Uninsured foreigners burdens Thai public hospitals

[TheCruncher]

When I stayed at the BKK HKT Hospital in Phuket a few years ago, they quoted a room price of some 5000 Baht/day. When I told them, that I have to pay from my own pocket not an insurance, the price went down to about 1900. So much about fair prices. Don't wonder why the cost of insurance goes up like crazy.

This happens everywhere. If the insurance pays the bill they get the full charge, while if the money comes out of the pocket of an individual, the charges will be more moderate.

I don't see a valid reason to complain that a insurance company get overcharged.

[F4UCorsair]

About 12 years ago i had a bit of an accident in The Sunshine Hotel in Pattaya just before going to bed. In the morning I couldn't move and phoned reception to get a doctor. They called an ambulance and there wasn't any choice it was to Pattaya Memorial. I have to say the service couldn't be faulted, within ten minutes of leaving the hotel I was having an X-ray. Turned out I had broken some ribs and was admitted for a couple of days.

When I came to be discharged they were not interested in my insurance, said I had to settle the bill before I could leave. I didn't have any money on me so I had to surrender my passport to go to the bank. It wasn't just a case of leaving my passport, it was an official form in duplicate and they gave me a copy signed by the hospital.

Considering the treatment I received the bill was very reasonable, in the first 24 hours I was X-ray in bed every 4 hours and then went to X-ray department about 4 times. It was nearly 3 days with 2 nights in private room and including food and all medication the total came to just over 13,000 baht.

Can't complain about that.

I recently spent a few days in a private hospital in Melbourne, for a knee replacement. I had private health insurance, and the cost of hospital alone was well over A$1000 a day, fortunately fully covered.

The cost of the knee replacement, surgeon, anaesthetist, theatre fees, four days in hospital, etc., almost A$30,000. The government decrees that the 'standard fee' for the surgeon for rebate purposes, is $1200, but his fee is $3700, so I met the rest. That fee includes the actual surgery, about an hour, and a couple of follow up appointments. The actual prosthesis was about A$15,000, fully covered. The surgeon does 5+ operations a day, three days a week!!!

Hospitals have changed......I received a menu for each day, great choice, and the food, considering it was prepared in bulk, excellent, perhaps not high end restaurant quality, but very good nevertheless.

[Keesters]

Just allow foreigner's to participate in the country's 30 baht medical universal coverage program by paying a fair fee. Most Thai's don't pay any income taxes and therefore don't provide funds to pay for govt services such as the free health care provides under the 30 baht program...as least a farang would be paying the fee which is more than a Thai pays.

I think you'll find that income tax pays a very small part of the governments tax collection. Much larger is VAT, business taxes and import duties. I believe the average farang resident would pay far more taxes than the average Thai resident per annum and therefore should if they wish be included in any government health scheme. It seems wrong to me that while you contribute more you are given less. But that does seem to be the (racist) Thai way as with double pricing. For the tourist they should be insured or have deep pockets.

[F4UCorsair]

Just allow foreigner's to participate in the country's 30 baht medical universal coverage program by paying a fair fee. Most Thai's don't pay any income taxes and therefore don't provide funds to pay for govt services such as the free health care provides under the 30 baht program...as least a farang would be paying the fee which is more than a Thai pays.

I think you'll find that income tax pays a very small part of the governments tax collection. Much larger is VAT, business taxes and import duties. I believe the average farang resident would pay far more taxes than the average Thai resident per annum and therefore should if they wish be included in any government health scheme. It seems wrong to me that while you contribute more you are given less. But that does seem to be the (racist) Thai way as with double pricing. For the tourist they should be insured or have deep pockets.

Not only the Thai way. A high income earner in Australia pays over 50% in tax, including the public health insurance levy, yet doesn't qualify for many, or possibly any, of the concessions that a person who pays NO tax does.

Somebody who is on government 'benefits' (the new politically term for cash given to those Rsoles who won't work) pays no tax, no health insurance levy, yet gets everything free!!

