand?...they are even availablenin hospitals...all this does is show how unethical some practitioners and hospitals can be in Thailand.

Sadlky I douybt if any government enquiry will be strong enough to engage the powerful medical / business hierarchy of the Thai healthcare industry.

Not wanting to deviate from the poster who reported his symptoms........

· Then in 2000, researchers conducted the largest double-blind, placebo-controlled study on MSG, consisting of 130 subjects who said they were sensitive to the additive. The researchers found that MSG produced short-lasting and minor reactions in a subset of people…….Clinical Correlations: The NYU Langone Online Journal of Medicine.)

· There are some people who may experience adverse effects after consuming MSG. In one study, people with self-reported MSG sensitivity consumed either 5 grams of MSG, or placebo (a dummy pill). 36.1% reported reactions with MSG, compared to 24.6% with placebo. Symptoms included headache, muscle tightness, numbness/tingling, weakness and flushing.

What this study indicates, is that MSG sensitivity is a real thing.

· However, researchers have found no definitive evidence of a link between MSG and these symptoms. Researchers acknowledge, though, that a small percentage of people may have short-term reactions to MSG. Symptoms are usually mild and don't require treatment.

So double blind studies do say that some people have symptoms related to MSG, and you will notice this "rider" in many of the controlled studies.

Quote. · Then in 2000, researchers conducted the largest double-blind, placebo-controlled study on MSG, consisting of 130 subjects who said they were sensitive to the additive. The researchers found that MSG produced short-lasting and minor reactions in a subset of people…….Clinical Correlations: The NYU Langone Online Journal of Medicine.).

The problem with your underlined text is it went onto say ".... but these could not be reproduced consistently upon retesting.

http://www.pri.org/stories/2014-10-03/science-suggests-msg-really-isnt-bad-your-health-after-all

Or if I were to quote from the original research paper. "More importantly, the responses reported were inconsistent and were not reproducible"

http://jn.nutrition.org/content/130/4/1058.long

[BKKdreaming]

it was posted......It's known as the Universal Coverage Scheme and was introduced in 2002.

It is commonly known as the 30 baht scheme, but the scheme is run by taxations through capita per area.

Some pay 30 baht, some pay nothing dependant on the area. The local hospitals set the subsidy fee.

Although it may have been introduced specifically for Thais, it seems to be offered to anyone in Thailand who register at their local Government hospital.

http://healthmarketinnovations.org/program/universal-coverage-scheme-Thailand

You may also want to read this topic http://www.thaivisa.com/forum/topic/739396-health-cards-for-foreigners-ceased/ which also discusses the UCS scheme in Thailand.

I tried to register for the Health scheme for Foreigners, only to find it had just been stopped last year. As an alternative the hospital registered me, no fee, along with many other expats thereafter once they found out the HCFF scheme had stopped.

I think the fee was 30 baht last year, but recently they only charged 20 baht.

As I understand it you must register with your local Government hospital and attend there for treatment. They will transfer you if required for something more specialised.

For your convenience I've attached the old, now ceased, HCFF card and the new Government hospital registration card.

**************************************************************

OK....I will give it a try.......if I can do it on a tourist visa ......

Do I just need to bring my USA Passport ?

[cumgranosalum]

(double-blind, placebo-controlled studies)....these studies show there is no evidence to support the theory of allergy to MSG........if there was any truth in it, the population of Asia would have been suffering for years...it also occurs in so many foods naturally, anyone who I had an allergy would not be able to eat them either....

Personal stories ARE anecdotes!

The plural of anecdote is not data....you need to understand what data is and how it is so important to medical science

People who pay money to practitioners for treatments for perceived ailments like these are indeed being taken for a ride by hospitals and wasting their money. However there is virtually no legislation in Thailand to prevent or espose this kind of stuff.

Why do you think it is so much easier to find these "alternative" therapies in Thailand?...they are even availablenin hospitals...all this does is show how unethical some practitioners and hospitals can be in Thailand.

Sadlky I douybt if any government enquiry will be strong enough to engage the powerful medical / business hierarchy of the Thai healthcare industry.

Not wanting to deviate from the poster who reported his symptoms........

· Then in 2000, researchers conducted the largest double-blind, placebo-controlled study on MSG, consisting of 130 subjects who said they were sensitive to the additive. The researchers found that MSG produced short-lasting and minor reactions in a subset of people…….Clinical Correlations: The NYU Langone Online Journal of Medicine.)

