Study finds huge difference in treatment costs

[Lite Beer]

Study finds huge difference in treatment costs
POUNGCHOMPOO PRASERT
THE SUNDAY NATION

BANGKOK: -- THE cost for treating five illnesses is about three times higher in private hospitals compared to prices charged by public hospitals, a study by a National Legislative Assembly (NLA) panel tasked with scrutinising hospital pricing has found. Results of the study were due to be submitted to the NLA yesterday.

The study found that some private hospitals charge from Bt50,000 to Bt200,000 for an appendectomy, compared to prices starting at Bt16,841 for the same surgery at public hospitals.

A comparison between 2009 and 2014 found that treatment prices at private facilities had risen three to four-fold, while those at public hospitals had dropped by 4 to 5 per cent.

Dr Sarana Boonbaichaiyapruck, a lecturer at Mahidol University's Faculty of Medicine at Ramathibodi Hospital and a member of the panel, said on Thursday that after receiving public complaints about the high prices charged by private hospitals, the NLA tasked his panel with conducting a study and seeking possible solutions.

The panel looked up how much treatment would cost for heart attack, appendectomy, knee and cataract surgery and for treating flu at three state hospitals - Rajavithi, Ramathibodi and Chulalongkorn hospitals in Bangkok. These figures were compared with those at six private hospitals, including those in suburbs, those backed by foundations and the so-called "medical hubs", he said.

As part of the study, 50 patients at each hospital were also interviewed to obtain an insight into how much people have to pay for treatment, and learned that:

- Treatment for a heart attack costs between Bt89,376 and Bt158,680 at state hospitals, while prices for the same treatment at general private hospitals are between Bt164,870 and Bt422,058. "Five-star" facilities, though, could charge up to Bt1.15 million for treatment, which may possibly include balloon heart valve surgery or emergency operations;

- An appendectomy can cost between Bt16,841 and Bt42,631 at state hospitals, while at general private hospitals prices could run from Bt57,683 to Bt102,150. Five-star facilities, meanwhile, can charge up to Bt211,765, with treatment possibly including additional CT scan and treatments for complications;

- Cataract surgery goes for between Bt19,468 and Bt44,740 at state hospitals, while general private hospitals charge between Bt59,263 and Bt113,238, though some five-star places charge up to Bt656,030;

- Knee surgery at state hospitals costs between Bt115,990 and Bt170,244, while at general private hospitals it costs from Bt182,542 to Bt295,727, though some five-star places charge up to Bt536,416.

- Treatment for flu costs between Bt490 to Bt1,252 at state hospitals, from Bt1,712 to Bt3,050 at general private hospitals and up to Bt3,940 at five-star facilities.

Meanwhile, a lecturer with Chulalongkorn University's Faculty of Pharmacy, said it was necessary to set up a mechanism to require pharmaceutical companies to reveal the actual cost of their medicines as part of an attempt to regulate prices charged by private hospitals. Then private hospitals can be allowed to charge patients based on the quality of their services, such as A-grade hospitals can charge 20 to 30 per cent more or B-grade ones can charge 10 to 20 per cent more, lecturer Suntharee Thor Chaisamritchoke said.

A study into hospitals' actual operating costs will also be necessary to set rates that are acceptable to both hospitals and patients, she said. The existing rule on the pricing of medicine, regulated by the Commerce Ministry, requires that private hospitals display the prices, she said. "However, this doesn't work because pharmaceutical companies can cite whatever prices they want and hide the actual cost from the public," she added.

Source: http://www.nationmultimedia.com/national/Study-finds-huge-difference-in-treatment-costs-30260801.html

-- The Nation 2015-05-24

[Robby nz]

I had a choice of having major surgery done at either a private or public hospital by the same surgeon, cost at the private hospital was quoted at twice that of the public hospital.

The main difference being that at a public hospital you are given an appointment day and you are seen on a first come first served basis while at a private hospital you have an appointment time with the doctor and are hopefully seen at that time, priority treatment.

Very happy with the treatment at the public hospital.

[Pimay1]

I had a choice of having major surgery done at either a private or public hospital by the same surgeon, cost at the private hospital was quoted at twice that of the public hospital.

The main difference being that at a public hospital you are given an appointment day and you are seen on a first come first served basis while at a private hospital you have an appointment time with the doctor and are hopefully seen at that time, priority treatment.

Very happy with the treatment at the public hospital.

Up here in this neck of the woods at a public hospital if you are seventy or above you go to the head of the line. I don't know about other places.

[trogers]

Time the government increase the number of large hospitals in major cities and the staff to man them.

