Overpriced medical care could bring down Thai health system

[Kees5555]

A doctor in Jomtien (Pattaya) treated my GF for 4 diseases (4 types of bacteria) she didn't have (knowing she had a foreign BF with money)! This without doing a lab test. I asked for doing a lab test... , no bacteria!
Medicines priced double, 500 baht profit on the lab tests.
And the doctor was a liar: said that she (lady-doctor) wanted to do a cheap treatment (no lab test) because she didn't know my GF had a foreign BF.... but the proof of her being a liar was that she gave my GF a letter in English for me with the schedule of further treatments. So disgusting !!!

Then I tried to fiel a complaint with The Thai Medical Council.. no response. So disgusting!

[Soutpeel]

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.

ok...so you have invested THB 1.2 million, had a bit of growth, so at least you have thought about medical care, but what happens if the medial care exceeds what you have invested ? so I have a problem with "you will be able to handle any major medial problem" statement

1.2 million + could be burned up very quickly in certain cases and certain major medical problems, further if in the case of your investment, how quick can you liquidate it, further are you the only one who can liquidate it ?....that would be a tad problematic if your in a coma and ICU !

What happens if the arse falls out the stock ?

Its great you have thought about these things, but seems you may not have thought it through fully...

As regards the topic at hand, the story relates to private health care, which is being run as a business, the government have no right to tell how to operate their business model per se, and of course in the case of the consumer, you have choice, you don't have to use private health care, if one is not happy with the pricing or the polices...go somewhere else then

The article is akin to the government instructing Ferrari to reduce their prices so every one an afford one

Edited June 22, 2015 by Soutpeel

[Soutpeel]

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.

Had surgery and been treated at private hospitals on more than one occasion in Thailand over the last 14 years and cant fault the service/treatment received

[Pib]

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 hospital -- make money.

I'm sorry, but I find it hard to believe, really hard to believe the doctor told you that. Me thinks that those are "your" words only.

No doubt the doc knows the issue of meds make the hospital money just like every medical services a hospital provides, but he's not going to say to you the hospital administrators have required all the docs to issue as many meds as possible...needed or not.

I too used a Bangkok Bank private hospital (Thonburi 2) for rabies treatment... I was bitten in the hand...the dog's fangs completely went through my hand...kinda like driving a nail through the hand...that's the thanks I get for saving the dog from drowning in a canal he couldn't get out of...as I was lifting him to dry land and with the dog being so scared he twisted around/out of my grip intended to avoid getting bitten and he bite me good in the hand...just missed the big vein on the back of your hand...but I still had plenty of blood coming out.

Anyway, went to the private hospital got the wound cleaned, bandaged, initial rabies vaccination, pain and antibiotic shots, and three take home meds. Around 5 days worth of take home meds which one an antibiotic and two pain killers costing Bt480 total...the initial rabies vaccine shot was Bt960...when including the these two mentioned costs into the total cost for that visit the total cost was Bt2,495 ($75 USD).

I too am price sensitive to meds a doc wants to issue out except on the first visit to the hospital...I just let them issue them because I never know what they are going to be for my aliment or if I can even get them at a drug store, and then if need continue the meds I will just go get the meds at a drug store where I'm "almost always" able to get the drug the doc ordered....and yes it's usually cheaper at the drug store by at least 25%. But like I said, on my initial visit to a hospital for treatment I don't argue with what the doc's wants to issue meds-wise.

I went back over the next couple of days for bandage changes...one day Bt170...the second day Bt240. Then I had to continue to got back for a few more bandage changes and the remaining 4 vaccines shot staggered over 28 days....total of 5 vaccines shots over 28 days. Anyway each of the 4 additional vacinces shot cost Bt680.

Anyway I had a total of 8 visits to the hospital for the initial visit, the follow-on bandage changes, and vaccines series of shots. Total cost of these 8 visits which includes as doctor, nurse, admin, vaccine, meds, just everything came to Bt7,638 (approx $228).

