Living in Thailand with no health insurance

[sirineou]

You're not the first farang to object to my spending habits and I doubt that you will be the last. It's not just me that is causing this problem, everyone with insurance is contributing to rising medical costs to some degree. If no one had insurance there is no way that private hospitals would be able to charge as much money as they do.

Yes! Yes!, finally, some one with seance.

Darn people paying for things!!! they are ruining it for the rest of us. Grrrrr.

An other observation

More people die in Hospitals than they die in bars,statisticaly you have a better chanse for survival in a Bar!

if I was you, next time I get sick,I would go to a bar,

have a drink, watch the game on TV.

I tell you if more people were like me and you.....

[JLCrab]

I would say calculating whether health insurance is a good investment is easy: If you get real sick and your medical costs greatly exceed your cumulative premiums, it was good investment. If you don't get real sick and your medical costs do not exceed your cumulative premiums, it was not a good investment.

So as long as you know that you are not going to get real sick, don't buy it.

Agreed, but my point is that because we have a highend insurance policy we have no incentive to minimize our medical expenses and hence we don't. There have been quite a few things that we could have had done for half the price if we shopped around for the best deal, but instead we head straight to Bumrungrad because the insurance will pay. If we didn't have insurance our medical bills would have been lower than what the insurance company paid.

You will pay for your choice eventually through higher premiums, it makes little sense to me to pay X for a procedure when far cheaper cost Y can be easily obtained elsewhere with same level of risk, case in point a coronary PCI. Selecting the higher cost option every time, just because the insurance company will pay, does nothing more than drive prices ever upwards.

... and we should all do what makes sense to you, HUH?

[chiang mai]

You will pay for your choice eventually through higher premiums, it makes little sense to me to pay X for a procedure when far cheaper cost Y can be easily obtained elsewhere with same level of risk, case in point a coronary PCI. Selecting the higher cost option every time, just because the insurance company will pay, does nothing more than drive prices ever upwards.

That's a pooled cost though, not an individual one. By selecting expensive care I am indirectly causing insurance rates to go up overall but it does not have a direct effect on my rates. Though some policies might be that way, my annual premiums are not a function of my actual medical expenses, they are determined by demographics and statistics.

"they are determined by demographics and statistics", of which your actual medical expenses form a part - Bumrungrad is one of the the most expensive private hospitals in the country. If you lived in the US you wouldn't automatically have al your health care issues taken care of at North Okaloosa Medical Center (FL), so why do similar in Thailand.

http://www.menshealth.com/health/50-most-overpriced-hospitals

You're not the first farang to object to my spending habits and I doubt that you will be the last. It's not just me that is causing this problem, everyone with insurance is contributing to rising medical costs to some degree. If no one had insurance there is no way that private hospitals would be able to charge as much money as they do.

You misunderstand, I'm not in a position to object to your spending habits, that's your business not mine, I was merely pointing out something that may not have been obvious. In fact I used to use Bumrungrad for all my medical needs when I first came to Thailand and then I started to realise that there are alternatives that are just as good if not better but also substantially cheaper.

[suzannegoh]

That's a pooled cost though, not an individual one. By selecting expensive care I am indirectly causing insurance rates to go up overall but it does not have a direct effect on my rates. Though some policies might be that way, my annual premiums are not a function of my actual medical expenses, they are determined by demographics and statistics.

"they are determined by demographics and statistics", of which your actual medical expenses form a part - Bumrungrad is one of the the most expensive private hospitals in the country. If you lived in the US you wouldn't automatically have al your health care issues taken care of at North Okaloosa Medical Center (FL), so why do similar in Thailand.

http://www.menshealth.com/health/50-most-overpriced-hospitals

You're not the first farang to object to my spending habits and I doubt that you will be the last. It's not just me that is causing this problem, everyone with insurance is contributing to rising medical costs to some degree. If no one had insurance there is no way that private hospitals would be able to charge as much money as they do.