When the supply should meet demand, prices would come down.

Let those Bentley riders keep the private hospitals in business.

[fittobethaied]

"A comparison between 2009 and 2014 found that treatment prices at private facilities had risen

three to four-fold, while those at public hospitals had dropped by 4 to 5 per cent".

This says it all as far as I'm concerned. The privates are gouging people and making huge profits. The apologists are justifying these exorbitant charges by saying that they are much lower than costs in Singapore and other countries around the world. That's not the point! Prices should be consistent with the costs of doing business in Thailand and other comparisons are totally irrelevant.

It's time for an old fashion price rollback like they do at Walmart.

[LuckyLew]

Private hospitals are run as a profit making business just like any other business

It is not a charity

If u cannot afford it .... then go to public hospital

[Gonzo the Face]

I had a choice of having major surgery done at either a private or public hospital by the same surgeon, cost at the private hospital was quoted at twice that of the public hospital.

The main difference being that at a public hospital you are given an appointment day and you are seen on a first come first served basis while at a private hospital you have an appointment time with the doctor and are hopefully seen at that time, priority treatment.

Very happy with the treatment at the public hospital.

Up here in this neck of the woods at a public hospital if you are seventy or above you go to the head of the line. I don't know about other places.

As a suggestion, perhaps when you post in a forum that is countrywide, it would be helpful to post where, someplace like " up here in this neck of the woods " is located...... yes you know, but we don't ....

[Pimay1]

I had a choice of having major surgery done at either a private or public hospital by the same surgeon, cost at the private hospital was quoted at twice that of the public hospital.

The main difference being that at a public hospital you are given an appointment day and you are seen on a first come first served basis while at a private hospital you have an appointment time with the doctor and are hopefully seen at that time, priority treatment.

Very happy with the treatment at the public hospital.

Up here in this neck of the woods at a public hospital if you are seventy or above you go to the head of the line. I don't know about other places.

As a suggestion, perhaps when you post in a forum that is countrywide, it would be helpful to post where, someplace like " up here in this neck of the woods " is located...... yes you know, but we don't ....

Point well taken. I live in Esan between Kalasin and Mukdahan.

[lovetotravel]

Private hospitals are run as a profit making business just like any other business

It is not a charity

If u cannot afford it .... then go to public hospital

The problem is, once you go in for a procedure, the extra charges start to roll in. You're committed at that point. Nothing you can do. And if you've got good insurance (i.e. covered from abroad), you can be kept onsite for a long time. It's a scam.

[NickJ]

What gripes me is that the samp operation or service does not cost the same for each patient within one hospital. You cannot stop private hospitals charging more than other hospitals as the quality of service and standard of care varies a great deal.

[Bob12345]

While the aim of the NLA panel was to show the huge price differences between government and private hospitals, it only shows how little they know about medical procedures and the costs associated with them. Let me give an example:

The study found that some private hospitals charge from Bt50,000 to Bt200,000 for an appendectomy, compared to prices starting at Bt16,841 for the same surgery at public hospitals.

I think we can assume the numbers are correct, but is it a valid comparison?

An appendectomy is done by scope in private hospitals while it is done the conventional way in public hospitals. Doing it by scope is far superior than doing it the convention method, but it is also more costly (the scope is not for free).

Besides, the procedure is done by a qualified doctor or specialist in a private hospital, while you have a good chance a medical student will perform it in a public hospital (my wife has done several when she was a medical student).

Maybe next the NLA can investigate the difference in hotel prices.

A shared room with smelly backpackers goes for 300 baht per night, while a 5-star hotel sometimes charges you 10,000 baht ormore. Shouldn't the 5-star hotel charge 300 baht also as both offer a place to sleep during the night?

[robblok]

I once had to go into the hospital for my nose. I had some problems breathing and they were going to use laser to open up my nose better. I met the Dr in private hospital but had the operation in a public hospital for a quarter of the price. It was great service even in the public hospital. Sure I had to wait a bit longer and shared the room with some others at that time but i did not really care. That was before I had good insurance here.. but still I doubt there is that much difference if the same doctor does the operating.

[trogers]

While the aim of the NLA panel was to show the huge price differences between government and private hospitals, it only shows how little they know about medical procedures and the costs associated with them. Let me give an example:

The study found that some private hospitals charge from Bt50,000 to Bt200,000 for an appendectomy, compared to prices starting at Bt16,841 for the same surgery at public hospitals.

I think we can assume the numbers are correct, but is it a valid comparison?

An appendectomy is done by scope in private hospitals while it is done the conventional way in public hospitals. Doing it by scope is far superior than doing it the convention method, but it is also more costly (the scope is not for free).

