Panel studying Thai hospital pricing readies a few solutions

[webfact]

Panel studying hospital pricing readies a few solutions
The Nation

BANGKOK: -- The committee tasked with tackling high medicine prices at private hospitals, plans to offer two options, namely requiring that doctors at private hospitals write prescriptions for patients to buy medicines at a pharmacy or that the medicine prices be kept at a "realistic" level and separate from other fees.

After a meeting with related agencies at the Public Health Ministry yesterday, Dr Supachai Kunaratanapruk, who is a member of the Medical Council of Thailand and chairman of the committee, said they had agreed on a four-point conclusion.

He said that after holding another discussion next week, the committee will offer this proposal to the larger panel led by the public health minister and commerce minister to consider later, he added.

Firstly, the solution proposal will have two options. One would be to maintain medicine prices as per market mechanisms and have doctors write prescriptions for patients to purchase the medicines at pharmacies, whose quality should also be improved to meet the standard. The other would be to get private hospitals separate the price of medicines from other fees and put price tags that reflect the factory rate.

Secondly, the Pharmacy Council, the Food and Drug Administration, the Department of Internal Trade, academics and people sector would be asked to negotiate the options with private hospitals over a week or two.

Thirdly, the issue of private hospitals charging emergency patients would be handled by the National Institute of Emergency Medicine (NIEM). The institute would set a definition of "emergency cases" and notify the public about it, and that all hospitals would be required to treat emergency patients for the critical 72 hours, he explained.

After the initial 72 hours, NIEM will contact the respective patients' healthcare scheme to refer them to proper facilities. If the patient referral system cannot be passed on to the patients, then NIEM will be responsible for the expenses, he said, adding that if the patients refused to move, then they would have to cover the bills themselves.

The institute will also negotiate the medical treatment rate with private hospitals and set a standard treatment time, he said. This negotiation should be completed in a week or two. NIEM will also set a joint committee with three healthcare schemes to handle issues stemming from this matter, he added.

Fourthly, medical treatments for 77 non-emergency illnesses would be publicised in the Department of Health Service Support's website with links to private hospitals, so people can look up and decide before seeking treatment. This part should be completed in a month, he said.

Source: http://www.nationmultimedia.com/national/Panel-studying-hospital-pricing-readies-a-few-solu-30260922.html

-- The Nation 2015-05-26

[lee b]

Emm, so point 1, pharmacy will increase the price of certain meds by 10 fold or point 2 get at hospital or refer to point 1.

[lujanit]

Would it be possible, under option 1, for people to buy generic equivalents instead of 'named' drugs. For example I need an anti-hypertensive and the doctor always used to provide me with Adalat which costs about $1 a pill when the script is filled at the doctors'. After some research I found that I could purchase OTC Nelapine which costs 105 baht ($3) for 30 pills. Same active ingredient and hugely cheaper.

Since discovering this I have found generic equivalents for several medications that my wife's parents require. Doctors seem to always prescribe the most expensive drug. I know in Australia the pharmacist will always ask if you are happy with a generic alternative.

Option 1 would save people a lot of money yet I think private hospitals will fight this tooth and nail, too much 'free' profit in supplying medications in house.

Most people who go to a private hospital end up with a "party bag" of overpriced drugs they mostly do not need. The over prescription of antibiotics is a huge money spinner yet does no-one any favours.

[Strangebrew]

Ok Let me clear this up for all manufacturers of drugs give doctors commissions on there drugs that they prescribe there patients to use Standard practice in the industry. Imodium 14 baht each lopermide 1 baht per tablet

[quandow]

The tenet of Big Pharma:

• Trying to suck every penny out of the pockets of the sick, injured, dying, and hypochondriacs;
• Inventing new maladies so people will buy more drugs;
• Renaming old maladies so people will think their conditions are more serious, making them more willing to pay higher prices for prescriptions.

"Tell your doctor..." Tell your Doctor? Shouldn't your doctor tell you what drugs you need? If you tell your doctor, isn't he just a dealer at that point? —Bill Maher, Victory Begins at Home

[NextStationBangkok]

Hospitals should be asked to display the treatment costs (Emergency/First Consultation/Followup etc) on a display board clearly. It will be easy if they print a Maximum Retail Price with Tax on each medicine clearly, because anyhow they have to print lable's in Thai for the medicines which are imported. Thailand is playing with lives who are in danger.

