Study finds huge difference in treatment costs

[jackanapes]

one must accept the fact that private hospitals overcharge patients in order to survive but there must be a regulatory body to control the prices private hospitals charge for medications.

[TallGuyJohninBKK]

I posted this in another thread here recently... I had a colonoscopy done in BKK recently by one of the most highly regarded gastro doctors in BKK, one who's been recommended here in the past.

She had hours at two different of the top farang oriented private hospitals in BKK, which quoted me from 20 to 22K baht plus (I suspect they would have added on the usual hospital facility fee, service charge fees) for the procedure done by her at their facilities.

But it so happens, she also does the exact same procedure at a private medical/surgical clinic in downtown BKK where she also sees patients. The total price there for her to do the same procedure was 12K baht.

So in that real world case, I had a 50% discount or close to it by using the same doctor at a different facility from one of the fancy privates.

The colonoscopy went fine, BTW, though I'd imagine there wasn't as much nursing hand-holding at the clinic as there would have been at either of the privates. But for a 50% discount, I'm fine to hold my own hand a bit...

[Robby nz]

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.

I also met the surgeon who did my work in a private hospital, he is actually a military surgeon from Pramonkutklau military hospital.

He was recommended to us by the man who at the time was considered the number two in the specialty in the country but had retired from operating due to his age. Number one was out of the country at the time.

He was actually a 'second opinion' as we had done a lot of research and the first Dr we were introduced to did not impress us with his answers to our questions, this one gave all the correct answers and was very professional.

I know now that specialists are moved around (farmed out) to hospitals both private and public that have no specialist in a required field.

Everyone has a choice as to where they go for elective medical treatment, if they choose a high priced private hospital then that is their choice.

If I understand correctly the problem of excess charges arose because of emergency care where a patient was taken without their or their relatives consent to a private hospital and their relatives were then required to sign something guaranteeing open ended payment for treatment.

It has also been said (whether true of not) that some rescue services will get paid by a private hospital for delivering an accident of emergency patient to that hospital.

[Robby nz]

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...

It is not a matter of being a victim or extortion.

Private hospitals give priority care to those who want it (can afford it) with menu meals and higher class wards and private rooms.

In public hospitals there are also private rooms but often they are all taken and a ward is the only option, which is OK for a short stay, I know, been there done that.

In Private hospitals you are given an appointment time to meet a specific Dr while in a public hospital you have a day to report and first come first served and unless you are under a particular Dr for some procedure you may get a different Dr on the day for most public hospitals see a huge number of patients and have several Dr's seeing patients at any one time.

If you really want to get an idea of things go along to a public hospital and look for yourself you wont be accosted at the door by bank balance checkers as you would in a private hospital.

[Yme]

When in pain, get on a plane

[Wadan]

This is a very interesting post. Certainly there is strong interest for everyone in health care and because of this, the costs involved comes into play.

The quality of healthcare one receives can be a determining factor in any state or economy in creating a class structure. As long as some fortunate ones, can get better care than others then the system is not balanced and is creating a class structure.

Those who can afford it can argue that, they should be entitled to whatever they can afford and if this means better quality health care, then so be it . but is this fair?

If health care is allowed to be operated as a business, then off course doctors , nurses , providers will always seek to be looking for places that pays them the highest for their services. Eventually, the best doctors, nurses , facilities will be chasing the higher fees and the cost will continue to rise to the point where even basic health will also rise.

Many advanced countries have counter this problem by establishing a universal form of health care. Countries like Canada, Australia, U.K are prime examples.

A very good solution for keeping health care costs down is for the government to get involved and turn out more doctors , nurses and health care personnel. Open up the Medical Universities and attract more students. The doctors and nurses you have then the cost of health care will be controlled.

Cuba is an excellent example. The government opened up the training facilities and now you have many trained personnel who are not making exorbitant salaries but provide excellent care.

People should not simply choose to go into medicine because the high salaries . They should have empathy and love for the profession. Money should not be the single biggest factor. Once this is established, the profession will attract the best caring people and the country will have quality health care. This is a win win situation . Soon the younger segments of the population will be seniors. The demand for more health care will increase. The government should take measures now. It is not just checking into the various costs and trying to control it. What is needed is provide more doctors and personnel. This is the only way to keep costs down.

[Benmart]

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 last sentence is unnecessary. I try not to tell people what to do with their money as I'm not in charge and don't pay their bills.

[Jimbo53]

My Friend recently had a stroke,he was in Pattaya Memorial for 12 days...cost...300,000 Baht.

His wife was hounded on a number of occasions,even inside his initial room in ICU regarding progressive Bill payment,until I had a word with them.

The Financial accounts personnel should not be allowed into the wards or rooms,rather they stay in their offices.

Whilst final payment was being paid in the accounts office,there was personnel hounding her so much in front of my friends doctor,that the doctor told her to go away,and that was inside the ICU!!

Pay 1500 Baht for a member card...it saved almost 15K off the bill.

[Jonmarleesco]

'The existing rule ... requires that private hospitals display the prices ... "However, this doesn't work because pharmaceutical companies can cite whatever prices they want and hide the actual cost from the public," ...' What does the wholesaler's citing of prices/suppressing of costs have to do with the hospital displaying the prices it charges?

[Balance]

I needed an angiogram in Chiang Mai. I was seeing a cardiologist at Ram, however, I needed to confirm that my Thai insurance would cover it. I could not find anyone from the physician to the billing office who could/would tell me the cost of a diagnostic angiogram. The physician made a guess and was TB100,000 too high.

In the end it all worked out for me, but it seems that private hospitals will not provide pricing for services, and so it is impossible for consumers to shop for the best deal. Regulation could start by requiring all hospitals, public and private to provide on their web sites the costs of the most common illnesses treated or surgeries performed. The data should come from their billing records, not guesses and should provide the range from low to high (with reasons for the high cost outliers) and the median price.

Public service messages could be run to inform everyone how to access the information or where to get the information at local hospitals.

[TallGuyJohninBKK]

I needed an angiogram in Chiang Mai. I was seeing a cardiologist at Ram, however, I needed to confirm that my Thai insurance would cover it. I could not find anyone from the physician to the billing office who could/would tell me the cost of a diagnostic angiogram. The physician made a guess and was TB100,000 too high.

In the end it all worked out for me, but it seems that private hospitals will not provide pricing for services, and so it is impossible for consumers to shop for the best deal. Regulation could start by requiring all hospitals, public and private to provide on their web sites the costs of the most common illnesses treated or surgeries performed. The data should come from their billing records, not guesses and should provide the range from low to high (with reasons for the high cost outliers) and the median price.

Public service messages could be run to inform everyone how to access the information or where to get the information at local hospitals.

According to the various news reports and government statements here on this topic, Thai law does already require hospitals to post and provide the exact kind of info you're talking about.

Now, whether anyone at the hospital(s) pays the least bit of attention to that requirement is another matter entirely.

You could file a complain with the Commerce and/or Public Health Ministries... though not sure what that would likely accomplish.

[Keesters]

Study finds pretty much what everybody already knew.

[maidee]

medicine has a 200% profit margin in private hospitals

you have no choice to ask for the meds name and try to find a generic in a pharmacy, as most pharmacies are just sale persons with no idea what is a generic of what

getting sick, is big business

there are not there for your health, they are there to make as much as profit as possible

[scorecard]

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

There is also the concept of reasonable price.

There's also the possibility of unaware people, especially tourists being taken / directed to the so called 5 star hospitals and incurring costs way beyond what is needed.

Edited May 28, 2015 by scorecard