· There are some people who may experience adverse effects after consuming MSG. In one study, people with self-reported MSG sensitivity consumed either 5 grams of MSG, or placebo (a dummy pill). 36.1% reported reactions with MSG, compared to 24.6% with placebo. Symptoms included headache, muscle tightness, numbness/tingling, weakness and flushing.

What this study indicates, is that MSG sensitivity is a real thing.

· However, researchers have found no definitive evidence of a link between MSG and these symptoms. Researchers acknowledge, though, that a small percentage of people may have short-term reactions to MSG. Symptoms are usually mild and don't require treatment.

So double blind studies do say that some people have symptoms related to MSG, and you will notice this "rider" in many of the controlled studies.

I don't think you understand...that study is rubbish and I fear you don't actually understand what a double blind trial is either.

You are simply clutching at straws - the fact that it was carried out on those who "who said they were sensitive to the additive" - rubbishes it from the start anyway.

[cumgranosalum]

Listen up folks, NO hospital requires that you use their services. You have no reason to bitch. Your not forced into anything.

As a comment on healthcare, this should get the most facile post award for this thread........

[cumgranosalum]

It occurs to me that those who are claiming "good" or bad" treatment aren't really in a position to say.

ost people who go to a hospital go because they are sick and need help. they are often worried or afraid. They certainly for the most part have o idea what is wrong with them.

When they leave the hospital they feel "cured" - they are relieved and glad to be home and not feeling so bad.

unfortunately they really have o way of assessing the treatment or therapies they have had or eve how much they contributed to their recovery....all they know is they felt sick and now they are OK. Whether this was through "goo" treatment or "good luck they simply can't tell....yet form then on they will continue to recommend that establishent on little more basis than they in one single incident left it alive.

if on the other hand they have a bad experience they still won't fully understand why and will blame the entire hospital both past and future telling their friends never to go there.

the problem is this is all ANECDOTAL and from in general a layperson. Everyone's illness is different - you can't put a price on a broken leg as you would a kilo of tomatoes.....

the situation is that unlike in Europe there are not any systems or bodies to monitor this sort of stuff and come out with a scientific assessment and recommend changes. So in reference to the OP, it looks to be that this will be more of a whitewash than a real step in the right direction....it's all mouth and no trousers.

[cumgranosalum]

I have been very pleased with the medical care I have received in Thailand. However, I do not live in a tourist trap--I believe that may be part of the difference. My wife collapsed, I took her to a good local hopsital, they put her in a private room performed several tests and gave her medication to reduce her very high blood pressure. Two days later with blood pressure back to normal, she was released. The bill was about $300 and that included two months of blood pressure medicine--my mother's BP medicine cost about $40/mo in the States and that was with full insurance coverage.

I had five broken ribs and a collapsed lung which was complicated by my own ignorance. I fell, hurt my ribs and went to a clinic in a resort town; they diagnosed bruised ribs and prescribed pain killers, muscle relaxers and anti-inflamatories. After three weeks, it was worse, I could not breathe. I went to my local hospital in Hatyai and was in surgery within two hours; they drained five litres of fluid from my lung cavity, but found I had several blood clots. The next day, after several more tests and specialists, I was back in the OR to remove the clots by major thoracic surgery. The docotrs said it would take three weeks for me to recover enough to be released. I had a private room which had a separate bedroom, two bathrooms, a full kitchen, two large screen TVs and enough comfortable furniture to seat a houseful of relatives. They gave me several medical tests-- MRIs, CTs, PFTs, ABGs, plethysmography, spirometry, x-rays, and numerous smaller blood and lung tests--I had 24/7 nurses, a plethora of medication, and four specialist doctors plus my GP. I recovered nicely with a delicate 11 inch rib cage scar from the thoracic surgery and a B10 coin-sized circular scar from the surgery to drain the fluids from my lung cavity. I was released from the hospital, at my insistance, in nine days. The thoracic surgeon was excellent, beyond criticism, he saw me twice before he took out the stiches, and then saw me every other month for the following year, all at no extra charge. The total bill was B240k, about $8k. I consider that a trivial cost for such great treatment, expensive tests, and complicated procedures-- the room would have cost more than that in the States. I have regained 100% lung capacity, all discomfort was gone in a year, the 11 inch scar looks as if it could have been done by a competent plastic surgeon--by comparison the circular scar, done by another surgeon, looks like it was performed in the hood with a can opener. I was 68 at the time. I rode my motorcycle the day after I got out of hospital. I feel great now and have no qualms about Thai medical care.

