Overpriced medical care could bring down Thai health system

[skildpadden]

I think it is a little bit more complicated than just blaming the prices on the arrival of rich foreigners.

These foreigners made it possible for the hospitals in the first place to invest in the latest technology in cancer, orthopedics and cardiology as well as attract the best Thai doctors - both domestically and the ones already working overseas. Bear in mind that 20 years ago Thais (who could afford it) were travelling abroad for treatments. Without the investments made that would still be the same, but now a broader number of Thais has access to prime healthcare in their own country instead of flying abroad.

Further, a medical tax on tourists would reduce the number of these tourists, so where will the revenue to pay for new investments come from?

"If the problem [of overpriced healthcare] is not solved in time, this could be mark the end of the government medical system - because all kinds of charges including medical fees, services and for medicine would have to increase, according to private hospitals," she warned".
I don't see how the private hospitals will make the government system collapse. If they - the public hospitals - invested in the latest technology they could offer same treatment to Thais at a fraction of the price. If anything they are now complementing each other - you can go for part of your treatment at a private facility and do the rest at a public facility. But to make the investments it means that taxes are collected correctly - and e.g. introduction of a land and building tax would generate income for hospital investments. Reducing import taxes on medication could also help.

Then again you are Thai - nobody is forcing you to go to a private hospital.

[Gandtee]

The government is right to be looking into the issue of price gouging and should also be examining the relationship with the health care insurers. I recently had a small procedure done at a private hospital and the initial estimate was 75,000 baht. When they discovered I had insurance from BUPA the price dropped to about 45,000 baht (pay now, claim later). OK, I had the money to pay this and will be refunded, but someone without the insurance would be gouged 30,000 baht by the hospital.

As a business relationship I can see there would be a discount applied to an insurance company, but nearly 50% tells you something doesn't it?

Why I wonder, don't the insurance companies investigate the hospitals?

[jobwolf]

For a start in Phuket you are most likely to find the same Doctor's in Private and Government Hospitals. I have a friend who was transferred from Bangkok Phuket Hospital ( private) to Wachira Hospital ( government) because the Government Hospital had better equipment. The medical service in Thailand is not as good as it is advertised. I personally had 2 big mistakes in Diagnosis for my own problems.

The only difference is better accommodation in private Hospitals.

[long klong]

The Thai mantra, is greed.

That pretty much sums it up.

It use to be "cheaper " but from personal experience I find it is the same if not more expansive now.

Shoulder surgery Bkk Hospital- close to 500k

Shoulder surgery in Sydney Australia, private room -$16000,close to 500k

The only competitive prices remain is the physio and dental, everything else is about the price of Western countries

Even dental charges are going up fast while the quality of service is going down sharply. At one "International" hospital the head dentist had to send back a crown to Bangkok three times as it did not fit properly. Instead of apologizing for the delay and prolonged discomfort, he charged the patient for the extra time on top of already exaggerated fees!

[Geordie59]

My wife's experience needing ESWL treatment for kidney stones was that the big American hospital in BKK was at least 6 times cheaper than what we would have paid in the US.

Two sessions of ESWL 80k THB for first session, 20k THB for second (plus some incidental's total 120k) In the US it would have easily cost over 500k THB for the same treatment.

We went to at least five different hospitals, some suggesting two nights stay, others suggesting treatment for over a month. We ended back at my first choice (wife had to shop around) and found it to be the best option.

The experienced Urologist we found laughed and said one treatment with a second follow-up in three days to ensure the stone was removed.

I would find it very difficult to believe the private hospitals in Bangkok come anywhere close to the US costs.

It may well be 6 times cheaper than the USA. However, the USA is well know for being extremely expensive for medical care compared with the rest of the world.

I recently got medical insurance worldwide except N America. To include N America would have more than doubled the cost of the policy.

[Equalizer]

Forget about the drugs. If they can explain why they charge almost 15000 baht per day in a standard room we may begin to get somewhere. ICU not included there is no justification for it.

[The Deerhunter]

I know some practising chirugians in BKK who only work for farang in private hospitals and i agree they make a huge amount of money. Even their collegues from the West can only dream of that.

All medical staff deserves a proper salary in my opinion but the ones who want to become millionaires should have become bankers. I don't understand why medical staff in the West (and also in Thailand it seems) has become so greedy.

What stops you to become a surgeon yourself and become a millionair also?