I see very few farangs in Thonburi 2 simply because it's in western Bangkok where few farangs live in comparison to highrise central Bangkok...whenever I go to the hospital I'm usually the only farang seen. I only mention this because it seems those private hospitals that have a large farang customer base (tourist or residents) seem to have much higher prices based on the posts I read, news articles, and looking at some of the prices quoted on hospital websites. But fortunately when looking at Thailand as whole...all 78 provinces the majority farang tourist and residents concentrate in central/highrise Bangkok, Pattaya, Phuket and a few other places and that population probably is increasing private hospital costs "in those areas" since that customer base is probably more able and willing to pay a higher price than a Thai....plus, the farang figures it's still significantly cheaper when compared to their home country.

[DividendGuy]

To Soutpeel:

My stocks have grown a lot in value (no need to boast) over the last 15 years. Plus I save the dividends and put them into a saving fund so it builds up too. It will take care of any small to medium medical costs, can be used to help pay down any major health bills, is easily available and I have been saving these dividends for almost 15 years too. I also have other funds available if needed. I didn't say my way is perfect, but it can cover most of the costs if not all, if you use some common sense. Of course nothing is perfect and each person has to do what he or she thinks is best for themselves.

[mogo51]

Licensed Armed Hold Up - referto section 'Bangkok Pattaya Hospital' I mean Bank!!!

[long klong]

There has been a repeated mention of $1 billion "profit" to Thailand from private hospitals, implying that they are charitable organizations and spend all their profit on public welfare. This profit goes straight into the pockets of the shareholders. Would the government allow the electricity, water and telephone companies also to charge such exorbitant prices?

Health services also come under essential needs and until such time that the government can offer a reasonably high- standard universal public health service in clean hospitals (such as in U.K) it must regulate the private hospitals to prevent price gouging and sheer exploitation.

A couple of people who have said that we have a choice not to use private hospitals are either apologists for these hospitals or are trying to feel important and showing off their money which they have acquired in Thailand! They are talking like high class privileged people, a status they never enjoyed in their home country!

[balford]

If medical tourists wish to have the procedures and can pay for them, let them. But surely medical tourism is not a justifiable excuse for charging the same fees for Thai and Expat patients, some of whom cannot afford the high fees, even with insurance.

Even the clinics do the same. I've been charged double and triple the cost of medicines compared to Thai patients getting the same items. Now I ask for a script, go to the chemist 200m up the road and get the same medications at a fraction of the cost and in sealed containers - not ziplock plastic bags.

And these same clinics are run by doctors working in the private hospital system as an after hours practice. Nice work if you can get it...

Bob A. Relaxed in Lampang.

[JHenry]

But the price for the "Foreign patient" should stay the same or even higher, right ?

[elgordo38]

The Thai mantra, is greed.

Medical hub medical tax lets just say like above its greed plain and simple lets not varnish the truth or spoon feed us crap. We are human beings and deserve to be treated as such. Its just another example of the world wide greed in action catching up here. Years ago they used to bleed patients to make them better now their hoping that to bleed us financially will make the private hospital system better for shareholders that is. Like usual governments will dither and doddle but in the end its business as usual. The Thai's better hang on to their 30 baht card it could go the way of the Dodo bird.

[elgordo38]

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.

At one point last year I thought I would need a cataract operation as the first EYE hospital I contacted here urged me to get it done immediately as my situation was critical (I went to Chiang Mai Ram for a second opinion good thing I did) I contacted my insurer in Canada. She explained to me that the insurance company would pay 4 TIMES what OHIP paid in Ontario to the physician. Really I thought WOW that is great! As it turned out even at 4 times OHIP it would still not cover the cost of the procedure if done here in a PUBLIC hospital. Insurance companies are ripping us off as well mine included. I can now understand why uncle Warren Buffet has these in his investment portfolio.