Besides, the procedure is done by a qualified doctor or specialist in a private hospital, while you have a good chance a medical student will perform it in a public hospital (my wife has done several when she was a medical student).

Maybe next the NLA can investigate the difference in hotel prices.

A shared room with smelly backpackers goes for 300 baht per night, while a 5-star hotel sometimes charges you 10,000 baht ormore. Shouldn't the 5-star hotel charge 300 baht also as both offer a place to sleep during the night?

Problem is, there's yet to be common info on prices of govt hospitals.

If price info is easily available, the buyer of services can make an informed choice - 35 baht somtum by the road or 200 baht in a 5-star establishment.

[evadgib]

It would help if pricing was based on nature of injury rather than ethnicity of patient!

[Andreas2]

Private hospitals are run as a profit making business just like any other business

It is not a charity

If u cannot afford it .... then go to public hospital

Obviously there is "a market" for the private hospitals in Thailand which is prepared to pay the upcharge. As long as there is competition and no monopoly of a state-protected company, I have no problem with that.

Anyway, what is "the market"? "The market" is a virtual entity. It consists (let's give a number) of 10 Million individual customers. Don't even try to explain their individual motivations; Nobody can, as there are 10 Million different reasons. Finally it's the individual customer - who is a little, tiny part of "the market" - who decides for himself what's the value of a service or a product.

Worst case which could happen to you: Fool me once, shame on you; Fool me twice, shame on me.

Or for the intellectually more versatile on this forum:"There's an old saying in Tennessee - I know it's in Texas, probably in Tennessee - that says, fool me once, shame on - shame on you. Fool me - you can't get fooled again."

[Srikcir]

There shouldn't be difference costs between comparable treatments and surgey methods. But there can be a significant difference in doctor diagnosis, recommended procedures, and surgery skills. The better doctor will cost much, much more. And it is the private hospitals that can attract highly quaified doctors from around the world.

You can have a scrub do your heart surgery or resident doctor. Both know the procedure. But who would you trust with your LIFE?

So if you do find treatment costs are the same between private and public hospital, interview the treating doctor first to know the skill behind the medicine or scalpel.

[Srikcir]

There shouldn't be difference costs between comparable treatments and surgey methods. But there can be a significant difference in doctor diagnosis, recommended procedures, and surgery skills. The better doctor will cost much, much more. And it is the private hospitals that can attract highly quaified doctors from around the world.

You can have a scrub do your heart surgery or resident doctor. Both know the procedure. But who would you trust with your LIFE?

So if you do find treatment costs are the same between private and public hospital, interview the treating doctor first to know the skill behind the medicine or scalpel.

[robblok]

There shouldn't be difference costs between comparable treatments and surgey methods. But there can be a significant difference in doctor diagnosis, recommended procedures, and surgery skills. The better doctor will cost much, much more. And it is the private hospitals that can attract highly quaified doctors from around the world.

You can have a scrub do your heart surgery or resident doctor. Both know the procedure. But who would you trust with your LIFE?

So if you do find treatment costs are the same between private and public hospital, interview the treating doctor first to know the skill behind the medicine or scalpel.

What I have found is that doctors here often work in both private and public hospitals. As i said i met my Dr in a private one but he operated on me in a public hospital. Often they work for both.. but it was 75% cheaper to do it in the public hospital.

[oneday]

"...A study into hospitals' actual operating costs will also be necessary to set rates that are acceptable to both hospitals and patients..."

Any drop in price would never be acceptable to any private hospital. That will dig too deeply into the owner's pockets and if they try to lower the doctor's pay then they risk losing doctors, but I'm all for them giving it a shot and here's wishing them success.

Here's an idea how to increase the number of doctor's available at government hospitals -- Take your best and brightest students with an aptitude for medical science and pay for their education to become doctor's on the proviso they work at a government hospital for 40 hours a week for 10 years before they are free to practice medicine anywhere they want. I think this would be a great investment in the country's health care system for a relatively minimal cost given how much money is wasted on stupid projects and corruption.

[robblok]

"...A study into hospitals' actual operating costs will also be necessary to set rates that are acceptable to both hospitals and patients..."

Any drop in price would never be acceptable to any private hospital. That will dig too deeply into the owner's pockets and if they try to lower the doctor's pay then they risk losing doctors, but I'm all for them giving it a shot and here's wishing them success.

