Uninsured foreigners burdens Thai public hospitals

[Sheryl]

Most of these hospitals are grossly expensive as all of them love to overcharge.

Not the public hospitals - which is what the article is about.

Their charges are quite reasonable.

Private hospital charges are another matter -- partly due to greed but also due to the need to recoup losses from patients who don't pay. Unlike the public hospitals, which just sustain a loss and run at a deficit (leading to less money for equipment purchase, building repairs and other necessities and lowering the quality of care for all), private hospitals can simply "cost shift" and raid their rates for all patients. So in effect all who use private hospitals are subsidizing those who do not pay.

This is huge problem for the public hospitals and I know from my time on the heath forum that there are many expats with both deeply ingrained unwillingness to pay for insurance and extremely unrealistic beliefs about the cost of health care and/or their personal susceptibility to illness and accidents.

I am sure this will end with a requirement for health insurance for visa extensions. I just hope that in tandem with that, resident expats are given an option for paying into one of the government helath schemes so that there are options for thsoe who can't afford private premiums or have significant pre-existing conditions.

I am less clear on how they can do this with tourist given the sheer logistics of checking for proof of insurance at immigration checkpoints -would be a nightmare and add to delays in processing considerably. I suppose they might just make everyone on a tourist visa or visa-exempt entry pay a flat amount for insurance, but that means that people who do have insurance will unfairly have to pay as well...

[billd766]

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.

The last time I went to hospital to have an ingrowing toenail removed it was at the district public hospital and the whole ting cost a little over 700 baht and was done within 15 minutes by the doctor who not only spoke good English but had a sense of humour. Further visits to the doctor were about 70 baht plus medicines. Normal treatment of re-dressings were done free at the local clinic even though I offered to pay.

[dageurreotype]

Most of these hospitals are grossly expensive as all of them love to overcharge.

Exactly. They can make up their measly million 'loss' with the 20 x rate for farang. Slow news day? More xenophobia needed?

[shirtless]

Wake up Thailand your people abuse the hospital system in Australia its paid for by the taxpayers , tuff TATAs thailand you make billions yet cry like babies if you have to spend 7 million on Hospital care,

[dageurreotype]

Most of these hospitals are grossly expensive as all of them love to overcharge.

Not the public hospitals - which is what the article is about.

Their charges are quite reasonable.

Private hospital charges are another matter -- partly due to greed but also due to the need to recoup losses from patients who don't pay. Unlike the public hospitals, which just sustain a loss and run at a deficit (leading to less money for equipment purchase, building repairs and other necessities and lowering the quality of care for all), private hospitals can simply "cost shift" and raid their rates for all patients. So in effect all who use private hospitals are subsidizing those who do not pay.

This is huge problem for the public hospitals and I know from my time on the heath forum that there are many expats with both deeply ingrained unwillingness to pay for insurance and extremely unrealistic beliefs about the cost of health care and/or their personal susceptibility to illness and accidents.

I am sure this will end with a requirement for health insurance for visa extensions. I just hope that in tandem with that, resident expats are given an option for paying into one of the government helath schemes so that there are options for thsoe who can't afford private premiums or have significant pre-existing conditions.

I am less clear on how they can do this with tourist given the sheer logistics of checking for proof of insurance at immigration checkpoints -would be a nightmare and add to delays in processing considerably. I suppose they might just make everyone on a tourist visa or visa-exempt entry pay a flat amount for insurance, but that means that people who do have insurance will unfairly have to pay as well...

Ever been to Phuket?

[chiang mai]

Whoa, do I read farang sense of entitlement surfacing here, get real guys!!!

[sunnyjim5]

Most of these hospitals are grossly expensive as all of them love to overcharge.

Not the public hospitals - which is what the article is about.

Their charges are quite reasonable.

Private hospital charges are another matter -- partly due to greed but also due to the need to recoup losses from patients who don't pay. Unlike the public hospitals, which just sustain a loss and run at a deficit (leading to less money for equipment purchase, building repairs and other necessities and lowering the quality of care for all), private hospitals can simply "cost shift" and raid their rates for all patients. So in effect all who use private hospitals are subsidizing those who do not pay.

This is huge problem for the public hospitals and I know from my time on the heath forum that there are many expats with both deeply ingrained unwillingness to pay for insurance and extremely unrealistic beliefs about the cost of health care and/or their personal susceptibility to illness and accidents.

I am sure this will end with a requirement for health insurance for visa extensions. I just hope that in tandem with that, resident expats are given an option for paying into one of the government helath schemes so that there are options for thsoe who can't afford private premiums or have significant pre-existing conditions.

I am less clear on how they can do this with tourist given the sheer logistics of checking for proof of insurance at immigration checkpoints -would be a nightmare and add to delays in processing considerably. I suppose they might just make everyone on a tourist visa or visa-exempt entry pay a flat amount for insurance, but that means that people who do have insurance will unfairly have to pay as well...

Ever been to Phuket?

What are you suggesting/implying ?

I have used the public hospitals in Phuket and the charge(s) were very reasonable.

[Bluespunk]

Most of these hospitals are grossly expensive as all of them love to overcharge.