Edited June 22, 2015 by elgordo38

[elgordo38]

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?

Yes that the government has been sadly lacking in their control of the medical industry. Its time the industry served the patients instead of the shareholders. What are we cattle?

[elgordo38]

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.

Why cant you understand it.You are dangerously ill,or painfully hurt.You have not a lot of money but you do not want to suffer and die.Whats the next choice??

Valhalla

[masuk]

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.

Have you noticed that when enquiring about travel insurance, it almost doubles if there is the slightest chance of you landing or staying in the USA.

Strange that no comparisons have been done with at least one other ASEAN country. Singapore provides excellent medical services, but I wonder how their costs compare with Thailand.

[Yann55]

The Thai mantra, is greed.

Yeah, right, and the Everyone Else's mantra is generosity, compassion, moderation, and benevolence.

The dumbness of such sweeping statements will never cease to amaze me.

[Swedenlars]

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

Really ? Thanks for telling us. Let me explain the isssue to you. YES, medical care is now massively overpriced in Thailand. So your wise calculations are redundant.

[Soutpeel]

Licensed Armed Hold Up - referto section 'Bangkok Pattaya Hospital' I mean Bank!!!

Armed hold ups are against someones will....you have a choice, no one is putting a gun to your head to go to BPH ?,

no one is putting a gun to your head to accept their quote for treatment ?

Having been to BPH many times, can you please direct me to where on Sukhumvit the masked man with a gun is ? holding people up, forcing them inside and forcing them to get medical treatment ?

Edited June 22, 2015 by Soutpeel

[elgordo38]

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).

Yes like every business in the world there is a middle man.

[NickJ]

My relative was in a hospital in bkk and everyone knew this patient would never be able to leave the hospital....In and out of ICU more than two dozen times....half for problems that were from unsanitary actions.......Unlimited Health coverage....at a cost of near 4 million.....DOLLARS......living nightmare. Was shown the cameras a dozen times by staff to make sure everything would remain as it should.......This poor person was a cash cow.......for years........I could write a book.

[elgordo38]

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?

Birds of a feather flock together. They both need each other to survive. They use a do not rock the boat approach.

[elgordo38]

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

sheer exploitation of people's distress just about says it all. Whether your buying a house or new car or medical care its a shopping experience. Hospitals are the only game in town when your sick unless you believe in witch doctors. Your a captive audience. Its a prime example of why the suicide rate among the elderly is increasing. The fact that they are sick is pressure enough. If you place on top of that the prospect of crazy medical bills there are not to many options left. I have decided I will never become a medical ATM. Living wills are legal here but the doctors ignorance or unwillingness to abide by them is another large problem. Of all the education they need to become doctors their education in the field of living wills is atrocious.

[Pib]

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.

At one point last year I thought I would need a cataract operation as the first EYE hospital I contacted here urged me to get it done immediately as my situation was critical (I went to Chiang Mai Ram for a second opinion good thing I did) I contacted my insurer in Canada. She explained to me that the insurance company would pay 4 TIMES what OHIP paid in Ontario to the physician. Really I thought WOW that is great! As it turned out even at 4 times OHIP it would still not cover the cost of the procedure if done here in a PUBLIC hospital. Insurance companies are ripping us off as well mine included. I can now understand why uncle Warren Buffet has these in his investment portfolio.

Sounds like your insurance company pays a percentage of allowed charges which is the way most operate unless you have a really good (and maybe pricey) insurance policy that covers all allowed charges 100% with no cost share/deductible. But there would still be a max amount the insurance company would pay for any allowed medical procedure.

So, if the insurance company only reimburses say 75% of an allowed charge with the remaining 25% being your cost share your insurance will never fully cover the cost regardless of the amount charged....be it t Bt30K, Bt120K...or if it even Bt100...you still just get reimbursed at 75%. And of course even that reimbursement hinges on it being an "allowed" charge.

