Treatment at public hospitals

[Eneukman]

Apologies if this has been covered recently.

My wife was at the Pattaya City Hospital yesterday morning for an operation on her hand. She asked someone there and was told that if I produced my passport (and presumably marriage certificate), I could "change my nationality" and therefore get the same low-cost treatment as she gets at Thai public hospitals. I suspect something has been lost in the translation but can anyone clarify what was meant? I was parking the car at the time so couldn't ask any questions.

She has to go back on Wednesday so I can seek more information then.

Thanks,

Alan

[inbangkok]

Lol.... She probably means "change nationality" in the computer system so you can get the Thai price. Some government hospitals will allow foreigners to pay the same as Thais if they are married to a Thai, or have a work permit. That was nice of then to tell you. The cost savings can be huge!

[NanLaew]

Yes, if you are not paying in any social security contributions locally, have not made any provision for personal health care, have no health insurance or can't afford self-funded care at a private hospital while living in Thailand, you can freeload on the Thai system.

Just don't post any complaints about your experiences here.

[Sheryl]

In most government hospitals price is the same regardless of nationality, though most Thais do not have to pay as they are covered under either SS or the "30 baht" scheme. (What I mean is, if they did pay, the price is same as would be for a foreigner -- there is only one schedule of rates). However there are a few hospitals that have on their own initiative created a separate fee structure for foreigners.

It may be that the Pattaya City Hospital, because of its location in a major tourist center, has developed a two (or even three) tier price system. First I have heard of this but would not surprise me.

[keeniau96]

Sheryl does excellent advisory work, any info if the Vachira Hospital (gov't) in Phuket has such a foreigner price system?

[nev]

Yes, if you are not paying in any social security contributions locally, have not made any provision for personal health care, have no health insurance or can't afford self-funded care at a private hospital while living in Thailand, you can freeload on the Thai system.

Just don't post any complaints about your experiences here.

I and our family get treated for free at the local public hospital because my wife works there. Am I classed as a freeloader?

[Sheryl]

Sheryl does excellent advisory work, any info if the Vachira Hospital (gov't) in Phuket has such a foreigner price system?

Not that I have heard.

[inbangkok]

In most government hospitals price is the same regardless of nationality, though most Thais do not have to pay as they are covered under either SS or the "30 baht" scheme. (What I mean is, if they did pay, the price is same as would be for a foreigner -- there is only one schedule of rates). However there are a few hospitals that have on their own initiative created a separate fee structure for foreigners.

It may be that the Pattaya City Hospital, because of its location in a major tourist center, has developed a two (or even three) tier price system. First I have heard of this but would not surprise me.

At least 2 of the best government hospitals in BKK have implemented a dual pricing system and the difference can be huge.

[keeniau96]

If a gov't hospital posts such a dual-price system is it mandatory that the fareng pay the higher price or is this just a "suggested" price, like the Metropolitan Museum in NYC. I would think the legal position in such case would be very weak for the hospital.

[sunnyjim5]

Sheryl does excellent advisory work, any info if the Vachira Hospital (gov't) in Phuket has such a foreigner price system?

Not that I have heard.

The vast majority of Thais who access care at Vichira do so under the "30 Bht" scheme

.Any attempt to determine the existence of a "dual " pricing policy would in the mind of many be "proved" because most "foreigners" are not entitled to access the 30 Bht scheme.

The charges made by Vicchira are very reasonable especially when compared to what is charged by the private hospitals.

[inbangkok]

Sheryl does excellent advisory work, any info if the Vachira Hospital (gov't) in Phuket has such a foreigner price system?

Not that I have heard.

The vast majority of Thais who access care at Vichira do so under the "30 Bht" scheme

.Any attempt to determine the existence of a "dual " pricing policy would in the mind of many be "proved" because most "foreigners" are not entitled to access the 30 Bht scheme.

The charges made by Vicchira are very reasonable especially when compared to what is charged by the private hospitals.

Don't know about the hospital you mentioned.... But....

I just re-registered as a "resident" (changed from "non resident") at a major government hospital in Bangkok by submitting my marriage certificate. I even have a signed letter from the hospital now confirming I am now entitled to the "Thai price" on future visits.

