It's time to fix Thailand's dire healthcare system

[farangmick]

"speak up" was used several times in the article, but, criticism is not something the Thai people do------EVER!

Not to each other. They store their pent up frustrations until they can take it out on their farang husband.

[connda]

I go to government hospitals, and other than the wait, I don't see a problem with the quality of care. If fact the quality of care has been as good, if not better, and some private hospitals I've been to.

However, corporate interests are itching to get into the game that would essentially make health care completely unaffordable for a large segment of the population, while enriching insurance companies and private interests.

Every time I see an Opinion-Editoral (Op-Ed) like this, all I can think is: "Who are the corporations interests backing the biased commentary?"

And that's my opinion.

[connda]

Please don't follow the USA Obamacare example

The Affordable Care Act was a piece of legislation written by insurance companies/for-profit health care organizations for the benefit of insurance companies/for-profit health care organizations. It's a nightmare. And it's a nightmare that insurance companies/for-profit health care organizations would love to come and visit Thailand.

The current Thai health care system provides a safety net for those who are on the lower rungs of the sociology-economic ladder in this still developing country. The citizens who use the care know that they have a wait when they obtain the care. Those who have insurance through work or can afford to insure themselves can and do opt to go to private hospitals where the prices are significantly higher, but the service is faster and nicely dressed nurses and administrative assistance will smile a lot - smiles that you pay for.

The rhetoric in this opinion piece simply urges the reader to believe that government hospitals are morbid, unfriendly, institutions that offer poor services to their clients. I routinely go to government hospitals, and other than the wait, the quality of care is as good as any private hospital that I've been to. So the public hospitals don't pay their staff more to put on a good show, smile a lot, to suck up to their richer clientele. Generally in the public hospitals, the staff are working their buns off to get a high volume of individuals processed efficiently each day, so they don't have the time to offer the personalized service that their private counter-parts do who service a fraction of the number of patients a day as do the public hospitals. The system is not broke. If functions well for those would otherwise would find it near impossible to pay for adequate healthcare, which is probably close to at least 1/3 of the population of Thailand. Change the current model, and the poorest segment of Thai society will suffer the most. Those who wish to enrich themselves have no issues doing so by disenfranchising the poor, while driving up health-care costs for everyone else in the country. Again - the system ain't broke - don't try to fix it.

Edited October 27, 2015 by connda

[connda]

My children and Mil use the state health care system.

Sure, you have to wait, but it's never caused a problem.

Longest wait was about 1/2 a day, but in an emergency no wait at all.

Mil has liver problems (induced by liver flukes), high blood pressure and diabetes, goes at least once a month.

As for quality of the doctors, never had a problem, when they get it wrong I tell them to try again or just go to another hospital.

They get it right 60-70% of the time.

Much better than the UK, where you can die waiting to get a hospital appointment.

How do you know when they get it right or wrong? The patient gets better or worse? IMHO, that seems pretty tough on the patient.

I would rather find a doctor with a good reputation, although I acknowledge that's tough here too.

I would rather find a doctor with a good reputation, although I acknowledge that's tough here too.

If you have the money, then you can pick and choose. If you're poor, you take what you get. However, as a farang, I've have no problem at all questioning my government hospital doctor's opinion and I do insist on discussing treatment options and the details of my care. If they are arrogant, I get right in their face and we discuss obtaining another doctor's opinion. I've done it more than once, both in government hospitals and private ones. I've done it for myself and my wife. I'm America. I don't accept arrogance, unlike non-assertive Thais. Once we can see eye to eye, the service and quality of care is also good to excellent.

On the other side of that equation, here in Chiang Mai, the doctor that you pay a premium price to see at a private hospital, often also works at the government hospital and often are professors at Chiang Mai University and work at the teaching hospital. I've booked appointment with doctors who I found in private hospitals, but after finding they also worked at Maharaj government hospital too, I simple booked an appointment with them at the government hospital at a significant savings. So much for finding doctors with good reputations. Professors at public teaching hospitals: who can be better? Not many...

[Pormax]

Many of the doctors that one sees also work in the government hospitals, this is the same in the UK and I suspect many other countries.

My guess is though that you go to see them privately and all they can think about is the 500B charge for a 5 minute 'consultation' and if you are really lucky an examination.

The last two private doctors I saw were in a room with one small table and two chairs, no examination table and not even an x-ray viewer.

I think the next time I go to see a doctor I will see if he is willing to listen, if not I will walk out after asking to see another doctor or just leave the hospital with no payment.

They might think they are God but should remember patients are customers, treat them bad and you will lose their custom.

Let's get this one out the door as quick as possible so I can see the next one (and make more money) is the attitude that comes to mind.

[digibum]

In the long run, it would be better to fix the education system first.

With educated people;

1. Fewer patients go gullibley to the hospital for minor ailments.

2. More efficient admin staff who can use modern systems.

3. Better qualified medical staff work more efficiently.

4. Forward-thinking Ministerial staff make wiser decisions.

5. More accurate diagnoses means fewer repeat visits.

My wife, someone used to the 30 baht scheme, always wants to go to the doctor for any minor ailment. Headache? Go see a doctor. Menstrual cramps? Go see a doctor. Upset stomach? Go see a doctor.

And both the official medical system as well as the pharmacists who will pretty much dispense any drug you ask for, make the problem even worse. My wife has declared Motrin and aspirin to be "No good" because when she complains of a headache to the pharmacist they give her something that knocks her out for 6 hours.

[stoneyboy]

In the long run, it would be better to fix the education system first.

With educated people;

1. Fewer patients go gullibley to the hospital for minor ailments.

2. More efficient admin staff who can use modern systems.

3. Better qualified medical staff work more efficiently.

4. Forward-thinking Ministerial staff make wiser decisions.

5. More accurate diagnoses means fewer repeat visits.

Personally fixing the government would be a start.