Now, I don't know what the Chiang Mai hospitals charge for a cataract procedure but I do know at a major govt public hospital the cost is approx Bt30K per eye based on pricing giving at two govt hospitals in Nakhon Pathom province which borders Bangkok. Found this out in getting the Thai mother-in-law's cataract issued addressed....and under the 30 baht program at these hospitals the procedure is free.

[Thai at Heart]

It isn't really the job of the govt to insure that Thais have access to private hospitals. They already provide a hospital service.

But of course reading the article, if they mandate that all medicine must be the same price, this means the hospitals lose money, and they can't have that.

So in order the gouge the foreigner they suggest a foreigners tax on healthcare???????????

These people want their cake and to eat it don't they. Wealthy foreigners stroll into Brumrungrad but some Thais can't and the answer is to.surcharge the foreigners?????

Next they will subsidize the Oriental and Shangrila hotel so that thais can stay there too

[rethaier]

The Thai mantra, is greed.

Greed is prevalent across the planet not only here.

[glasswort]

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?

I find this amazing. In my experience when hospitals know that you have insurance the price doubles.

[Pib]

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?

I find this amazing. In my experience when hospitals know that you have insurance the price doubles.

My experience with medical and dental insurance you get "lower" prices if you have insurance because the dental/medical facilities know the insurance company will reimburse them at a lower, set cost...each procedure has a price they will reimburse. But if you don't have insurance then the sky is the limit....it's whatever you can negotiate with the medical facility, how bad (or not) they want your business, etc.

[glasswort]

Licensed Armed Hold Up - referto section 'Bangkok Pattaya Hospital' I mean Bank!!!

Armed hold ups are against someones will....you have a choice, no one is putting a gun to your head to go to BPH ?,

no one is putting a gun to your head to accept their quote for treatment ?

Having been to BPH many times, can you please direct me to where on Sukhumvit the masked man with a gun is ? holding people up, forcing them inside and forcing them to get medical treatment ?

My experience within the past month: Angiogram and one stent BPH quoted THB430,000. Angiogram and one stent Queen Sirikit Royal Naval Hospital, Sattahip where I had the procedure done THB 176,000. Says it all. Even then I suspect that a Thai would not be charged THB176,000.

[Thai at Heart]

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?

I find this amazing. In my experience when hospitals know that you have insurance the price doubles.

My experience with medical and dental insurance you get "lower" prices if you have insurance because the dental/medical facilities know the insurance company will reimburse them at a lower, set cost...each procedure has a price they will reimburse. But if you don't have insurance then the sky is the limit....it's whatever you can negotiate with the medical facility, how bad (or not) they want your business, etc.

Not in my experience and I know for a fact that a friend of my wife spends hours every day reducing bills at hospitals that will be covered by her employer, AIA.

They pad the bills so openly these days, it is getting out of hand

[TravelerEastWest]

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).

Bob,

Your post is perfect - I have no idea what most of the people on this thread are talking about. The prices I see at Bangkok hospital for top service with often Western educated specialists is a fraction of the US costs.

As an example seeing a Western trained specialist for an appointment that is scheduled for up to a half an hour is 600 baht with no insurance. So just under $20. A similar appointment in the US would be a large multiple of $20.

Medicine at the hospital pharmacy is more expensive than an outside pharmacy so I get what they call a passport which is a summary of your prescribed medicine which I then take to an outside pharmacy - no problem no pressure.

Edited June 22, 2015 by TravelerEastWest

[Bob12345]

...

Health services also come under essential needs and until such time that the government can offer a reasonably high- standard universal public health service in clean hospitals (such as in U.K) it must regulate the private hospitals to prevent price gouging and sheer exploitation.

...

Just for your information: the Thai government does offer reasonably high-standard universal public healh for all its citizens for free (or 30 baht, but they often not even collect that). Doesnt that little fact completely end your argument?

(stating it should be the same standard as in the UK sounds like nonsense, this is a 3rd world country unlike the UK).