Not the public hospitals - which is what the article is about.

Their charges are quite reasonable.

Private hospital charges are another matter -- partly due to greed but also due to the need to recoup losses from patients who don't pay. Unlike the public hospitals, which just sustain a loss and run at a deficit (leading to less money for equipment purchase, building repairs and other necessities and lowering the quality of care for all), private hospitals can simply "cost shift" and raid their rates for all patients. So in effect all who use private hospitals are subsidizing those who do not pay.

This is huge problem for the public hospitals and I know from my time on the heath forum that there are many expats with both deeply ingrained unwillingness to pay for insurance and extremely unrealistic beliefs about the cost of health care and/or their personal susceptibility to illness and accidents.

I am sure this will end with a requirement for health insurance for visa extensions. I just hope that in tandem with that, resident expats are given an option for paying into one of the government helath schemes so that there are options for thsoe who can't afford private premiums or have significant pre-existing conditions.

I am less clear on how they can do this with tourist given the sheer logistics of checking for proof of insurance at immigration checkpoints -would be a nightmare and add to delays in processing considerably. I suppose they might just make everyone on a tourist visa or visa-exempt entry pay a flat amount for insurance, but that means that people who do have insurance will unfairly have to pay as well...

Ever been to Phuket?

What are you suggesting/implying ?

I have used the public hospitals in Phuket and the charge(s) were very reasonable.

https://www.phuketgazette.net/phuket-news/Phuket-hospitals-defend-fractured-pricing/19225#ad-image-0

From 3 years ago mind, so might have stopped this now...

[robblok]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

[chiang mai]

The hospital has a point, they are reimbursed by either the social security system, the 30 baht scheme or by the insurance company in the case of Thai patients, the rates for foreigners does need to be higher if they don't have insurance because they are not part of the other two systems.

[sunnyjim5]

"https://www.phuketga...9225#ad-image-0

From 3 years ago mind, so might have stopped this now..."

A clickbait article designed to appeal to whining "farang".

If they think they can get care at the one of the private hospitals on Phuket for the same or lower cost they should know what to do.

If they want 30 Bht healthcare they will be right out of luck ! I fully support the Government hospitals charging foreigners a cost which will cover their expenses+. The 30 Bht scheme is intended to provide universal health cover to people earning 300 Bht a day.

If the "farang" does not like the health care options/costs in Thailand they had best return home where many will be forced to pay a great deal more.

[chiang mai]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

And what if I and others want to self insure instead of lining the pockets of the insurance companies?

[useronthenet]

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

[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?

[robblok]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

And what if I and others want to self insure instead of lining the pockets of the insurance companies?

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

[sunnyjim5]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

Sure, however some elderly people are forced out of the private insurance market by ever increasing cost and/or extreme policy restrictions. I am personally aware of two such individuals.

For long stay ex-pats I would like the Thai Government to provide low cost "insurance" based access to public hospitals funded by a surcharge on long stay visas/extensions of stay. Possession of a valid visa/extension being evidence of "entitlement" to care.

[chiang mai]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

And what if I and others want to self insure instead of lining the pockets of the insurance companies?

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

[robblok]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

Sure, however some elderly people are forced out of the private insurance market by ever increasing cost and/or extreme policy restrictions. I am personally aware of two such individuals.

For long stay ex-pats I would like the Thai Government to provide low cost "insurance" based access to public hospitals funded by a surcharge on long stay visas/extensions of stay. Possession of a valid visa/extension being evidence of "entitlement" to care.

Should should should.. no entitle ment for us foreigners.. if you can't insure too bad. Only exception would be if they deposit a million or so on a locked account to prove they can self insure.

[jpinx]

How many times has this old chestnut been roasted? Getting medical insurance is perfectly possible (ask Sheryl) even for 90-year-olds - see threads I referenced above.

www.CignaGlobal.com

Charging 30/40/50 baht per head at the airport is ridiculous since some people only stay a week and others 3 months or a lot more. Asking already hard-pressed immigration offices to check incomers medical insurance is equally ridiculous. Check against what database, format, standards? It is actually CHEAPER for Thailand to pay the bill in the cases where the farang can't/won't pay,,,,,

Edited March 7, 2016 by jpinx

[robblok]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

And what if I and others want to self insure instead of lining the pockets of the insurance companies?

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

Yes for those who choose to self insure.. (and not the American style swearing you got it.. but really put it on a locked account). Self insure is a choice.. so then the restrictions get higher. I don't self insure.. i pay insurance.. then no million extra.. Seems fair to me the government needs some assurances too.

[sunnyjim5]

Make it mandatory for tourist and long stay foreigners to have insurance. No insurance no visa. Sounds reasonable to me. Its just bad of all those foreigners skipping on their hospital bills.

Maybe the government can set up an insurance for foreigners, if not too bad. I am insured.. sure its expensive but at least I have a peace of mind.

In previous topics all the older foreigners are moaning because the premium is so high, that bad for them (and me in future) but not a reason to let the Thai taxpayer pay the bill for their hospital costs. No insurance.. no visa.

And what if I and others want to self insure instead of lining the pockets of the insurance companies?