Maybe the 6 years of medical school with 60+ hour work weeks followed by 4 years of specialisation with 80+ hour workweeks (I know one doctor who is currently specializing to become a surgeon and he makes 20 hour workDAYS regularly). If you can get in at least, as they do require you to be at the top of your class to even be considered to enter.

And the pay during those 10 years? Most get paid so little that they need to find side jobs during that period if their parents don't send money (taking shifts in the hospital where they study or a nearby hospital).

What you say is correct. Even in countries where there is a national free healthcare system. In those situations I think it must be a bit like bullying in private schools. "I had to put up with it so why should the young doctors of today have an easy ride?" Seconded of course by state medical admin & executive staff who are on great salaries (because they are in the medical sector) but like to squeeze the trainee Drs & nurses to get the country better bang for their buck, (and thereby "earn" their high salaries by holding onto these outdated policies. But let one of the intern drs or surgeons on 100, 150 plus hours a week rosters make a mistake that kills or misdiagnoses someone and all hell breaks loose. "Is this the best we can expect from our highly paid professional national healthcare system?" Greed is rampant in e administrative and professional branches of the medical service in all countries.

Let the govt set a tight price for all "emergency" services to Thai people at all private hospitals and a higher maximum price for all Thais for elective procedures. Then set a maximum of 20% or 50% or whatever for overseas people and make them publish typical prices on websites or in waiting rooms. (And prosecute liars.) Don't forget a 10,000 baht or 100,000 baht procedure would already have a nominal 2.000o or 20,000 baht profit margin so a 20% price hike for overseas patients means a substantial hike in profit. When it is hurting or life threatening and you do not have a Thai spokesperson, you have to pay.

Private hospitals sure have different attitudes to each other. Our experiences at two of the biggies in Sri RaCha sure confirm that.

Also, definitely control prices of drugs administered and keep discharge prescriptions separate from in hospital cost so people can vote with their feet where they have their "scrip" filled.

Edited June 22, 2015 by The Deerhunter

[long klong]

Far too many cases of sheer exploitation of people's distress is becoming a legend in Phuket. It is now one of the main topics of discussion on social occasions - bringing a very bad name to the medical profession and Thailand. One recent case - a worried couple were charged 4,500 baht by the small clinic at Laguna (canal village) for five-minute "treatment" of a young child who had been stung by a jelly fish on the beach at the Outrigger resort. The parents told everyone that the shock of the bill was almost as much as the incident on the beach

[cumgranosalum]

.....been on about this for over 10 years... there are serious flaws in a system that is first and foremost trying to make money and has few controls on how they do this - they obviously go after the most lucrative areas which means the poor and "un-sexy" medicine suffers.

most countries regulate how many hours their doctors work for government hospitals - sadly in Thailand once "qualified" (there's another heap of issues) they are only committed to working in government hospitals if they ae govt trained for about 3 years....this means a huge drain of qualified staff into the more lucrative private sector.....

coiuple this with what is basically a pure profit0-based business model and you have a healthcare system that benefit only the shareholders and leaves the nation with second-rate healthcare.

Edited June 22, 2015 by cumgranosalum

[cumgranosalum]

BTW - I fail to see the point of comparing Thai healthcare with the US as they are suffering from appalling systemic problems too..

it's much better to look at healthcare systems in Europe that for better or worse actually work - they provide UNIVERSAL healthcare.

Edited June 22, 2015 by cumgranosalum

[masuk]

utkb...

The issue is not whether the thai HC system is cheaper than the US. It's apples and oranges. It's much cheaper - the issue is whether the Thai hospitals are charging a fair market value compared to their profit margin...

Give you some perspective. A Thai nurse makes 100B an hour - his/her counterpart makes $30 - $50 an hour in the USA....Labor. legal and regulatory costs are huge expenses in the US HC system; very small in the thai HC system...

CB

I see on the charts at the start of this article that private hospitals must pay 25% tax. That must increase costs.

I had a knee replacement 18 months ago at the Chiang Mai University Hospital. It cost me 25% of what the Australian cost would have been, and I waited 10 days, not many months.

No complaints apart from the food!

[long klong]

My wife's experience needing ESWL treatment for kidney stones was that the big American hospital in BKK was at least 6 times cheaper than what we would have paid in the US.

Two sessions of ESWL 80k THB for first session, 20k THB for second (plus some incidental's total 120k) In the US it would have easily cost over 500k THB for the same treatment.

