Tragedy played out on Facebook as sick and uninsured Bangkok expat dies on the way to hospital

[Monomial]

12 hours ago, geriatrickid said:

1.  You cannot insure  the pre-existing condition itself, but you can  obtain coverage for everything else. For example if you have  heart disease, you cannot insure loss arising from the  heart disease itself, but you can insure injury due to mishap such as a fall or crash.

 

Here is why I can't agree with what you recommend. Let's say you and I are the same age, but I have a pre-existing condition and you don't. We both get a quote (it's the same amount) but I have an exclusion, and you don't.

 

Where is my discount because the insurance company has reduced its exposure?  The insurance company has equal exposure on both of us on every area except the excluded condition, however it has additional exposure on you for the items it excluded on me. I therefore deserve a lower premium than you, yet I don't get one.

 

Insurance companies view exclusions as cash cows, and as such, it is not fair to the insured.

 

If the insurance companies were honest, they would break health insurance up into specific categories, each category having its own cost, and then offer or not offer specific categories of insurance to an individual based on preexisting conditions. That would do 2 things. It would make the system equally fair for everyone, and it would prevent the insurer from going in after an illness and trying to find a way to tie it back to your preexisting condition. They would need to decide up front what was covered and what wasn't. Yes, this might make life difficult for them because they can't imagine every contingency. Too bad. They are the experts and are getting paid to take that risk.

 

Given the way Thai insurance companies work, anyone with a BMI of over 35 and high blood pressure is effectively excluded from health insurance in Thailand. All you can get is personal accident insurance. Sure, you can BUY health insurance (with every imaginable thing excluded),  but you can't actually USE health insurance if you need it (because everything is excluded).

 

It is a scam.

 

Self insure. It is the only fair system.

 

[TallGuyJohninBKK]

One question I don't see much being asked or discussed here is what happened with this guy and the treatment (?) he was receiving at the Thai hospital that left his leg in that kind of condition after (based on his account) quite an extended period of treatment (?).

 

Perhaps lucky for those involved in this case, pursuing and winning a legitimate/serious medical malpractice case here has about the same odds as winning first place in the Thai national lottery (or maybe even less).

 

But obviously, we simply don't know what happened with the guy and his treatment. Maybe he was mis-treated and mis-diagnosed. Maybe he didn't follow the treatment regimen and medicines directed by the hospital. Maybe he couldn't afford to do what they told or wanted him to do.  So many unanswered questions.

 

Edited February 26, 2017 by TallGuyJohninBKK

[metisdead]

Posts containing a link to a disallowed site have been removed as well as the replies. 

[TallGuyJohninBKK]

1 hour ago, Torfan said:

AS a expat doctor Living in Buriram I know that the oath you are talking about is the Hippocrates oath. Thai doctors have never heard about Hippocrates. 

Apparently medical oaths are common among new doctors in many countries, not just the U.S.  But even in the U.S., apparently there is a lot of variation of just what doctors swear to (as in, different versions of an oath):

 

Quote

In a 2000 survey of US medical schools, all of the then extant medical schools administered some type of profession oath. Among schools of modern medicine, sixty-two of 122 used the Hippocratic Oath, or a modified version of it. The other sixty schools used the original or modified Declaration of Geneva, Oath of Maimonides, or an oath authored by students and or faculty. All nineteen osteopathic schools used the Osteopathic Oath.^[15]

https://en.wikipedia.org/wiki/Hippocratic_Oath

 

I would be surprised if incoming Thai doctors here aren't asked to give an oath to something -- King, Country and Religion, or who knows.

 

[yardrunner]

19 hours ago, TSF said:

Thailand's gov hospitals are so cheap. Anyone can go and receive good medical care. A couple years ago I was sitting in my car in Nong Khai and I got chest pains. I went immediately to the Nong Khai gov hospital, within 5 minutes they had completed the admission form and had me on a stretcher and took me for an EKG. After the EKG I was examined by a doctor. Fortunately for me it was a false alarm and I had only suffered a muscle spasm not a heart related problem.