Most Thais actually do not access care under the 30 baht scheme these days. They access it through a specific hospital linked to their social security. When a Thai is registered under the SS system they cannot participate in the 30 baht program at other hospitals. Not only this, but if a Thai wants to see a Dr or specialty department outside of the hospital they are registered, they have to pay. So yes, there are dual price systems at some government hospitals now.

[gamini]

The problem with government hospitals is that they all seem to have different rules and regulations as regards to foreigners.
For example Hua Hin has a special foreigners department with English-speaking receptionists and a two hundred baht express service. If you use the latter you see a doctor straight away and the receptionist takes you to the head of the queue to get your medicine and pay your bill.
At the same hospital. I notice that most of the Thais don't use the thirty baht system and I can understand why. If you use it you have to wait until all the Thai paying patients are seen first . Also You can only get a very limited types of medicine which are produced by the GPO.
If you live in Bangkok you can go to some of the very large government hospitals and you will be charged very little. I often go to Siriraj , where many of the doctors who work in the leading private hospitals also work and pay a tenth of the fee.
I don't agree with some of the posts saying that some of the costs that government hospitals are huge. I have been to government hospitals in Bangkok, Chiang Mai and Hua Hin and the fees always have been very reasonable.
I used to go to private hospitals, but now that I have a lot of medical problems, so now I have found some wonderful doctors in government hospitals and use them instead. It takes a bit of research and asking your Thai friends for advice on where the best doctors are. Although I live in Hua Hin, I travelled to Chiang Mai to see my cardiologists who reputedly is one of the best in Thailand both my wife and I have been operated on by him. However, if I have a real difficult problem like cancer that requires expert advice and treatment. I would go to Bumrungrad.

[hgma]

I had major surgery in Khon Kaen (nakrian) Last year, had to pay myself (apart from a small covered insurance part) as they asked my wife's nationality, it was said that if she would have been Thai the whole surgery would have been covered or piggy backed by my wife's Thai Nationality & 30 bath scheme.

Excellent treatment,succesful heart surgery (bypasses) and a reasonable price.

Oh my wife doesn't have Thai nationality.

[nev]

I had major surgery in Khon Kaen (nakrian) Last year, had to pay myself (apart from a small covered insurance part) as they asked my wife's nationality, it was said that if she would have been Thai the whole surgery would have been covered or piggy backed by my wife's Thai Nationality & 30 bath scheme.

Excellent treatment,succesful heart surgery (bypasses) and a reasonable price.

Oh my wife doesn't have Thai nationality.

Srinakarin is a excellent hospital, I had a prostate operation done there, I paid a bit extra to have it done straight away rather than wait 3 months which was the waiting list.

They do this in there off time for extra money for them on a weekend, all arrange by the head doctor, well worth the extra money paid, if I did not pay and wait it would have meant having a catheter attached for 3 months.

[Sheryl]

Thais have to pay out of pocket if they get care at a hospital other than the one they are registered at (whether under SS or the "30 baht" scheme) unless it is an emergency.

So it does happen that Thais sometimes pay full price, and every government hospital will have a schedule of rates for this. The issue is whether they also have a second price for non-Thais.

Adding to the confusion, an increasing number of government hospitals now have a semi-private track AKA after hours clinic AKA express service AKA "elite" clinic. This always costs more than going through the public channel, though it saves a great deal of time and has some other advantages as well. The private channel may have just one rate or it may have dual pricing. My impression is that dual pricing is more common for the private channel than the public channel, but it will depend on the specific hospital. So you might have:

• public channel only, no private channel, same price for all
• public channel only, no private channel, dual pricing Thai/foreigner
• public channel same price, private channel same price
• public channel same price, private channel dual pricing
• public channel dual pricing, private channel dual pricing

I haven't heard of public channel prices, even where it is different for Thais and foreigners, being anywhere near as high as the rates at private hospitals. However, I have heard of private channels at some public hospitals having charges for foreigners that are at private hospital levels. These places will also often automatically direct a foreign patient to the private channel unless the foreigner clearly specifies otherwise. Ramatibhodi Hospital being one example of this.