You misunderstand, I'm not in a position to object to your spending habits, that's your business not mine, I was merely pointing out something that may not have been obvious. In fact I used to use Bumrungrad for all my medical needs when I first came to Thailand and then I started to realise that there are alternatives that are just as good if not better but also substantially cheaper.

I made it sound like we were using exclusively Bumrungrad and wantonly running up the bill but that's not the case. We have certain routine tests and MRIs done at other places for reasons of convenience, we've used BNH in Bangkok a couple of times for minor surgeries, and I cut the insurance company a break on prescription costs by having them filled at an independent pharmacy instead of at the hospital.

I'm well aware that Bumrungrad is not the only place with good doctors, but I think that Bumrungrad is the gold standard in Thailand. Almost all of the doctors that they have on staff have rock-solid credentials, most of their doctors are good at explaining treatment option to patients, and I think that the odds of receiving successful treatment there are as high as anywhere in SE Asia. And they can direct bill to foreign insurance companies.

The point that I was inelegantly trying to make is that if your insurance company is willing to pay for even the most expensive hospital in Bangkok then you don't have much incentive to beat the bushes looking for cheaper alternatives, for anything complicated you might as well go straight to the hospital that you trust most. And that means that your medical costs are apt to be more expensive than if you didn't have insurance or if you had a less comprehensive policy.

[JLCrab]

The healthcare insurers in Thailand have network hospitals and that's where they want you to go barring an absolute emergency. They are familiar with the doctors at the network hospitals and most likely have negotiated rates with them for the most common procedures.

[NancyL]

I was always a healthy active 5'10 165 lb male , never sick in 55 years, the during a routine medical , that I might add I might not have if I did not have medical insurance to pay for.

a heart murmur was detected, upon further investigation, a bi-cuspid aortic heart valve was discovered to be the cause, a condition I was born with.

If gone undiscovered and or untreated , I could have died from it. Open heart valve replacement surgery, at one of the best hospitals in the world, subsequent followup, an arrhythmia developed,

One of the problems with 'routine medicals', they make money from finding problems.

The problems may be real but no treatment needed, or they may be fictitious.

The outcome is always the same, loads of money spent, and a new victim proclaiming how he was saved.

You had lived a healthy life for 55 years, I suspect you would have continued to live without any doctor intervention.

I agree that it may not have been necessary to immediately replace the heart valve, but it is ABSOLUTELY necessary for someone to know they have this condition. It's a congenital defect that exists in 1 - 2% of the population, with men much more likely to have it. It's a silent killer and is usually the reason that seemingly healthy athletes suddenly die of heart failure during performance. You see, the condition can cause enlargement of the aorta and sudden aortic dissection upon exertion. Someone with this condition should:

• Patients with known BAV should undergo:
  • An echocardiogram to evaluate the aortic valve for stenosis or regurgitation and to assess for any other structural heart problems
  • A chest CT scan to make measurements of the diameter of the aorta at various points along its length.
• Cardiac CT scan or magnetic resonance imaging (MRI) are alternatives if echocardiography is not available or possible for some reason
• If there is enlargement of the beginning portion of the aorta to greater than 4.0 cm, the individual should have a yearly assessment of the diameter of the aorta
• Medical therapy may be useful to slow or halt the progression of aortic valve disease and aortic enlargement by reducing the blood pressure and the blood pressure across the aortic valve. Beta-blockers (eg, metoprolol) are recommended for this purpose.
• Because BAV may be an inherited condition, first-degree relatives of individuals with BAV should undergo evaluation.

Source: http://www.athletesheart.org/2013/09/more-on-athletes-and-bicuspid-aortic/

I'm sorry BritManToo, but you're not making a good argument for ignoring one's health and failing to have routine health screenings. However, Sirineou probably should have sought a second opinion and asked if there were non-surgical ways to manage his condition. Someone can live a long time with heart valve issues that are managed with medications and periodic screenings.