You feel satisfied with your procedures - which is what most patients feel when they don't die - it's a recognised syndrome a bit similar to "Stockholm" - all you have described is a procedure that would happen anywhere in the world and how YOU feel about it. - it is purely the perception of a single lay-person - and as your yardstick appears to be one of the worst healthcare systems in the western world one has to take that with a pinch of salt.

there is no analysis of the efficacy of the procedures used or how efficiently they were carried out or any comparison with treatment in other countries - this is of course nigh-on impossible in individual cases and one must have bilk stats to draw any concrete conclusions - in other words ANECDOTE!

The topic is foreigners being ripped off by Thai hospitals, not the quality of healthcare. I am sure I could have gotten that quality of healthcare at higher prices elsewhere. I am satisified with what happened to me and mine. Satisfied enough to trust a Thai doctor again. Yes, it is my opinion, but my opinion is the only one I have.

As with many of the posts here, it is how the opinion is arrived at that is so questionable.

[DividendGuy]

Are there any government hospitals located near or which is the closest one to Queen Sirikit Convention Center on Asoke?

[haroldc]

I have lived in Thailand for 27 years and have always used St. Louis Hospital in Bangkok. Unlike most private hospitals, St. Louis is a non-profit organization operated by the Catholic Church in Thailand. I have always been in good health, and on the few occasions that I did use the hospital's services, I found their charges to be very reasonable

Four weeks ago, I woke up at 2 AM coughing blood. I went to the St. Louis emergency room, the bleeding was controlled with drugs, and I was admitted as an in-patient. In the morning, a CAT scan showed a 7 cm. tumor in the upper lobe of my right lung which the pulmonologist said was the source of the bleeding and almost certainly cancer. He recommended surgery as soon as possible to avoid the possibility of a massive hemorrhage which could be fatal.

Fortuately, the consulting thoracic surgeon was in the hospital at the time and was able to assemble his surgical team in a matter of hours. He is truly a world class surgeon - a professor at Chulalongkorn University, a fellow in heart and lung transplantation at Harefield Hospital in London, in cardiovascular surgery at the Baylor College of Medicine in Texas, and in cardiovascular surgery at the Texas Heart Institute. He removed the upper lobe of my right lung and some 15 lymph nodes. Laboratory results showed that the tumor was an adenocarcinoma and that the cancer had spread to a number of the lymph nodes. I was ambulatory three days after the surgery, and on the sixth day was taken by ambulance to a nuclear medicine facility and given state-of-the art MRI scans of the brain, entire skeleton, and lower abdomen. The scans showed that the cancer had already spread to my liver, but not to my brain or bones. Two days later, I was discharged from the hospital and scheduled to begin chemotherapy at the end of May.

The total cost for 8 days in the hospital was approximately USD 11,000. I had a private room, and the treatment and care that I received was in every way exemplary. In comparison, a 2012 study by the US National Institute of Health showed that the average cost of a lobectomy was USD 21,000 and the average hospital stay was 8 days.

My consulting oncologist is also world-class -- he has an M.D. from Chulalongkorn University, a Ph.D. in Cellular and Molecular Medicine from the Johns Hopkins University School of Medicine in the USA, is Chief of Medical Oncology at Chulalongkorn Hospital, and a a vistiing fellow at the US National Institute of Heath. At St. Louis, his consultation fee is 500 baht!

My prognosis is not good -- I have stage IV cancer, so maybe 12 to 18 months if the chemotherapy works, 6 to 8 months if it doesn't. The chemotherapy will be horrendously expensive, simply because one of the drugs, Alimta (pemetrexed), will cost USD 3,275 per treatment. I have researched the cost of Alimta, and the 900 mg. that I need per treatment retails in the USA (Publix, CVS, Walmart, etc.) for about USD 5,500. Apparently, St. Louis will be purchasing it directly from the manufacturer, Eli Lilly, and administering it at cost.

I have no experience with other private hospitals in Thailand, but fees at St. Louis are reasonable, 100% transparent, and the same whether the patient is a Thai or a foreigner. I should also note that both my thoracic surgeon and oncologist also practice at the "famous" international hospitals such as Bumrungrad, Bangkok Hospital, BNH, etc. When I look on the Bumrunggrad website, I see that the median cost for brochoscopy (examination of airways into the lung using a bronchoscope) is 74,155 baht -- at St. Louis it is about 16,000 baht.

I highly recommend St. Louis to anyone needing medical care.