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

The 800,000 can be removed from an account as soon as the extension has been approved. It "guarantees" nothing !

[robblok]

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

The 800,000 can be removed from an account as soon as the extension has been approved. It "guarantees" nothing !

And if your an American you don't even have to have the money just swear you got it.. even less of a guarantee. So only a locked account would do.

[JLCrab]

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

The 800,000 can be removed from an account as soon as the extension has been approved. It "guarantees" nothing !

And if your an American you don't even have to have the money just swear you got it.. even less of a guarantee. So only a locked account would do.

You don't have to have it either -- you just have to convince your Embassy that you do.

[chiang mai]

And what if I and others want to self insure instead of lining the pockets of the insurance companies?

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

The 800,000 can be removed from an account as soon as the extension has been approved. It "guarantees" nothing !

Yes it CAN be removed but it has to be replaced the following year when the visa extension is requested, effectively that 800k is locked otherwise the expat retiree doesn't get his visa extended and has to give up his home, his family and his life in Thailand go else where, that's "locked" by any other name. I agree however that the situations with Americans simply saying they have the 800k is one that needs to be addressed since the rest of us actually have to show the money in an account in Thailand.

Edited March 7, 2016 by chiang mai

[Sheryl]

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

This can work for people with visas, since proof of insurance can be reviewed at the time of visa issuance or extension.

But a large proportion of tourists enter visa exempt, and many of the spectacular multi-million baht unpaid bills fiascos involve such tourists.

I can't see how it would be feasible, without greatly adding to bottlenecks at immigration checkpoints, to screen for proof of insurance among those entering visa exempt.

I suppose they could require payment at the point of entry (with machine kiosks similar to what they used to have for airport tax) and then counters for people who want an exemption based on proof of insurance. (The savings will cost them in time, though..kind of like the VAT refunds)

BTW the amounts that have been bandied about as a tourist insurance fee fare nothing like 20 baht. More like 500 baht. Hopefully that would include not only medical care but also medical evacuation/repatriation.

The other problem to consider is among long-term expat residents here who do not have insurance and either cannot afford private premiums or have pre-existing conditions such that any policy they could get would exclude the major illness they are most likely to subsequently get. If a mandatory insurance became a requirement for visa extensions and was not matched with an option for paying into either the "30 baht" or SS schemes, chaos would result with potential for creating family separations etc. The SS scheme, since it is already contribution based, would be the most logical one to utilize and should be feasible to set this up, though there needs to be some actuarial work done first to calculate what the contribution cost should be.

[billd766]

How many times has this old chestnut been roasted? Getting medical insurance is perfectly possible (ask Sheryl) even for 90-year-olds - see threads I referenced above.

www.CignaGlobal.com

Charging 30/40/50 baht per head at the airport is ridiculous since some people only stay a week and others 3 months or a lot more. Asking already hard-pressed immigration offices to check incomers medical insurance is equally ridiculous. Check against what database, format, standards? It is actually CHEAPER for Thailand to pay the bill in the cases where the farang can't/won't pay,,,,,

I have just got an online quote from Cigna.

Their cheapest rate plan, Silver, comes to £341.01 per month or a little over 17,000 thb per month or 204.606 thb per year using 50thb/£1 as an exchange rate.

The Gold plan is £426,27 or 21,310 thb per month and 255,760 thb per year.

The Platinum plan is £532.83 or 26,640 thb pcm and 319,700 thb per year.

[billd766]

Let them deposit a million bt on a locked account or something like that. There should be some guarantees at least.

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

The 800,000 can be removed from an account as soon as the extension has been approved. It "guarantees" nothing !

And if your an American you don't even have to have the money just swear you got it.. even less of a guarantee. So only a locked account would do.

What about retired people like me who use the income method of over 65,000 thb per month?

[robblok]

But we already provide a guarantee of 800,000 baht a year, you want another 1 million on top of that?

The 800,000 can be removed from an account as soon as the extension has been approved. It "guarantees" nothing !

And if your an American you don't even have to have the money just swear you got it.. even less of a guarantee. So only a locked account would do.

What about retired people like me who use the income method of over 65,000 thb per month?

No idea, I don't make the plans but there should be some assurance for the government as a deposito or something like that otherwise everyone would say self insure and never have the money. I am insured and like to keep it that way but the premiums you are quoting like 17.000 bt a month are crazy.

[fey]

thats only around 70k usd negative a year for phuket.

they must not be doing much business if that makes a dent

Edited March 7, 2016 by fey

[gk10002000]

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.

I agree. Living on the cheap, accepting some health insurance risk, and expecting to be able to pay as you go or work out decent payment plans is going to get harder and harder to do. Sadly, from the USA anyway, there is no medical insurance I am aware of that will direct pay a Thai hospital. If an American has USA health insurance, obamacare, blue cross blue shield, etc., that won't do much in thailand. The best I would be able to do is pay the Thais out of my own pocket and then submit my expenses to my Florida blue cross. Of course if I was retired in Thailand, I would not be paying obamacare or blue cross and would get insurance in Thailand. I would bet that at least 50% if not more of retirees do not carry adequate health insurance.