As I said I have top of the line medical insurance, provided by my lob.

All the tests Nancy mentioned were done, second and third opinions were taken measurements of the stenosis were conducted over the period of a couple of a year,

and the degree of calcification monitored.

The conclusion, I could live many years or could have a cardiac episode at any time

Regardless If I was to be re-certified and continue to do the work I love I had to do it.

As a vested member of two Trade unions I could have gone out on disability and collect full SS disability also , but that meant that I could never work again, and I love working.

Anyway, this is not about me or my medical condition. It is about the need for medical insurance.

I am not claim to be holier than thou , I had insurance because of my job, as I said, I was in good physical condition, I did not fit the profile, never being sick in my life, dont smoke, and only drink for medicional purposes and if I had to pay for it personally, I might have gone the cheap Charley way, I am certainly not above that.

But I am glad I had the insurance, if I did not, I could have died, I would certainly have had an increasingly decreasing quality of life. and I would have had to give up my job.

Point , you never know what life will throw at you

PS: some one in this thread, said if God is calling you.... Me and God have always had a difficult relationship. She can call all she wants, I will go when I am good and ready

OK, so there BritManToo -- Sirineou wasn't rushed into having a heart valve replacement simply because he had insurance and the doctors saw a chance to score a "quick sale" It seems that his condition was managed prudently -- monitored over a period of several years and he made the wise decision. Do I go on disability and have a reduced quality of life because I'm living with a bad heart valve or do I get it repaired and go back to being fully functional? Fortunately, for him he had the option to "go on disability" where he still would have had some income. Expats living here without health insurance wouldn't have that option. They'd just have to live with the reduced quality of life.

[suzannegoh]

The healthcare insurers in Thailand have network hospitals and that's where they want you to go barring an absolute emergency. They are familiar with the doctors at the network hospitals and most likely have negotiated rates with them for the most common procedures.

The problem with Thai policies, at least the last time that I checked into them, was relatively low limits on the maximum amount that they pay out each year. Basically Thai policies are backwards of what I want. I'd rather have a policy with a high annual deducible and high annual limits than a policy with no deductible and low annual limits. The reason is if ran into ongoing medical expenses (perhaps dialysis or prolonged cancer treatments) in excess of what those Thai policies pay it could bankrupt me, but paying the admittedly ridiculously high cost of a worldwide policy from a US insurance company is something that I can budget for. And by now, in our 50's, both of us have "pre-existing" conditions thought would probably prevent any Thai insurance company from writing us a policy.

[JLCrab]

BUPA Platinum is structured on a limit per incident basis with no limit to annual amounts or lifetime payments. There are no deductibles for outpatient only coverage.

[anto]

There is always this available ...http://www.dignitas.ch/?lang=en example case https://youtu.be/6OPXfWsTLPI

Edited April 11, 2016 by anto

[chiang mai]

"they are determined by demographics and statistics", of which your actual medical expenses form a part - Bumrungrad is one of the the most expensive private hospitals in the country. If you lived in the US you wouldn't automatically have al your health care issues taken care of at North Okaloosa Medical Center (FL), so why do similar in Thailand.

http://www.menshealth.com/health/50-most-overpriced-hospitals

You're not the first farang to object to my spending habits and I doubt that you will be the last. It's not just me that is causing this problem, everyone with insurance is contributing to rising medical costs to some degree. If no one had insurance there is no way that private hospitals would be able to charge as much money as they do.

You misunderstand, I'm not in a position to object to your spending habits, that's your business not mine, I was merely pointing out something that may not have been obvious. In fact I used to use Bumrungrad for all my medical needs when I first came to Thailand and then I started to realise that there are alternatives that are just as good if not better but also substantially cheaper.

I made it sound like we were using exclusively Bumrungrad and wantonly running up the bill but that's not the case. We have certain routine tests and MRIs done at other places for reasons of convenience, we've used BNH in Bangkok a couple of times for minor surgeries, and I cut the insurance company a break on prescription costs by having them filled at an independent pharmacy instead of at the hospital.