[cougar52]

This is all a scam to take you money. Just yesterday I went to the Thai Hospital not even a Private Hospital to get my drugs (Zimva and Clopidogrel) the last 2 years the cost has been 100 baht a month, yesterday the cost has gone up to 700 baht. The Nurse said the hospital changed supplier? That was a lie because the pills that I bought last month came from that supposed new supplier for less than 100 Baht.

Edited May 26, 2015 by cougar52

[smedly]

The problem with Thailand is quality control, I agree that a script should be written to be filled at a pharmacy of your choosing and for a generic if available -your choice, but how do you know what you actually get in the pharmacy is not a fake (baking powder), this is the problem and as we are fully aware in Thailand greed and money rules and the counterfeit business is rampant

If they want to make changes as proposed then the FDA needs to be very very proactive at inspecting stock and severely punishing those that are found to be cheating, you cannot mess with medical drugs - your life most likely depends on it, you need to be 100% certain that what you are given is a genuine authentic generic or otherwise

[mike324]

I think the issue with what private hospital charges is overblown, why not focus on the efficiency of public hospitals and problems, that would do more good...

[tigermonkey]

Hospitals should be asked to display the treatment costs (Emergency/First Consultation/Followup etc) on a display board clearly. It will be easy if they print a Maximum Retail Price with Tax on each medicine clearly, because anyhow they have to print lable's in Thai for the medicines which are imported. Thailand is playing with lives who are in danger.

Unfortunately that which you propose is a pure 'nanny state ' solution to the problem. It will not work ! What will you do when you arrive at Emergency ? Will you or your representative spend the next 1/2 hour or so, perusing the "display board" to decide which treatment option you want, or if you want to go to another hospital. Of course, that would be ludicrous.

The truth is that the system is a broken mess, and can not be repaired because the money folks are completely in charge - there is no hint of any medical ethics or morals left in the system, except at the level of the doctor/patient relationship. It needs a new start based on medical ethics and the Hippocratic oath. Medicine should not be entrepreneurial venture.Doctors should be running hospitals, not investors.

Edited May 26, 2015 by tigermonkey

[stoli]

Saw the first change at the hospital yesterday since all of the discussion about the government to step in and focus on what private hospitals are charging their customers. I have been to Bangkok Hospital Pattaya about 10 times in the last 13 days. It is always the same. See the doctor, have the treatment, then escorted to the cashier where you are presented with the cost for the first time on that visit. Yesterday, I went into wound care to again have the doctor check out the wound, and see that it is re-wrapped. For the first time ever, they took the bandage off, the doctor looked at the wound, and then a woman came in a asked the nurse to tell her every item she would be using on me to re-wrap the wound. Within minutes, that woman brought a list back to the nurse, who then told me what the entire cost would be. Once I agreed to it, she then re-wrapped the wound. Never have I seen this done before. Interesting.

[wowfactor10]

So how will this stop the negotiating in the hospital intensive care units with these doctors before they start to operate on foreigners..?

Och i get it it not really to end that its just about having thais not get scammed out on their meds..

We are in good hands with this panel..great job..

[Ulic]

Hospitals should be asked to display the treatment costs (Emergency/First Consultation/Followup etc) on a display board clearly. It will be easy if they print a Maximum Retail Price with Tax on each medicine clearly, because anyhow they have to print lable's in Thai for the medicines which are imported. Thailand is playing with lives who are in danger.

Unfortunately that which you propose is a pure 'nanny state ' solution to the problem. It will not work ! What will you do when you arrive at Emergency ? Will you or your representative spend the next 1/2 hour or so, perusing the "display board" to decide which treatment option you want, or if you want to go to another hospital. Of course, that would be ludicrous.

The truth is that the system is a broken mess, and can not be repaired because the money folks are completely in charge - there is no hint of any medical ethics or morals left in the system, except at the level of the doctor/patient relationship. It needs a new start based on medical ethics and the Hippocratic oath. Medicine should not be entrepreneurial venture.Doctors should be running hospitals, not investors.