We went to at least five different hospitals, some suggesting two nights stay, others suggesting treatment for over a month. We ended back at my first choice (wife had to shop around) and found it to be the best option.

The experienced Urologist we found laughed and said one treatment with a second follow-up in three days to ensure the stone was removed.

I would find it very difficult to believe the private hospitals in Bangkok come anywhere close to the US costs.

It may well be 6 times cheaper than the USA. However, the USA is well know for being extremely expensive for medical care compared with the rest of the world.

I recently got medical insurance worldwide except N America. To include N America would have more than doubled the cost of the policy.

Please stop comparing every thing with America. That's what the doctors and hospitals are doing. Thailand is not America. Your comparison hurts people who are retired here. You may be a visitor and consider the charges moderate compared with the U.S. But people who live here have to shell out six times more money because of frivolous comparisons.

[khunianb]

A number of private hospitals in Thailand meet international JCI standards , which requires significant investment. Yet the prices are still lower than the West.

Using a private hospital is voluntary and you are advised of the price - consumer choice.

These actions are being pushed by Thai NGO s which want to gain access to private hospitals without paying for the value.

[gemguy]

Hmmmmm.

We all know that most businesses try to maximize profits.

However the health care industry and its lucrative profits must come with a number of considerations while being regulated on behalf of the public...and not in favor of maximizing profits for the flourishing industry.

The health care industry in every country in the world is up there in the top 10 percent of business models and industries that are and always will be a growth industry.

They more or less have a captivated audience that does not have a whole lot of choice while the world over the citizens of each and every nation bemoan the costs of health care and hospitals and their costly services.

Even without the medical tourism business flourishing in Thailand and encouraged by the government and the health care industry itself you can be assured the costs of health care and hospital services would still remain far more costly than the average Thai citizen can afford.

Meantime ...without a doubt, scrutiny of the flourishing private hospital industry is long over due and like the public insurance companies that are interrelated they do need to be regulated and controlled.

Without government intervention ( supposedly, on behalf of the people???? ) it is clear and plain to see the industry would continue to raise their prices and increase their profits when ever they feel they can and or want to do so....with impunity.

Every country in the world has gone through the same or similar motions concerning their health care industry while the citizens more or less have to rely on their government officials to step in and thwart the over zealous profiteering that always occurs if the health care industry is not brought under control, somehow and some way.

Cheers

[NickJ]

The Big 4 Hospitals in Bkk went public. they used to be owned by families or small groups of people. At one of these hospitals,The cost increases and the policy to attract patients from outside of Thailand,can be attributed pretty much to one Dr who came here from the west. His policies, practices and proceadures were followed by the rest.

[eusabai]

I went to a major private hospital in Bangkok to start the rabies shots after having been bitten by a dog nearby. In addition to the shot, the doctor ordered antibiotics and 2 kinds of pain killers. I told him that could buy all these medicines more cheapy on the outside, and that I did not need the pain killers. He replied that he was required by the hospital administrators to prescribe as many and as large an amount of drugs as he could. He then agreed to reduce his order to me to save me money. The bottom line is -- as it is in America which provides the model for this hsopital -- make money.

[aussieinthailand]

This is an open secrete that Thai private hospitals are fees gougers and some time to the extreme,

Most local business acumens is to milk the proverbial cow to it's last drop and milk and gut

the goose that lays the golden eggs, they don't know where to stop, and how much is too

ridiculously too much already, yes, they have fantastic facilities with fairly advanced good

care, but they make you sick again when you get the bill...

In short, Our service is great , but our prices will kill you,

For a foreigner at a privet hospital with insurance, Sometimes just sometimes if you can produce a yellow house book you can get a much reduced price.

The public system is the same, My wife worked in the health business for a decade or more.

1. for a Thai person, if you have not resisted your name with that particular hospital you go too the 30 baht scheme will not apply.

2. The hospitals purchased price of medicines and health supply's and the price charged is MASSIVE.

3. Anything that is specialist based :ie, staff equipment, and medicines, the mark up is again MASSIVE.

4. Many out-patient procedures are directed to be in-patient procedure, and the system is manipulated to generate money.

5. Public hospitals Basic patient care is NOT done by the nurses but the family members, anyone who has been in a public hospital ward will know this.

6. Any checks and balances are simply lip service as the money that is made is on a scale only those in the business know.

7. So if there were real transparency instead of open corruption the health care budget could be slashed by how many MILLIONS???

8. The privet hospitals don't give a flying @#$*&^ what is happening to the public sector or those that can't afford privet hospitals, MONEY IS EVERYTHING!!!