 

I couldn't have expected faster medical attention anywhere and the bill was 300 Bt.

I am in Khon Kaen and i use the University Hospital (Government) every 90 days i need a blood test, see my doctor (a top cardiologist) and then am given prescriptions for blood thinning etc and less than 1000 Baht every time.

18 months ago i had  appendicitus and needed an operation with extra care and tests due to being on blood thinners and two extra days in hospital while they got my medicine levels stable again, total cost under 30000 Baht and excellent care, at least as good as the UK.

from my experience i would recommend goverment hospitals to anyone

[TallGuyJohninBKK]

4 minutes ago, yardrunner said:

from my experience i would recommend goverment hospitals to anyone

There are WIDE / ENORMOUS / HUGE variations in the quality and competence of care among different government hospitals. Because in part, there are several different levels of government hospitals all around the country -- local, district, provincial, etc.

 

KK, perhaps because it has its own medical school, seems to have a good reputation. Other places you wouldn't want to get caught dead in.

 

[billd766]

13 hours ago, geriatrickid said:

 

What oath  do they swear?  Is this something new?  Don't confuse  a  voluntary optional pledge of conduct with no legal standing that some countries have, as an obligation.  This is not a  television novella.

 

You are delusional if you believe that physicians in Thailand are obliged to provide complex and invasive medical treatments gratis. It does not occur. The best that one can hope for is a stabilization of an incident, but not a treatment or a "cure".  Thai hospitals may have compassionate care policies that will allow for emergency immediate care, but  they are not obliged either legally, nor morally, to do anything more.  

 

The downside is there is no such thing as a free lunch. All medical costs have to be paid for by somebody somewhere down the line or the whole system will collapse and there will be no healthcare for anyone other than the rich.

 

Back in the west, for example if you are a Brit in Euroland  somewhere and you need emergency treatment it will be given most probably for free but you will need to provide your personal details so that eventually the UK will cover the costs and the same goes the other way. This is because you are covered by the National Insurance scheme and a percentage of your salary is deducted at source, or if you are unemployed the government pays for you. There is an agreement in place withing Europe to manage this.

 

The problem comes when you go to a country which does not have a reciprocal agreement with your government. Quite reasonably why should they foot the bill for your treatment and not you? That is what insurance is for after all.

 

Now this is where the problems really start especially if you are living in the country and not a tourist. (tourists can and should get their own insurance).

 

Living here and getting insured are not always that easy. All sorts of covenants and restrictions come into play along with age and pre-existing conditions and that is a minefield that I am not qualified to explore nor am I willing to.

 

Suffice to say that it has been covered in other topics.

Edited February 26, 2017 by billd766

[paulbj2]

1 minute ago, Monomial said:

 

Given the way Thai insurance companies work, anyone with a BMI of over 35 and high blood pressure is effectively excluded from health insurance in Thailand. All you can get is personal accident insurance. Sure, you can BUY health insurance (with every imaginable thing excluded),  but you can't actually USE health insurance if you need it (because everything is excluded).

 

It is a scam.

 

Self insure. It is the only fair system.

 

This I find hysterically funny. From BMI = 30 upwards, a person is considered to be clinically obese.  If a patient's BMI is 35 or more and they have high BP (something they are extremely likely to have), they are a walking medical time bomb! It would utterly irresponsible of any medical insurer to take them on. They need to spend the money they would have spent on the insurance premium, on bariatric surgery. OK, there are a few - a very, very few people, body builders, who can reach very high BMIs whilst being muscle-bound rather than burdened down with fat and there are a few people who have medical conditions that cause them to put on weight; however, for the most part, people who are grossly overweight eat too much and/or drink too much and often show a marked preference for extremely calorie dense foods (think: fried breakfast, McDonalds, KFC, pizza).   