You probably guess I'm not to the left of politics.

[DrDave]

Bangkok Hospital Phuket offers a free expat privilege card, that among other discounts provides a 50% discount on the room for customers paying cash. Just go to the reception desk and complete an application form for the card.

Which is nice to know, but kinda proves that their "standard" price is double, to cover the non-payers

No different from my personal experience with hospitals in the US. As a cash-paying customer, I was initially charged triple the price that they subsequently (and voluntarily) adjusted. I believe this is standard practice in the US, so I'm not surprised to see it here.

[jpinx]

Why do insurance companies not re-imburse patients, rather than paying hospitals direct? They'd save a fortune and premiums would come down,,,,

[useronthenet]

Solution, all foreigners to have mandatory comprehensive insurance. If not, no visa to enter Thailand. The problem can be solved very quickly

There's about 3.1 million foreigners living in Thailand, many of them are over age 65 and not eligible for medical health insurance, many want to pay as they go, what about them?

Foreigners chose to come to Thailand of their own free will, and with that comes responsibility to make sure that you are not a burden to the system. Furthermore, for Thais who wish to enter the EU must have a paid-up insurance policy. Surely Thailand has a right to protect itself in the same fashion.

[soalbundy]

Why do insurance companies not re-imburse patients, rather than paying hospitals direct? They'd save a fortune and premiums would come down,,,,

In most if not all cases they do reimburse patients but that doesn't help with overcharging. When i was younger i went private as opposed to the state insurance in Germany (it was cheaper as long as you are young,silly me) When i put a claim in from my dentist the insurance paid everything except for one item which they found unnecessary when i confronted my dentist (i had already paid up front) he said as a doctor he knew the best way to treat me and if i didn't agree i could take him to court ( for the sum of 56 Euro's) End of story.

[chiang mai]

Solution, all foreigners to have mandatory comprehensive insurance. If not, no visa to enter Thailand. The problem can be solved very quickly

There's about 3.1 million foreigners living in Thailand, many of them are over age 65 and not eligible for medical health insurance, many want to pay as they go, what about them?

Foreigners chose to come to Thailand of their own free will, and with that comes responsibility to make sure that you are not a burden to the system. Furthermore, for Thais who wish to enter the EU must have a paid-up insurance policy. Surely Thailand has a right to protect itself in the same fashion.

Insurance polices can be good but they are not mission critical, not in the same category as air and water. I and many others reserve the right to not have one and pay directly as needed.

[nontabury]

Solution, all foreigners to have mandatory comprehensive insurance. If not, no visa to enter Thailand. The problem can be solved very quickly

There's about 3.1 million foreigners living in Thailand, many of them are over age 65 and not eligible for medical health insurance, many want to pay as they go, what about them?

Foreigners chose to come to Thailand of their own free will, and with that comes responsibility to make sure that you are not a burden to the system. Furthermore, for Thais who wish to enter the EU must have a paid-up insurance policy. Surely Thailand has a right to protect itself in the same fashion.

Agree Thailand does have a right to protect it's health service.But you are wrong when you state that Thais must have a health insurance policy to enter the EU, certainly not the UK.

[little mary sunshine]

All foreigners living or retired in Thailand should have to

Pay B3000 (B1000/month) every 90 days when they report

To Immigration. This would be the insurance premium that

Would allow foreigners to be covered with health care at any

Government Hospital. Out patient, inpatient and prescription

Drugs covered. All ILLEGAL overstays that do not report and

Do not pay insurance will be deported immediately when

Discovered. PERIOD......PROBLEM SOLVED Win win for

Thailand and Westerners.

[jpinx]

Why do insurance companies not re-imburse patients, rather than paying hospitals direct? They'd save a fortune and premiums would come down,,,,

In most if not all cases they do reimburse patients but that doesn't help with overcharging. When i was younger i went private as opposed to the state insurance in Germany (it was cheaper as long as you are young,silly me) When i put a claim in from my dentist the insurance paid everything except for one item which they found unnecessary when i confronted my dentist (i had already paid up front) he said as a doctor he knew the best way to treat me and if i didn't agree i could take him to court ( for the sum of 56 Euro's) End of story.