[cumgranosalum]

I can't quite see how this has any releveance to the OP - "Government concerned with foreigners being ripped off by Thai hospitals"

Is it simply an advert for the St Louis hospital?

does it imply they don't rip foreign patients off? Maybe....but at the end of the day this is a totally subjective anecdote.

"I have no experience with other private hospitals in Thailand, but fees at St. Louis are reasonable" - then how does he know???

As for the drug Alimta, yes it is very expensive - about $24K per patient and as such is not used by many hospitals who prefer less costly alternatives. it is not used as a first-line drug usually, only after others have been tried.

I'm not an oncologist and have no idea of this patient's background any more than he has of other cancer patients...so how can he be sure he has got the most appropriate and cost effective treatment....or are they just going for the most expensibb=ve drugs they can because someone is covering the cost?

It is very sad to hear of someone who is fighting cancer, but I think the exprience related here has little to do with whether foreigners are being over-charged, in fact it raises more questions than it answers.

[dageurreotype]

I can't quite see how this has any releveance to the OP - "Government concerned with foreigners being ripped off by Thai hospitals"

Is it simply an advert for the St Louis hospital?

does it imply they don't rip foreign patients off? Maybe....but at the end of the day this is a totally subjective anecdote.

"I have no experience with other private hospitals in Thailand, but fees at St. Louis are reasonable" - then how does he know???

As for the drug Alimta, yes it is very expensive - about $24K per patient and as such is not used by many hospitals who prefer less costly alternatives. it is not used as a first-line drug usually, only after others have been tried.

I'm not an oncologist and have no idea of this patient's background any more than he has of other cancer patients...so how can he be sure he has got the most appropriate and cost effective treatment....or are they just going for the most expensibb=ve drugs they can because someone is covering the cost?

It is very sad to hear of someone who is fighting cancer, but I think the exprience related here has little to do with whether foreigners are being over-charged, in fact it raises more questions than it answers.

Your post is ignorant and harsh. As per. Judging from the many posts on this long thread, many posters may be seeking alternatives to the NOW highly inflated cost of medical treatment for foreigners and Thai alike.

I too, along with many of my friends, have received excellent and AFFORDABLE aka not rip off, care from the St Louis on Sathorn. So put that in your self important pipe and smoke it.

[cumgranosalum]

I can't quite see how this has any releveance to the OP - "Government concerned with foreigners being ripped off by Thai hospitals"

Is it simply an advert for the St Louis hospital?

does it imply they don't rip foreign patients off? Maybe....but at the end of the day this is a totally subjective anecdote.

"I have no experience with other private hospitals in Thailand, but fees at St. Louis are reasonable" - then how does he know???

As for the drug Alimta, yes it is very expensive - about $24K per patient and as such is not used by many hospitals who prefer less costly alternatives. it is not used as a first-line drug usually, only after others have been tried.

I'm not an oncologist and have no idea of this patient's background any more than he has of other cancer patients...so how can he be sure he has got the most appropriate and cost effective treatment....or are they just going for the most expensibb=ve drugs they can because someone is covering the cost?

It is very sad to hear of someone who is fighting cancer, but I think the exprience related here has little to do with whether foreigners are being over-charged, in fact it raises more questions than it answers.

Your post is ignorant and harsh. As per. Judging from the many posts on this long thread, many posters may be seeking alternatives to the NOW highly inflated cost of medical treatment for foreigners and Thai alike.

I too, along with many of my friends, have received excellent and AFFORDABLE aka not rip off, care from the St Louis on Sathorn. So put that in your self important pipe and smoke it.

"ignorant" of what?

I don't believe you fully understand my point about anecdotal evidence either.

so rather than just an ad hominem attack, why don't you show how this argues for or against the government's dictum?

[haroldc]

I can't quite see how this has any releveance to the OP - "Government concerned with foreigners being ripped off by Thai hospitals"

Is it simply an advert for the St Louis hospital?

does it imply they don't rip foreign patients off? Maybe....but at the end of the day this is a totally subjective anecdote.

"I have no experience with other private hospitals in Thailand, but fees at St. Louis are reasonable" - then how does he know???

As for the drug Alimta, yes it is very expensive - about $24K per patient and as such is not used by many hospitals who prefer less costly alternatives. it is not used as a first-line drug usually, only after others have been tried.

I'm not an oncologist and have no idea of this patient's background any more than he has of other cancer patients...so how can he be sure he has got the most appropriate and cost effective treatment....or are they just going for the most expensibb=ve drugs they can because someone is covering the cost?

It is very sad to hear of someone who is fighting cancer, but I think the exprience related here has little to do with whether foreigners are being over-charged, in fact it raises more questions than it answers.