I'm well aware that Bumrungrad is not the only place with good doctors, but I think that Bumrungrad is the gold standard in Thailand. Almost all of the doctors that they have on staff have rock-solid credentials, most of their doctors are good at explaining treatment option to patients, and I think that the odds of receiving successful treatment there are as high as anywhere in SE Asia. And they can direct bill to foreign insurance companies.

The point that I was inelegantly trying to make is that if your insurance company is willing to pay for even the most expensive hospital in Bangkok then you don't have much incentive to beat the bushes looking for cheaper alternatives, for anything complicated you might as well go straight to the hospital that you trust most. And that means that your medical costs are apt to be more expensive than if you didn't have insurance or if you had a less comprehensive policy.

I think that National University Hospital in Singapore is probably the gold standard for the region but that's an aside. Libel laws prevent me from detailing my experiences with Big B. over many years but I think if you had the entire picture you would change your views. Anyway, you must seek treatment where you feel comfortable doing so.

[Kwasaki]

i can only shake my head when i read/hear that health insurance is an "investment"; good when one gets sick and bad when one stays healthy.

oh dear...

Yep agree, lets those who feel healthy don't get Dengue fever or alikes.

[JLCrab]

... and , but for libel laws, the gent above based upon his own personal experiences with Bumrungrad Hospital, would be capable of providing the ENTIRE picture?

Edited April 11, 2016 by JLCrab

[totally thaied up]

Not sure about Thai Health Insurance now.

A friend of mine recently had to go in. Insurance said they would cover it. He spent three days in and then as he was about to leave, the hospital told him the needed his credit card to pay for the services. He told them his insurance had it covered, and they said no, they were not going to pay.

He contacted his agent, and they just said to him to pay the Hospital. They needed to check out if he had been to any other Thai hospital with this problem first but this certainly was not a pre-existing problem.

To date, he has not been paid back but are telling him 'end of the month.' I will not say the agent or Insurance provider due to slander laws, but if you suddenly needed to come up with the cash and then, the company says that you're 'covered' before being put in but does not put up, I would be mightily pissed off.

[uptheos]

There is always this available ...http://www.dignitas.ch/?lang=en example case https://youtu.be/6OPXfWsTLPI

This is a very strange and inappropriate comment. Dignitas will only take care of you if you are terminally ill and have an examination by two Swiss doctors. They also want to see all your medical records and interview you personally. You just don't turn up and say "any vacancies today?"

What has that to do with the thread which is about medical insurance in Thailand?

[JLCrab]

To the case above, either this is a total fabrication and rip-off on the part of the hospital /insurer or there was something that led them to believe that an accurate medical history had not been provided by the friend. Say tuned.

[chiang mai]

... and , but for libel laws, the gent above based upon his own personal experiences with Bumrungrad Hospital, would be capable of providing the ENTIRE picture?

You seem to be having a problem with my posts in this thread Crab, what's the problem?

Edited April 11, 2016 by chiang mai

[JLCrab]

... and , but for libel laws, the gent above based upon his own personal experiences with Bumrungrad Hospital, would be capable of providing the ENTIRE picture?

You seem to be having a problem with my posts in this thread Crab, what's the problem?

Just waiting for you to divulge the entire picture, whether it is how the word-wide insurance industry operates and what is a good deal or a bad deal or what is the TRUE genuine picture of a hospital that has a world-wide reputation, I go where there is material and you've become the mother-lode.

It's OK I guess for you to say that you think buying health insurance is a game for mugs (this topic) but I'm not supposed to have a problem with that.

Edited April 11, 2016 by JLCrab

[totally thaied up]

To the case above, either this is a total fabrication and rip-off on the part of the hospital /insurer or there was something that led them to believe that an accurate medical history had not been provided by the friend. Say tuned.