Just an opinion as truth in a country of lies can be a crime, TIT

[Bannum opinions]

To put a political tinge to this to and fro about medical costs and coverage's in Thailand, one must realize that in the current political climate, it is the Bangkok-centric elite speaking/negotiating with the Bangkok-centric elite.

Other political persuasions and the people they represent, are not applicable.

It is a well-known fact, the Medical establishment has a hate-on for Thaksin and those who benefited from his time as Prime Minister.....They considered that 30-baht hospital program as a direct affront to them. It emasculated their golden-goose...............But that program is considered the most beneficial of many others introduced by Thaksin, that brought some equilibrium to Thai people at all levels....Subsequent electoral results affirmed that.

So to see the Thaksin-hater medical establishment with its' equal disdain for those of a lesser station, negotiating with their fellow political brethren, is absent credibility, legitimacy and political balance.

Edited June 22, 2015 by Bannum opinions

[StephGo]

Controlling hospital costs would certainly be a qualifier for Thailand to be a retirement destination.

I think controlling quality health care is more important to promote Thailand as a retirement destination.

Let the private sector do what they do best: offer best value for money thru market competition, without hinderance from governments whom only solution is to apply yet another tax.

They are not promoting better quality, but just pushing the prices up on the private hospitals so that their "cheap" system becomes more competitive. And in the end, overall prices will only go up because the private hospitals will now charge 60000 instead of 45000, so the "cheap" hospitals will be able to charge 45000 instead of 30000, and that's without any improvement on quality.

Furthermore, the 1 billion baht medical tourism industry will greatly suffer from this new proposed tax. Thailand's private hospitals are not in competition with the free medical hospitals of Thailand...they are in competition with Singapore's and India's private hospitals. The result may push many of the best medical staff and hospitals away from Thailand, resulting in a generally lower quality system.

As for their final statement: "have access to quality but cheap healthcare", I can only reply that I also want that!

And I also want a cheap Ferrari, and a cheap villa where I can retire (with ocean view), and cheap flights back to Europe or America where everything is so cheap!

[cumgranosalum]

A number of private hospitals in Thailand meet international JCI standards , which requires significant investment. Yet the prices are still lower than the West.

Using a private hospital is voluntary and you are advised of the price - consumer choice.

These actions are being pushed by Thai NGO s which want to gain access to private hospitals without paying for the value.

the number of times I see this

"A number of private hospitals in Thailand meet international JCI standards"

This is a hugely misleading statement.

the JCI is NO guarantor of good healthcare.

It is a SEPARATE organisation from JC dealing with foreign hospitals with different criteria, and they will, for a fee "certify" your hospital - it has nothing to do with the quality of care or abilities of doctors it is just a review of facilities and a licence for insurance companies to send patients there.

​there have been many cencerns expressed to oabout how hopitals qualify - there is no unannounced inspection or follow up...everything is done by negotiation with the hospital - they have also a reputation for NEVER failing any hospitals.

Edited June 22, 2015 by cumgranosalum

[DDbkh]

I recently had a knee replacement. The costs quoted by various hospitals varied from 300k to 600k. Eventually I decided to seek out the top surgeon. At a govt hospital he would have done the op for around 50k but I would have to wait 2 years. I saw him at a private hospital and he looked at his diary and said 'how about Saturday week' - the eventual cost was less than 260k. The result is fantastic and I could not praise the surgeon or hospital staff enough.

The point really is I could have had the same surgeon at a govt hospital for a quarter of the price but I would have had to wait two more painful years and risk the potentially lower standards of care.

Private hospitals are expensive, some very, but they generally provide a higher level of treatment in a shorter time frame. If they overcharge then the medical tourists will go elsewhere.

[Suradit69]

The Thai mantra, is greed.

You have to be joking. They don't come close to the out of control health care greed in the US. And in those countries that provide "free" or subsidized medical care, services are being cut back and the governments funding the services are sinking under debt that is unlikely ever to be repaid.

And in the US, potentially life-saving medical procedures are routinely withheld from those who can't afford them. Even those who pay for expensive insurance coverage are not really protected. Insurance companies can decided with a flip of the coin whether or not to pay for anything out of the ordinary.

How any farang can come to Thailand and "see" greed here as if it didn't exist on a far higher scale in his own country ought to be amazing ... but then this is Thai Visa where posters wear rose colored glasses when thinking about the farang paradise from which they fled as economic refugees and now they wile away their time in Thailand sitting by the pool, looking for things to criticize.