The relevance of my post is simply to inform people who are concerned of being ripped off of a hospital that, in my experience and opinion, St. Louis does not do so. It certainly is not an advertisement.

I have a large number of friends throughout Thailand -- both foreigner and Thai -- who have needed hospital treatment of one sort or another either for themselves or for a family member. I have two sons and many relations in Udonthani; my wife, two younger children, and many relations are in Surin; and her large family has relatives scattered in a dozen north and northeastern provinces. Over the past 27 years I must have helped almost 50 people who needed treatment that they couldn't get in the provinces by contacting private and government hospitals in Bangkok on their behalf. Personally, I have never been ill enough to be admitted to a hospital before this happened.

Alimta will being used in combination with carboplatin. The most recent research and meta-research studies have shown that carboplatin/pemetrexed as first-line treatment for stage IV non-small cell lung cancer produces an optimal combination of progression free time and median survival time with significantly fewer side affects. My oncologist gave me a choice of two alternatives to pemetrexed -- paclitaxel and gemcitabine, both of which are much less expensive, and explained the pros and cons of each. When I chose pemetrexed, he gave me the choice of the Lilly product or a generic at about a 25% discount.

Is this really the "most appropriate and cost effective treatment?" Well, anyone who decides to do chemotherapy is basically putting their life (and their pocketbooks!) in the hands of their oncologist and the hospital. I could do worse than the Chief of Medical Oncology at Chula with a Ph.D. from Johns Hopkins in a non-profit hospital run by the Catholic Church...

Anyway, good luck to all of you who need medical care, no matter where you get it or how much you pay for it. My last words on the subject.

[balo]

Sorry to hear about your cancer and good luck with the treatment. Even if it's a serious condition you always have a chance to fight this. I'm sure you're in the best hands at St. Louis hospital.

[Liquorice]

I can't quite see how this has any releveance to the OP - "Government concerned with foreigners being ripped off by Thai hospitals"

Is it simply an advert for the St Louis hospital?

does it imply they don't rip foreign patients off? Maybe....but at the end of the day this is a totally subjective anecdote.

"I have no experience with other private hospitals in Thailand, but fees at St. Louis are reasonable" - then how does he know???

As for the drug Alimta, yes it is very expensive - about $24K per patient and as such is not used by many hospitals who prefer less costly alternatives. it is not used as a first-line drug usually, only after others have been tried.

I'm not an oncologist and have no idea of this patient's background any more than he has of other cancer patients...so how can he be sure he has got the most appropriate and cost effective treatment....or are they just going for the most expensibb=ve drugs they can because someone is covering the cost?

It is very sad to hear of someone who is fighting cancer, but I think the exprience related here has little to do with whether foreigners are being over-charged, in fact it raises more questions than it answers.

Wow! Talk about kick a guy in the teeth when he's down.

haroldc has as much right as anyone to express his views, opinions and personal experience on this subject.

He expressed facts that in his experience not all Thai hospitals are overcharging, which is quite relevant to the topic that the government is concerned that foreigners are being ripped off by Thai hospitals.

Obviously not all Thai hospitals are ripping people off, which is the point Harold was making.

[smotherb]

I have been very pleased with the medical care I have received in Thailand. However, I do not live in a tourist trap--I believe that may be part of the difference. My wife collapsed, I took her to a good local hopsital, they put her in a private room performed several tests and gave her medication to reduce her very high blood pressure. Two days later with blood pressure back to normal, she was released. The bill was about $300 and that included two months of blood pressure medicine--my mother's BP medicine cost about $40/mo in the States and that was with full insurance coverage.