It is not a fabrication. Look at my post history previously. I sure so not go off making 'fairy stories.'

The above has happened, and I will report the outcome in the future when I know more. I have known this guy for well over eight years: he is fit as, and this was his first claim ever.

From what I can gather is that the hospitals here are all inter-connected, and the Insurance has access to this information. He seems confident to getting his money back but in reality, being told one thing and then given another is not on.

[JLCrab]

To the case above, either this is a total fabrication and rip-off on the part of the hospital /insurer or there was something that led them to believe that an accurate medical history had not been provided by the friend. Say tuned.

It is not a fabrication. Look at my post history previously. I sure so not go off making 'fairy stories.'

The above has happened, and I will report the outcome in the future when I know more. I have known this guy for well over eight years: he is fit as, and this was his first claim ever.

From what I can gather is that the hospitals here are all inter-connected, and the Insurance has access to this information. He seems confident to getting his money back but in reality, being told one thing and then given another is not on.

No -- I said that the 'fabrication' was on the part of the hospital and insurer that there was some pre-existing condition when you are certain (even though it isn't you) that there isn't.

Edited April 11, 2016 by JLCrab

[totally thaied up]

Thanks for clearing that up. He just went in for a yearly check-up. Nothing was wrong with him, but one test came back 'unusual' and it ended up becoming an issue.

All is good as it ended up being nothing but the part that he had to pay up in the end. I hope he gets paid but with all things in this Country, nothing is for certain. In a perfect world, they should have kept their word from the beginning but we are talking Insurance and nothing in that sector is a certain and that is what I am trying to say.

[chiang mai]

... and , but for libel laws, the gent above based upon his own personal experiences with Bumrungrad Hospital, would be capable of providing the ENTIRE picture?

You seem to be having a problem with my posts in this thread Crab, what's the problem?

Just waiting for you to divulge the entire picture whether it is how the word-wide insurance industry operates and what is a good deal or a bad deal or what is the TRUE genuine picture of a hospital that has a world-wide reputation,I go where there is material and you've become the mother-lode.

I have no idea how the world wide insurance industry works and coming from you on this subject, I'll regard that as a flame.

As for the "entire" picture of how a hospital works: the poster I responded to had a particularly positive view of one particular hospital. My experience with that same hospital is very different hence I suggested that she needed a more complete or entire view before cementing her opinion of it.

As for my experience there: the hospital was very good at identifying my blocked coronary artery and later in performing PCI and inserting a stent, it was a highly satisfactory and cost effective experience. But what the hospital did not mention is that the outcome and survival rates for patients undergoing PCI who were asymptomatic for coronary artery disease is the same as patients who undergo platelet and statin therapy alone. Given that I am obliged to take statins and plavix anyway the placement of a stent was not necessary - cost 174k baht unnecessarily spent.

During subsequent visits I tried unsuccessfully to track down the cause of swelling and discomfort to the side of my face and neck. My own research beforehand suggested a blocked salivary gland and a shrunken submandibular gland were a part of the picture. The next three months saw me passed around from department to department, specialist to specialist in search of a cause - ENT said it was nothing, Ortho. said the discomfort was caused by using the computer too much, Endocrinology ran batteries of tests and an FNA and diagnosed unrelated thyroid tumours, something experienced by over 50% of the adult population. - cost circa 100k baht.

Out of frustration I went to National University Hospital in Singapore where a Head and Neck Surgeon immediately diagnosed a stone in the parotid gland, caused by the blocked salivary gland.

I went through the complaints process at that hospital and that was a complete whitewash, stories were changed, notes were altered and quickly realised that the wagons had circled.

[chiang mai]

... and , but for libel laws, the gent above based upon his own personal experiences with Bumrungrad Hospital, would be capable of providing the ENTIRE picture?

You seem to be having a problem with my posts in this thread Crab, what's the problem?

