In-patient only cover with high excess?

[Craig krup]

Craig krup: You are mixing travel based health insurances with expat health insurances.

No, I do understand the conceptual distinction

I'm drawing attention to what seems to be a sophisticated market in travel insurance which provides cheap coverage, and an unsophisticated market for health cover for long-term residents which provides expensive cover. It all-but defies reason that the prices for the two things should differ as much as they do. The reason they do differ has to be 1) a less efficient and sophisticated market for expat health cover, and 2) the people who buy long-term cover pose risks that are peculiar to the group. A 51 year old male who spends six weeks in Thailand has much less than 6/52ths of the risk of serious misadventure of a 51 year old resident. The resident is in a self-selected group with special characteristics, and he'll make more claims.

That said, I've stood in court and tried to use reason to explain to a Scottish sheriff what insurance was, and what prices told us. I didn't get too far then, either. It's a shame that the web doesn't allow for this kind of reasoning. There would be a lot less unhappiness in the world if it did.

I think you're right about the other stuff, and it's very helpful. But there's no way I'll be paying anything like 5,000 baht a month for health cover. If it doesn't come in way below that I'll live somewhere else. It annoys people when you refer to yourself in seemingly glowing terms, but facts are facts. If my blood pressure is 100/50, my pulse is 42-44 at rest, my cholesterol is 3.94 and my body fat is 7% there is absolutely **** all chance that I'll be paying a premium that subsidises the characters on the bar stools!

[Swiss1960]

Craig krup: You are mixing travel based health insurances with expat health insurances.

No, I do understand the conceptual distinction

I'm drawing attention to what seems to be a sophisticated market in travel insurance which provides cheap coverage, and an unsophisticated market for health cover for long-term residents which provides expensive cover. It all-but defies reason that the prices for the two things should differ as much as they do. The reason they do differ has to be 1) a less efficient and sophisticated market for expat health cover, and 2) the people who buy long-term cover pose risks that are peculiar to the group. A 51 year old male who spends six weeks in Thailand has much less than 6/52ths of the risk of serious misadventure of a 51 year old resident. The resident is in a self-selected group with special characteristics, and he'll make more claims.

That said, I've stood in court and tried to use reason to explain to a Scottish sheriff what insurance was, and what prices told us. I didn't get too far then, either. It's a shame that the web doesn't allow for this kind of reasoning. There would be a lot less unhappiness in the world if it did.

I think you're right about the other stuff, and it's very helpful. But there's no way I'll be paying anything like 5,000 baht a month for health cover. If it doesn't come in way below that I'll live somewhere else. It annoys people when you refer to yourself in seemingly glowing terms, but facts are facts. If my blood pressure is 100/50, my pulse is 42-44 at rest, my cholesterol is 3.94 and my body fat is 7% there is absolutely **** all chance that I'll be paying a premium that subsidises the characters on the bar stools!

I think the key reason for travel insurances to be cheap is - as you implicitely mentioned -the fact that people who travel do NOT only spend much less time within the country, it is also clear that

• travel insurances do exclude coverage for pre-existing conditions (i.e. cancer)
• people who travel are most likely (assumed) healthy and therefore a much lower risk of ever using the policy

BTW: Did you ever realize that travel insurances do ALSO have a risk based price? Not only your age is a factor, also where you travel is a factor. You might not be covered in areas with health issues (i.e. yellow fever, malaria, ebola etc.) AND depending on the country you travel to, the price will also be different. Travel insurance for Germany is less expensive than for Switzerland and Switzerland is less expensive than the US of A. So even within travel insurances, you do NOT get around being risk rated.

As far as health coverage goes: As I mentioned in my previous post, I do NOT know of any long-term health insurance that would give you lower prices based on personal excellent health. You are in an age and location group, your medical pre-exam will be used to exclude certain things, but insurance providers (not only in health) use statistical models to calculate the average price they need to cover all possible events and still make profit. Imagine the overhead costs taht they would incur, if they would want to do individual risk assessments for each client... imagine who would have to pay for that...

Being healthy is therefore a disadvantage for you - but only with regards to the premiums, otherwise you are clearly on the winning side.

Oh, one more thing: No, not all 51y old residents are in the "self-selected group with special characteristics". I am 55, married, have hobbies outside the bar-areas, do not whore around at all, keep myself fit and enjoy family life at home... and so are the majority of the expats living in my area outside Pattaya... and since I retired last year, my health has actually improved massively, from disappearance of my migrane attacks to my blood pressure to my sugar and cholesterole values to my sleep... and I do NOT intend to use my health insurance anytime soon, that is why I used many exclusions and rebate schemes, so that I pay less but am covered for the big things that might come one day.

[Craig krup]

C insurance providers (not only in health) use statistical models to calculate the average price they need to cover all possible events and still make profit. Imagine the overhead costs taht they would incur, if they would want to do individual risk assessments for each client... imagine who would have to pay for that...

Well, again, the market deals with this. The people who would benefit from an individual assessment pretty much know who they are. They would pay for the medical precisely because they'd win on the premiums. It wouldn't cost the companies anything. It's just market failure and a failure of modelling. We now know that doctors get sued because they spend 11 minutes with their patients and talk over them, and they'll never get sued if they spend 18 minutes with them, and let the patient talk. Patients won't sue doctors they like. American insurance companies found this out because they had massive incentives. Thailand just doesn't have that sophistication of risk analysis.

[Sheryl]

Unless you are under 50 years of age, even with deductibles, you are not going to find decent health cover for undet 5000 baht a month.

No expat policy that I am aware if is specific to Thailand so the various factors you cite have nothing to do with their rates. What is perhaps relevant is that, precisely because they are not Thailand specific, international expat policies have higher levels of cover (i.e. 1-5 million USD a year) than you would ever need in Thailand and you are paying for that unnecessarily high kevel...because the caps and premiums are based on a pool of people libing all over the world, often in places where health care is much more expensive.

You can get a Thai-issued policy with coverage in suitable amount but these do not have deductible or copay options.