Here's an idea how to increase the number of doctor's available at government hospitals -- Take your best and brightest students with an aptitude for medical science and pay for their education to become doctor's on the proviso they work at a government hospital for 40 hours a week for 10 years before they are free to practice medicine anywhere they want. I think this would be a great investment in the country's health care system for a relatively minimal cost given how much money is wasted on stupid projects and corruption.

Thais are not that stupid that is what is happening.. that is why many Thai doctors work in both private as public hospitals.

[trogers]

"...A study into hospitals' actual operating costs will also be necessary to set rates that are acceptable to both hospitals and patients..."

Any drop in price would never be acceptable to any private hospital. That will dig too deeply into the owner's pockets and if they try to lower the doctor's pay then they risk losing doctors, but I'm all for them giving it a shot and here's wishing them success.

Here's an idea how to increase the number of doctor's available at government hospitals -- Take your best and brightest students with an aptitude for medical science and pay for their education to become doctor's on the proviso they work at a government hospital for 40 hours a week for 10 years before they are free to practice medicine anywhere they want. I think this would be a great investment in the country's health care system for a relatively minimal cost given how much money is wasted on stupid projects and corruption.

Such scholarships are already in effect. The govt need to build more infrastructure and give out scholarships to the nursing field.

[Bob12345]

"...A study into hospitals' actual operating costs will also be necessary to set rates that are acceptable to both hospitals and patients..."

Any drop in price would never be acceptable to any private hospital. That will dig too deeply into the owner's pockets and if they try to lower the doctor's pay then they risk losing doctors, but I'm all for them giving it a shot and here's wishing them success.

Here's an idea how to increase the number of doctor's available at government hospitals -- Take your best and brightest students with an aptitude for medical science and pay for their education to become doctor's on the proviso they work at a government hospital for 40 hours a week for 10 years before they are free to practice medicine anywhere they want. I think this would be a great investment in the country's health care system for a relatively minimal cost given how much money is wasted on stupid projects and corruption.

You do know that already exists right?

A medical education is free in Thailand when you work upcountry for 2-3 years after graduating. You can also chose to pay a "fine" and you are free to work where you want.

The problem is that many prefer private hospitals over government hospitals because:

1. More pay

2. More holidays

3. More status

4. Less annoying patients

5. Less stress

6. Better secundary pay

7. Chose your own working hours

8. Free treatment of yourself and spouse

9. More career opportunities

10. Etc

[AsiaCheese]

- Treatment for a heart attack costs between Bt89,376 and Bt158,680 at state hospitals, while prices for the same treatment at general private hospitals are between Bt164,870 and Bt422,058. "Five-star" facilities, though, could charge up to Bt1.15 million for treatment, which may possibly include balloon heart valve surgery or emergency operations;

- Cataract surgery goes for between Bt19,468 and Bt44,740 at state hospitals, while general private hospitals charge between Bt59,263 and Bt113,238, though some five-star places charge up to Bt656,030;

A friend of mine had a heart attack (ruptured aorta), was brought to the leading private hospital in Pattaya in time, was patched-up/stabilized there and then transported to BKK for the operation, because they didn't have qualified/enough specialists for the OP locally. The OP and 10-day stay set his insurance back 2.2 mio baht... That's 5x the "official" figure. He was dead-lucky to have an insurance that paid.

Problem is just: it's crucial to get to a specialist in a hurry in a case like this. I'm not really sure if I would want to risk going to a gov't hospital with something like that, unless it's a big, good one (nearest one here: Sattahip Queen Sirikit Navy hospital).

Cataract surgery was quoted as THB 30k for khun Thai and THB 60k for khun farang at gov't hospital. I got mine at the private Supamitrsena hospital (www.supamitrsena.com), 20km from Ayutthaya, for THB 25k, all included with a 1-night stay, and I'm a totally happy camper! Other quotes I got from private hospitals started at around 65k, and that was without any "extras" (pre-op check, post-op check, 1-night stay optional) which you'd have to add to get the total cost.

[RigPig]

While the aim of the NLA panel was to show the huge price differences between government and private hospitals, it only shows how little they know about medical procedures and the costs associated with them. Let me give an example:

The study found that some private hospitals charge from Bt50,000 to Bt200,000 for an appendectomy, compared to prices starting at Bt16,841 for the same surgery at public hospitals.

I think we can assume the numbers are correct, but is it a valid comparison?

An appendectomy is done by scope in private hospitals while it is done the conventional way in public hospitals. Doing it by scope is far superior than doing it the convention method, but it is also more costly (the scope is not for free).

Besides, the procedure is done by a qualified doctor or specialist in a private hospital, while you have a good chance a medical student will perform it in a public hospital (my wife has done several when she was a medical student).