I had five broken ribs and a collapsed lung which was complicated by my own ignorance. I fell, hurt my ribs and went to a clinic in a resort town; they diagnosed bruised ribs and prescribed pain killers, muscle relaxers and anti-inflamatories. After three weeks, it was worse, I could not breathe. I went to my local hospital in Hatyai and was in surgery within two hours; they drained five litres of fluid from my lung cavity, but found I had several blood clots. The next day, after several more tests and specialists, I was back in the OR to remove the clots by major thoracic surgery. The docotrs said it would take three weeks for me to recover enough to be released. I had a private room which had a separate bedroom, two bathrooms, a full kitchen, two large screen TVs and enough comfortable furniture to seat a houseful of relatives. They gave me several medical tests-- MRIs, CTs, PFTs, ABGs, plethysmography, spirometry, x-rays, and numerous smaller blood and lung tests--I had 24/7 nurses, a plethora of medication, and four specialist doctors plus my GP. I recovered nicely with a delicate 11 inch rib cage scar from the thoracic surgery and a B10 coin-sized circular scar from the surgery to drain the fluids from my lung cavity. I was released from the hospital, at my insistance, in nine days. The thoracic surgeon was excellent, beyond criticism, he saw me twice before he took out the stiches, and then saw me every other month for the following year, all at no extra charge. The total bill was B240k, about $8k. I consider that a trivial cost for such great treatment, expensive tests, and complicated procedures-- the room would have cost more than that in the States. I have regained 100% lung capacity, all discomfort was gone in a year, the 11 inch scar looks as if it could have been done by a competent plastic surgeon--by comparison the circular scar, done by another surgeon, looks like it was performed in the hood with a can opener. I was 68 at the time. I rode my motorcycle the day after I got out of hospital. I feel great now and have no qualms about Thai medical care.

You feel satisfied with your procedures - which is what most patients feel when they don't die - it's a recognised syndrome a bit similar to "Stockholm" - all you have described is a procedure that would happen anywhere in the world and how YOU feel about it. - it is purely the perception of a single lay-person - and as your yardstick appears to be one of the worst healthcare systems in the western world one has to take that with a pinch of salt.

there is no analysis of the efficacy of the procedures used or how efficiently they were carried out or any comparison with treatment in other countries - this is of course nigh-on impossible in individual cases and one must have bilk stats to draw any concrete conclusions - in other words ANECDOTE!

The topic is foreigners being ripped off by Thai hospitals, not the quality of healthcare. I am sure I could have gotten that quality of healthcare at higher prices elsewhere. I am satisified with what happened to me and mine. Satisfied enough to trust a Thai doctor again. Yes, it is my opinion, but my opinion is the only one I have.

As with many of the posts here, it is how the opinion is arrived at that is so questionable.

What gives you the right to trivialize my personal experiences and those of other posters by calling them mere anecdotes, of questionable note?

It is true a scientific study must provide empirical evidence to reach any viable conclusion. How do you think empirical evidence is acquired? It is acquired by observation or experimentation and compiled for review.

Each of our "observations" through expressing our personal experiences is the basis of empirical evidence. Look at the sample we have already collected to posit the theory that Thailand has good medical care without being "ripped-off".

Therefore, based on the sample of observations we have collected herein; it is possible to get good medical care in Thailand without being ripped-off.

However, in Thailand as it is anywhere else, you can you get ripped-off for medical services and you can you get poor health care.

[cumgranosalum]

I can't quite see how this has any releveance to the OP - "Government concerned with foreigners being ripped off by Thai hospitals"

Is it simply an advert for the St Louis hospital?

does it imply they don't rip foreign patients off? Maybe....but at the end of the day this is a totally subjective anecdote.

"I have no experience with other private hospitals in Thailand, but fees at St. Louis are reasonable" - then how does he know???

As for the drug Alimta, yes it is very expensive - about $24K per patient and as such is not used by many hospitals who prefer less costly alternatives. it is not used as a first-line drug usually, only after others have been tried.

I'm not an oncologist and have no idea of this patient's background any more than he has of other cancer patients...so how can he be sure he has got the most appropriate and cost effective treatment....or are they just going for the most expensibb=ve drugs they can because someone is covering the cost?

It is very sad to hear of someone who is fighting cancer, but I think the exprience related here has little to do with whether foreigners are being over-charged, in fact it raises more questions than it answers.

Wow! Talk about kick a guy in the teeth when he's down.

haroldc has as much right as anyone to express his views, opinions and personal experience on this subject.

He expressed facts that in his experience not all Thai hospitals are overcharging, which is quite relevant to the topic that the government is concerned that foreigners are being ripped off by Thai hospitals.

Obviously not all Thai hospitals are ripping people off, which is the point Harold was making.

I by the same thinking I have a right to point out the flaws in his views. the health of the poster is not relevant to the argument.

just because he is "satisfied" with his treatment it doesn't follow that this hospital is or isn't involved in the same practices as others...as a religious based they certainly will have their own interpretation of ethics which is an issue I raised earlier.

so long as people confuse anecdote with evidence, the picture will not be clear. As I have said before any government "concerns" cannot be properly addressed until the EVIDENCE is collated and examined.....just one person telling us a hospital is "good" or "honest" is not enough

[soalbundy]

I am more worried about why they are concerned about this. When the government is concerned about anything to do with farang it is never to our advantage.