Most medical treatment is not emergency room work. If prices for various treatments was displayed or available on line

in Thai and English, from public and private hospitals people could make an informed choice. This has absolutely nothing

to do with a "nanny state". Would you shop at a grocery store or any other store that does not clearly have the prices marked?

When I go into a shop that does not have the prices marked, I turn and leave unless I already know the prices. So yes

if you are arriving at the emergency in dire straights you cannot be looking at the cost menu, But if you have done a little

research and had treatment before, you will probably know which hospital emergency room you go too, to get the service

you want at a price you feel is fair.

[scorecard]

Still one more item I hope they scrutinize, raising the bill when they know the patient will use a health insurance card.

Total and absolute rip off and ultimately must raise premiums for no reason whatever associated with actual costs of providing health services.

[BngkkB]

I think it was last month the govt seized a load of fake merchandise, the usual stuff but in this haul they mentioned flu vaccines in the list of knock offs. Great they stopped one shipment a month ago, no new news of recent shipments being confiscated. Did they bother to follow up what clinics or hospitals the fake flu vaccine was going to? Unlike the USA where you can a flu shot in the local pharmacy I believe but not sure you need to go to a hospital or Dr to get a flu shot in Thailand, so where were those vaccines headed?

No follow up nothing fixed.

[Jonmarleesco]

'The committee ... plans to offer two options, namely requiring that doctors at private hospitals write prescriptions for patients to buy medicines at a pharmacy ...' That would be good. But it wouldn't address a hospital stay, where one can hardly tell the staff that one wants medicines supplied by an external provider.

[stoli]

Hospitals should be asked to display the treatment costs (Emergency/First Consultation/Followup etc) on a display board clearly. It will be easy if they print a Maximum Retail Price with Tax on each medicine clearly, because anyhow they have to print lable's in Thai for the medicines which are imported. Thailand is playing with lives who are in danger.

This would have to be written in a 1 point font for it all to fit. Let's be realistic here. A hospital is not a limited menu board like a McDonalds. Do you want it in Thai? Thai & English? Thai, English, Russian, Spanish, Swedish? Where do you stop and start? We could also be playing with our lives by pretending to be doctors ourselves.

Does your local Pharmacy have a menu board? They must be laughing their ass off.

Edited May 27, 2015 by stoli

[smedly]

without going back and reading again I thought they were saying emergency treatment was going to be free, same as in most hospitals in Europe/UK, the problem arises if you are not fit to tell them to take you to a private hospital as the private room IC care bills start to accumulate once you are stable but unable to tell them yourself

anyway also as mentioned it is a well known fact that the pharmacy in private hospitals is a money spinner for them but most doctors are quite willing to right a script for an external pharmacy upon request but it is quite clear that the hospital admin do not approve of such practise - maybe that has now changed

and the best and most valid point made on this thread so far by tigermonkey -

quote Medicine should not be entrepreneurial venture.Doctors should be running hospitals, not investors.

[Colabamumbai]

Srinakarind Hospital Khon Kaen University just charged me 14,000 Baht for Hep C meds, but I paid the Doctors nurse, not the cashier, and I received no receipt. So if I had insurance I could not complain.

I have a piece of paper the size of a post it note with the price one week 3,500 x 4 = 14,000.

"Thats all she wrote."

This is for one month 4 injections of Peginterferon Alpha 2 A Expiry date September this year, I do the injections at home and Ribavirin pills 4 daily more than a months supply expire next year, made in Toronto, my home town. The injectable syringes made in Switzerland.

I did have to pay 150 Baht for the Doctors visit at the Cashiers window and did receive a receipt for that.

So is something illegal going on at this hospital I ask Thai Forum members and Mr. Ocha.?

I am having a Thai call the toll free number that the Health Ministry gave out this month, and will be calling the foreign English speaking lady who is kind of like the ombudsman/lady at the hospital.

This is the liver care hospital in Isaan where I also paid 6,610 Baht to determine that I had Hep C Genotype 3

.

[Thai at Heart]

No one should be compelled to have to buy from the hospital. The doctors job is to diagnose and administer . he can only recommend not force where to purchase.

[scorecard]

Still seems to be no focus on hospitals upping the bill substantially when they learn you have health insurance.

Greed, nothing more nothing less.