Ah - yes -- of course -- the insurance companys loss-adjusters will agree the actual treatment with the hospital, but might not re-imburse a patient for some treatment they deem unnecessary...

[robblok]

Solution, all foreigners to have mandatory comprehensive insurance. If not, no visa to enter Thailand. The problem can be solved very quickly

There's about 3.1 million foreigners living in Thailand, many of them are over age 65 and not eligible for medical health insurance, many want to pay as they go, what about them?

Foreigners chose to come to Thailand of their own free will, and with that comes responsibility to make sure that you are not a burden to the system. Furthermore, for Thais who wish to enter the EU must have a paid-up insurance policy. Surely Thailand has a right to protect itself in the same fashion.

Agree Thailand does have a right to protect it's health service.But you are wrong when you state that Thais must have a health insurance policy to enter the EU, certainly not the UK.

They certainly do have to have it if they want to stay in the Netherlands. I know i helped Thais go to the Netherlands.

[aRobotnamedWAR]

THais burden ASEAN.

[geriatrickid]

Just a matter of time before the government runs off more retirees by requiring that they have insurance that would wipe out a third of some monthly incomes. Universal coverage is the answer but no one is asking the question.

Why are you demanding of Thailand what your own country does not demand? Where in the world are tourists given medical coverage by the host nation? Where?

The Thai government would not be "running" off retirees if it adopted a responsible policy. Is it so difficult for people to take responsibility for their own lives? Your argument is that it would cost visitors too much money, so the Thais should continue to carry the financial burden of the deadbeats. Who do you expect to pay for this universal coverage? Foreign visitors to Thailand are in Thailand at their pleasure. It is not a matter of life or death. It is a voluntary, non essential choice. Basically, the retirees you speak o, are in Thailand having a good time, taking life easy. And yet your demand for universal coverage would at some point require contributions by other people who are able to pay for their own insurance, or who are young, or who have portable travel coverage, to subsidize the foreigners who refuse to purchase the coverage. Keep trying, because there are more people who pay their bills and who have insurance who will refuse to subsidize these people who don't want to pay for coverage.

Oh, and don't tell me it's sooooooooooooo difficult. Every year, hundreds of thousands of Canadian and European snowbirds head down to the USA. Insurance coverage is far more expensive in the USA than it is in Thailand and yet these snowbirds purchase their coverage through various group plans. Thailand attracts deadbeats. It needs to respond accordingly by tightening barriers to the foreigners who are financially incapable of taking care of themselves.

[moe666]

This is already a very old debate and has been covered many times in TV. The issue at hand in the quoted instances is that fact that the hospitals overcharge and apply inappropriate treatments in many cases. Go to a government hospital and the bill will usually be reasonable.

Did I miss something I believe the story was about government hospitals

[Bobotie]

All foreigners living or retired in Thailand should have to

Pay B3000 (B1000/month) every 90 days when they report

To Immigration. This would be the insurance premium that

Would allow foreigners to be covered with health care at any

Government Hospital. Out patient, inpatient and prescription

Drugs covered. All ILLEGAL overstays that do not report and

Do not pay insurance will be deported immediately when

Discovered. PERIOD......PROBLEM SOLVED Win win for

Thailand and Westerners.

Why should i pay thb 3000 a month to a gov department for health insurance when i have already done the responsible and adult thing and got my own policy at a significantly higher cost, i dont see why immigration or any other gov dept should have to facilitate anything, other than to require all foreigners have adequate medical insurance as part of their extension or visa being issued

[sunnyjim5]

All foreigners living or retired in Thailand should have to

Pay B3000 (B1000/month) every 90 days when they report

To Immigration. This would be the insurance premium that

Would allow foreigners to be covered with health care at any

Government Hospital. Out patient, inpatient and prescription

Drugs covered. All ILLEGAL overstays that do not report and

Do not pay insurance will be deported immediately when

Discovered. PERIOD......PROBLEM SOLVED Win win for

Thailand and Westerners.