So if seeking the least expensive option, be aware of whether you are going through public or private channel at a government hospital.

[NanLaew]

Yes, if you are not paying in any social security contributions locally, have not made any provision for personal health care, have no health insurance or can't afford self-funded care at a private hospital while living in Thailand, you can freeload on the Thai system.

Just don't post any complaints about your experiences here.

I and our family get treated for free at the local public hospital because my wife works there. Am I classed as a freeloader?

No, because your family coverage is part and parcel of your employed wife's insurance coverage towards which she contributes.

Is that right nev? I mean, do you feel you are a freeloader?

[nev]

Yes, if you are not paying in any social security contributions locally, have not made any provision for personal health care, have no health insurance or can't afford self-funded care at a private hospital while living in Thailand, you can freeload on the Thai system.

Just don't post any complaints about your experiences here.

I and our family get treated for free at the local public hospital because my wife works there. Am I classed as a freeloader?

No, because your family coverage is part and parcel of your employed wife's insurance coverage towards which she contributes.

Is that right nev? I mean, do you feel you are a freeloader?

No I don't mate, the government sets the rules, Amy major surgery or treatment I head to srinakarind hospital as the local hospital she works is only good for certain problems.

[Sheryl]

There is a separate SS scheme for civil servants which includes coverage for spouse and children. Regular SS does not.

[thaiduncankk]

I had major surgery in Khon Kaen (nakrian) Last year, had to pay myself (apart from a small covered insurance part) as they asked my wife's nationality, it was said that if she would have been Thai the whole surgery would have been covered or piggy backed by my wife's Thai Nationality & 30 bath scheme.

Excellent treatment,succesful heart surgery (bypasses) and a reasonable price.

Oh my wife doesn't have Thai nationality.

Srinakarin is a excellent hospital, I had a prostate operation done there, I paid a bit extra to have it done straight away rather than wait 3 months which was the waiting list.

They do this in there off time for extra money for them on a weekend, all arrange by the head doctor, well worth the extra money paid, if I did not pay and wait it would have meant having a catheter attached for 3 months.

Although Srinakarin is an excellent hospital, it is more expensive than the main Khon Kaen hospital.

[Eneukman]

Lol.... She probably means "change nationality" in the computer system so you can get the Thai price. Some government hospitals will allow foreigners to pay the same as Thais if they are married to a Thai, or have a work permit. That was nice of then to tell you. The cost savings can be huge!

Yes, I think that's what she means. I'll find out on Wednesday and will, if I remember, post here how I got on.

Alan

[lopburi3]

Thais have to pay out of pocket if they get care at a hospital other than the one they are registered at (whether under SS or the "30 baht" scheme) unless it is an emergency.

So it does happen that Thais sometimes pay full price, and every government hospital will have a schedule of rates for this. The issue is whether they also have a second price for non-Thais.

Adding to the confusion, an increasing number of government hospitals now have a semi-private track AKA after hours clinic AKA express service AKA "elite" clinic. This always costs more than going through the public channel, though it saves a great deal of time and has some other advantages as well. The private channel may have just one rate or it may have dual pricing. My impression is that dual pricing is more common for the private channel than the public channel, but it will depend on the specific hospital. So you might have:

• public channel only, no private channel, same price for all
• public channel only, no private channel, dual pricing Thai/foreigner
• public channel same price, private channel same price
• public channel same price, private channel dual pricing
• public channel dual pricing, private channel dual pricing

I haven't heard of public channel prices, even where it is different for Thais and foreigners, being anywhere near as high as the rates at private hospitals. However, I have heard of private channels at some public hospitals having charges for foreigners that are at private hospital levels. These places will also often automatically direct a foreign patient to the private channel unless the foreigner clearly specifies otherwise. Ramatibhodi Hospital being one example of this.

So if seeking the least expensive option, be aware of whether you are going through public or private channel at a government hospital.

Believe family income may also be a factor - at least it was 15 years ago when Thai wife had treatment at Chula. Although this may have only been for the private room charges.