Edited June 22, 2015 by Suradit69

[Bob12345]

Let the govt set a tight price for all "emergency" services to Thai people at all private hospitals ...

Isn't that moving the problem around instead of solving it?

The "tight price" will most likely be below what they charge now, and possibly even below cost.

So that will raise the prices of all other procedures.

Or did you expect the private hospitals to just lower profits in general?

(btw, every patient is different and every procedure is different, how are you going to set a standard price for that? And won't that encourage private hospitals to do the absolute minimum to save costs risking lives?)

[StephGo]

My wife's experience needing ESWL treatment for kidney stones was that the big American hospital in BKK was at least 6 times cheaper than what we would have paid in the US.

Two sessions of ESWL 80k THB for first session, 20k THB for second (plus some incidental's total 120k) In the US it would have easily cost over 500k THB for the same treatment.

We went to at least five different hospitals, some suggesting two nights stay, others suggesting treatment for over a month. We ended back at my first choice (wife had to shop around) and found it to be the best option.

The experienced Urologist we found laughed and said one treatment with a second follow-up in three days to ensure the stone was removed.

I would find it very difficult to believe the private hospitals in Bangkok come anywhere close to the US costs.

It may well be 6 times cheaper than the USA. However, the USA is well know for being extremely expensive for medical care compared with the rest of the world.

I recently got medical insurance worldwide except N America. To include N America would have more than doubled the cost of the policy.

Please stop comparing every thing with America. That's what the doctors and hospitals are doing. Thailand is not America. Your comparison hurts people who are retired here. You may be a visitor and consider the charges moderate compared with the U.S. But people who live here have to shell out six times more money because of frivolous comparisons.

I totally agree! so keep the government away with their taxes! You're only following the american/european models which will bring prices up! Even for locals!

[Bob12345]

My dad used to say: "knowing the answers is useless if you are asking the wrong questions".

Khun Viroj Na Ranong should not ask himself how he can make medical procedures more expensive for foreigners (answer: by introducing a medical tax), he should be asking himself the following question:
Q: if my spouse/kid turned up terribly ill tomorrow, would I bring him/her to a government hospital or a private hospital?

(in case he would answer "government hospital" he should next ask himself "would I do the same if I did not have my influential connections guaranteeing me better care?").

Next he should ask himself why he would prefer a private hospital over a government hospital.

And the answer to that question is where he should focus his attention on!

[FangFerang]

ANyone who comes here for medical tourism, rather than go to South Korea, has failed to shop.

Cleaner facilities, ewxpert level care, less than half of Western prices. Thailand, once again,

[jackanapes]

i noted the article stated private hospitals buy xpensiveand imported drugs why when they can be bought in Thailand.

[DividendGuy]

All the hype regarding lower medical care here in Thailand is just pure BS. Now the spotlight is on Thailand's overpriced medical costs and when it passes then everyone will forget about it and move on without anything concrete being done. For me, I won't be using any Thai hospitals for any major hospital care unless it is an emergency as I can afford to go to Singapore or any other higher quality facility. Several years ago I bought 4 stocks (Bt300,000 each share) on the SET to cover any major problems and have had this in effect for more than 15 years. This fund has grown and grown so, that now my family is basically covered if/when we need major medical care in the future. The plus side is that until I sell the stocks for medical care I get the dividends as sort of a free gift or can re-invest. I recommend all foreigners in Thailand to do the same, because after a few years invested you will be able to handle any major medical problem too for you or your family.

[seajae]

I know some practising chirugians in BKK who only work for farang in private hospitals and i agree they make a huge amount of money. Even their collegues from the West can only dream of that.

All medical staff deserves a proper salary in my opinion but the ones who want to become millionaires should have become bankers. I don't understand why medical staff in the West (and also in Thailand it seems) has become so greedy.

Many years of difficult study and high university fees is maybe one reason don't you think ?

trouble is that their qualifications are that p*ss poor they are not accepted by some other countries, they need to re sit them to practice in Australia because they simply are not world class, unfortunately thai degrees are pretty worthless outside Thailand. When you go to a thai doctor who tries to tell you that you need you appendix removed until you tell him that it was removed 30 years ago you really have to wonder at their qualifications,

[realenglish1]

THis is a crisis in mind If you want to see overpricing go the the United States and see what medical cost are

It will blow your mind.