Why should i pay thb 3000 a month to a gov department for health insurance when i have already done the responsible and adult thing and got my own policy at a significantly higher cost, i dont see why immigration or any other gov dept should have to facilitate anything, other than to require all foreigners have adequate medical insurance as part of their extension or visa being issued

In any Western country which offers "free" or subsidised health care the tax payer pays even if the tax payer has private insurance. (The USA's Medicare scheme is an example)

[JLCrab]

One of the reasons that my family acquiesced to my moving to Thailand years back -- especially my late Father -- was because excellent health insurance was available to me here at a reasonable cost which was certainly not the case if I remained in the US at least until I reached Medicare age. So I have been fully insured here in Thailand from within months after arriving full-time.

But again, others on ThaiVisa like to make the case as to why not being insured by a health insurance company better suits their circumstances -- for me, having health insurance available was one of the reasons that I came in the first place.

[chiang mai]

One of the reasons that my family acquiesced to my moving to Thailand years back -- especially my late Father -- was because excellent health insurance was available to me here at a reasonable cost which was certainly not the case if I remained in the US at least until I reached Medicare age. So I have been fully insured here in Thailand from within months after arriving full-time.

But again, others on ThaiVisa like to make the case as to why not being insured by a health insurance company better suits their circumstances -- for me, having health insurance available was one of the reasons that I came in the first place.

I know you will tell us that even the very rich buy health insurance, personally I think those that do must be very much in the minority, either that or we both have different concepts of what means "very rich". Personally if I was "very rich" by my definition I would not entertain the idea at all, why should I, because I'm very rich and only the people who can't afford to pay for their treatment need such things. If that comes across as ostentatious or vulgar it's not intended that way, the fact is there are lots of people on the planet who can afford to self insure use a reserve for such things, there's not just the two groups of "can't afford it" and the "very rich", there is a third very viable group which I'm going to label the, "not too poor to pay, not too rich not to".

And finally, it's worth pointing out to the current tranche of readers your past association with the insurance industry, which in part has helped cement your views on this subject, not to suggest you are biased towards the industry in any way, ahem.

[Sheryl]

.... i dont see why immigration or any other gov dept should have to facilitate anything, other than to require all foreigners have adequate medical insurance as part of their extension or visa being issued

The problem that will arise if they do not facilitate anything is that many resident expats already have pre-existing conditions which any private insurance policy would exclude. Meaning good chance they would face a medical emergency that their insurance would not cover.

In addition, there are some resident expats who truly can't afford private insurance premiums. I think this is far from all those who say they can't afford it, many of those simply do not want to cut down on other expenses or face the fact that they do need to spend money on health care. But there are those who are on very limited fixed incomes that really can't manage private insurance. These tend to be elderly people who settled here long ago when cost of living was lower, and some of them no longer have much in the way of ties to their home countries to fall back on either.

So a lot of problems if insurance is made mandatory but left entirely to the private market.

In addition, provided it is priced appropriately, there could be advantages for Thailand's health financing schemes to expand the pool of covered persons to include expats.

[JLCrab]

I won't bother with the quote/reply: The very rich buy health insurance because they see it as a good deal. I never worked in the insurance industry.

[little mary sunshine]

BonoIte. It's a B 1000/ month...read the post! It

Would help everyone and Thailand. You,wouldn't

Have to carry any additional ins. Unless you,wanted.

In either case it's on $28-30/month...no money!!

[arunsakda]

Another reason most of the very rich have insurance is that they get it "free" from the companies they work for or own. Gold-plated "indemnity" plans.

[F4UCorsair]

Another reason most of the very rich have insurance is that they get it "free" from the companies they work for or own. Gold-plated "indemnity" plans.