Just waiting for you to divulge the entire picture, whether it is how the word-wide insurance industry operates and what is a good deal or a bad deal or what is the TRUE genuine picture of a hospital that has a world-wide reputation, I go where there is material and you've become the mother-lode.

It's OK I guess for you to say that you think buying health insurance is a game for mugs (this topic) but I'm not supposed to have a problem with that.

"It's OK I guess for you to say that you think buying health insurance is a game for mugs (this topic) but I'm not supposed to have a problem with that".

I understand that some people need the security of medical insurance, I understand also that some people don't have a reserve and can't afford to pay directly for their medical care, we've agreed those things many times. And I've also written that people who don't have a suitable reserve should buy medical insurance.

In post 15 of this thread I wrote:

"If you can afford it you should buy it,

If because of your age you think the premiums are too high AND you have cash reserves, 3 to 5 million set aside to cover these things will easily work.

But, if you can't afford the premiums AND you don't have cash reserves, there's a problem looming.

I'm with poster LivinLOS on this point, I've always believed health insurance is a mugs game and I've not had it for years hence I'm well ahead - I have 5 mill. ring fenced for this purpose".

There, now you can let your hard on relax and you can get off my case.

Edited April 11, 2016 by chiang mai

[JLCrab]

I can probably pay for all my medical costs but if you want to go calling people 'mugs' who might differ with you as part of a rational discussion that's up to you.

[BritManToo]

I think the problem between JLC and CM is more basic,

CH is a Brit, and we don't really do health insurance.

JLC is American, and they obsess about health insurance.

Cultural difference, It's as simple as that.

Edited April 11, 2016 by BritManToo

[chiang mai]

I can probably pay for all my medical costs but if you want to go calling people 'mugs' who might differ with you as part of a rational discussion that's up to you.

I wrote that it's a "mugs game", that's an expression and nobody was slighted or slurred, yet!

[JLCrab]

Dictionary.com

1.

a foolish, useless, or ill-advised venture.

a mug's game

(British informal)

an activity that will not make you happy or successful (http://idioms.thefreedictionary.com)

Edited April 11, 2016 by JLCrab

[chiang mai]

Oh dear, how sad is that! Grow up Crab and get over it.

[anto]

There is always this available ...http://www.dignitas.ch/?lang=en example case https://youtu.be/6OPXfWsTLPI

This is a very strange and inappropriate comment. Dignitas will only take care of you if you are terminally ill and have an examination by two Swiss doctors. They also want to see all your medical records and interview you personally. You just don't turn up and say "any vacancies today?"

What has that to do with the thread which is about medical insurance in Thailand?

Its a fall back option .I know my Insurance in Thailand will not cover me for long term Cancer treatment .So in the event of a Cancer diagnosis i would consider going to Dignitas .

[JLCrab]

Get over what? You've been posting for years that insurance is a game for suckers and that your 5 mil socked away can handle any and all come-what-may. There are people reading these posts who maybe are in a position to buy insurance now but if they read your stuff and delay they might not be. I''m concerned about them -- not you.

[chiang mai]

Get over what? You've been posting for years that insurance is a game for suckers and that your 5 mil socked away can handle any and all come-what-may. There are people reading these posts who maybe are in a position to buy insurance now but if they read your stuff and delay they might not be. I''m concerned about them -- not you.

We hope that anyone reading this thread is old enough and sufficiently sensible to make their own decisions in life and to read both sides of an argument without the need for self appointed censors to intervene on their behalf. For third time in this thread I'll restate my position in this matter:

In post 15 of this thread I wrote:

"If you can afford it you should buy it,

If because of your age you think the premiums are too high AND you have cash reserves, 3 to 5 million set aside to cover these things will easily work.

But, if you can't afford the premiums AND you don't have cash reserves, there's a problem looming.

I'm with poster LivinLOS on this point, I've always believed health insurance is a mugs game and I've not had it for years hence I'm well ahead - I have 5 mill. ring fenced for this purpose".