Maybe next the NLA can investigate the difference in hotel prices.

A shared room with smelly backpackers goes for 300 baht per night, while a 5-star hotel sometimes charges you 10,000 baht ormore. Shouldn't the 5-star hotel charge 300 baht also as both offer a place to sleep during the night?

EXACTLY!!

When the government raises the standard of public hostpitals to that of private hostpitals then it will be a fair comparison. If that happened and the price differences remained the private hostpitals would go out of business!!

[Strangebrew]

Chulalongkorn university hospital charge a friend 500,000 baht for an infection in his leg, length of stay 2 weeks and infection not controlled or cured. Room was semi private. Not say there not good but they wanted to take his leg but once the deposit of 500,000 baht was gone so was he ended up sending him to Guam Cured infection in a week cost 5,000.00 USD in semi private room. told if he stayed another week there would have lost leg and maybe life.

[Gonzo the Face]

I had a choice of having major surgery done at either a private or public hospital by the same surgeon, cost at the private hospital was quoted at twice that of the public hospital.

The main difference being that at a public hospital you are given an appointment day and you are seen on a first come first served basis while at a private hospital you have an appointment time with the doctor and are hopefully seen at that time, priority treatment.

Very happy with the treatment at the public hospital.

Up here in this neck of the woods at a public hospital if you are seventy or above you go to the head of the line. I don't know about other places.

As a suggestion, perhaps when you post in a forum that is countrywide, it would be helpful to post where, someplace like " up here in this neck of the woods " is located...... yes you know, but we don't ....

Point well taken. I live in Esan between Kalasin and Mukdahan.

....and I say thank you Pimay1 for taking my reply as it was intended and for the gracious and very adult response. There are too many jackass' on this forum that would not have responded in the manner you did, and would have given a sarcastic and caustic answer. Thank you friend.

[TallGuyJohninBKK]

That's a VERY interesting and informative study, referenced in the OP...

And, it was good they used some of the best, most respected govt. hospitals as their comparison group -- Rajavithi, Ramathibodi and Chula -- and not some dumpy places out in the sticks.

One thing the study, or at least the OP news report of it, didn't address is I'm assuming the public hospital rates they quoted are their general Thai rates. So they're not using the higher rates that farangs would often encounter if they went thru the afternoon/appointment-based clinics that the big BKK govt hospitals tend to offer. But still, the pricing differences between the govt. and the private hospitals are shown to be enormous.

In the end, it comes down to quality of treatment and care for the money paid. There are horror stories recounted here of allegedly poor treatment that various members have claimed to receive at various private/pricey hospitals, just as there's one posted above about the poster's friend who had an un-cured leg infection that wasn't resolved at Chula.

For me, here in BKK, I have no personal experience using the big govt hospitals, since I've stuck with the privates and/or non profits thus far in my years here. But I'm feeling like I ought to at least become more familiar with the kind of care offered at places like Ramathibodi and Rajavithi for farang patients by making some outpatient visits and such... So I have a better basis for deciding if I'd ever want to use them in the event I require any kind of inpatient care.

[uptheos]

I paid roughly the same at Chiang Mai Ram (Private) for cataract surgery as quoted in the article for public hospitals.

Both eyes less than 100,000 Baht, which included general anesthesia and the surgeons professor needing to be present for reasons I won't go into.

Knee arthroscopy in a private hospital (Rajavej) this year 81,000 Baht

Gawd knows where they are getting the prices from.

[cloghead]

Private hospitals are run as a profit making business just like any other business

It is not a charity

If u cannot afford it .... then go to public hospital

Asolutely...

...only to find the exact same physician will do the exact same procedure at a govt/public hospital--in the mornings, before he/she goes to a private hospital to make the big bucks later in the morning--and the victim patient pays whatever charges the private hospital can extort

Pretzel Logic...

Edited May 24, 2015 by cloghead

[ginjag]

I had a choice of having major surgery done at either a private or public hospital by the same surgeon, cost at the private hospital was quoted at twice that of the public hospital.

The main difference being that at a public hospital you are given an appointment day and you are seen on a first come first served basis while at a private hospital you have an appointment time with the doctor and are hopefully seen at that time, priority treatment.

Very happy with the treatment at the public hospital.

Up here in this neck of the woods at a public hospital if you are seventy or above you go to the head of the line. I don't know about other places.

As a suggestion, perhaps when you post in a forum that is countrywide, it would be helpful to post where, someplace like " up here in this neck of the woods " is located...... yes you know, but we don't ....

Point well taken. I live in Esan between Kalasin and Mukdahan.

I know it---that would be Kaldahan