So there's something to aspire to.

Own, or work for, a company that will provide you with gold plated 'indemnity'

Does it get any easier? ?

[JLCrab]

Another reason most of the very rich have insurance is that they get it "free" from the companies they work for or own. Gold-plated "indemnity" plans.

That is true but wealthy people are not always employed or do not own companies with group plans and buy individual policies -- the premiums to them are insignificant and there is a big potential upside which is why their financial advisers have them enroll in such plans.

[Caspersfriend]

...or Thailand should get a free NHS service like U.K.

what 'free' NHS service? you mean the 'free' service all Brits pay into all their working lives???

Is it true a Brit ex-pat who may have paid NI for 40+ yrs, on visiting the UK and taken ill is expected to pay the full cost plus an extra 50%?

As far as I understand the answer is yes, but that is only if you go back on a holiday and are not intending to stay in the UK permanently. Also it believe it applies if you go for treatment for an existing condition.

Should you be involved in an accident, have a fall etc requiring emergency treatment then I believe that treatment will be free.

I have a good friend who is a doctor in A&E. He said that A&E has always been busy but you did get the odd spell when you could catch your breath. No longer is this the case as some get to realise that A&E can give them a free ride to something they would otherwise be charged for.

[arunsakda]

Another reason most of the very rich have insurance is that they get it "free" from the companies they work for or own. Gold-plated "indemnity" plans.

So there's something to aspire to.

Own, or work for, a company that will provide you with gold plated 'indemnity'

Does it get any easier? ?

Yeah it get's easier. In the US the elite managerial class gets what is known as "Gross Up". So when they get say a $10,000,000USD salary that is what they get. Company pays their income taxes. I remember reading about GE former CEO Jack Welch compensation. Included a super lux New York penthouse to use, food, wine, flowers, all paid for.

Only the little people pay taxes.

[Caspersfriend]

So, TAT has 200 million Bhat fund to reimburse hospitals. The question not answered is if the fund is generated annually from a levy from tourists or something else. Setting that aside, the 187 foreigners that were mentioned ran up an average of 106, 000 each. That would provide reimbursement for about 1,900 people.

The hospitals have been whining about being ripped off by farang for years. If TAT has the money, why aren't they reimbursing the hospitals? I would be interested to know what percentage of all tourists arrive in the country with travel insurance? What are the top five problems that run up the bills? Does the average travel insurance cover the things that tourists do? If the hospitals are overcharging then it makes sense for those without or with not enough go to public hospitals and bad cases can go to the public teaching hospitals.

There are solutions, but no one seems at all interested in actually doing anything. As my wife says, "some time I get bored."

Every possibility that TAT does have such a fund. Every possibility that this fund was introduced to reimburse hospitals for unpaid bills; primarily the public hospitals. Every possibility that the fund, at the end of every financial year, has disbursed those funds to worthy and justifiable causes. No doubt their accounts are audited.

And yet those public hospitals are still complaining! How can this be?

[JLCrab]

Another reason most of the very rich have insurance is that they get it "free" from the companies they work for or own. Gold-plated "indemnity" plans.

So there's something to aspire to.

Own, or work for, a company that will provide you with gold plated 'indemnity'

Does it get any easier? ?

Yeah it get's easier. In the US the elite managerial class gets what is known as "Gross Up". So when they get say a $10,000,000USD salary that is what they get. Company pays their income taxes. I remember reading about GE former CEO Jack Welch compensation. Included a super lux New York penthouse to use, food, wine, flowers, all paid for.

Only the little people pay taxes.

"Only the little people pay taxes" is a quote attributed to the billionaire Ms. Leona Helmsley who later spent 19 months in US Federal prison after being convicted for tax evasion.

https://en.wikipedia.org/wiki/Leona_Helmsley#Tax_evasion_conviction

She died in 2007 at age 87 with an estimated net worth of USD 4 billion.