 

At that level of obesity, the patient is at massive risk of Type II diabetes with all the enhanced health risks that implies. They are at grave risk of fatty liver disease and other hepatic disorders, of heart attack and of cardi-vascular accidents. Moreover the hip, knee and ankle joints will be under the most extreme stress leading, most likely, eventually, to the joint failure. High BP also puts a person at significantly enhanced risk of kidney failure. There's plenty more, but I'll stop there as I'm sure most people will have the message.

 

In some countries, being clinically obese (BMI => 30 < 35),  severely obese (BMI =>35 ) or morbidly obese (BMI > 40) is so common it is considered normal; according to WHO figures, in the USA 35% of men and 40% of women are clinically obese. In Japan the corresponding figures are: 3.8% of men and 3.4% of women. In Thailand the figures are 4.7% of men and 9.1% of women. However, medically, being obese, is emphatically NOT normal nor is it in any way healthy.

 

 

[Prbkk]

24 minutes ago, yardrunner said:

I am in Khon Kaen and i use the University Hospital (Government) every 90 days i need a blood test, see my doctor (a top cardiologist) and then am given prescriptions for blood thinning etc and less than 1000 Baht every time.

18 months ago i had  appendicitus and needed an operation with extra care and tests due to being on blood thinners and two extra days in hospital while they got my medicine levels stable again, total cost under 30000 Baht and excellent care, at least as good as the UK.

from my experience i would recommend goverment hospitals to anyone

Of course you are correct: some of the care offered in Thailand is first rate and affordable ( with the rider that it is better to be well-informed about procedures, tests etc so that one can make an educated decision to decline some of the bill 'padding' tests...more so in the private sector and equally true of many providers in the west).

While there is not much point being wise after the (tragic) event, it is extremely unfortunate that Mr Melzer waited so long , in great pain, to seek help from others and a second opinion.

While ulcerated wounds of that nature can be notoriously difficult to treat, he would have been wellAdvised to get a second opinion a long time ago. If it had been me,, I would have been off to another hospital after about 10 days....let alone 6 months. And if the second treatment wasn't successful I would have gotten on a plane to Singapore or Australia. Easier said than done though.

It's a really sad case.

[tandor]

10 hours ago, Telecom66 said:

Hey Tandor.

 

While I agree that from our Western perspective it looks like the Thais are treating a dead body as a spectacle - that is actuallt the exact opposite of what they are doing.

 

Please allow me a moment to enlighten TV members as to why Thais do this.

 

Thai's (Buddhism) belive that after you die and the Ceremonial Rights of Cremation are performed, your (soul or spirit) gently rise and floats up with the heat from the Cremation Kiln, to be reborn again with either a higher status if you were good, or with a lower status if you were bad. That is why there is a week of daily "Bathing Rites" at the temple to cleanse the spirit of all the pollution and baggage from this life, prior to cremation. This is the exact reasons why Thai's often treat soi dogs like their own.

 

The cremated ashes are a physical reminder for your loved ones - but the Cremation Ceremony is where what we in the western world refer to as out "Spirit" or "Soul" is uplifted for Buddha to return to earth in a new form as he sees fit.

 

Therefore, when a Thai comes apon an accident where there are dead body's, there is a sense of duty to help see the spirit on to the next stage safely. It is seen as disrespectful to leave the scene of an accident before the bodies have been removed. If it is a Thai cadaver, some people will pay their respects and move on early, because they feel that a Thai spirit has been taught Buddhism and understands the journey and where it needs to go.

 

When the Thai's see a Farang cadaver, they believe that it's spirit will not understand the  Buddha spirit that is about to take it by the hand and help safely ferry the Farang spirit back to their own god. I use the term "Ferry" because it is a similar belief in Christian traditions to put coins on the eyes or in the mouth of the cadaver prior to burial to "pay the Ferryman". While it may seem that they stop and gawk, they actually have a sense of duty from their Buddha teachings to stay until the Farang spirit has safely been ferried to the next level. Typically this is either an Ambulance, Medical Examiners vehicle, or the Community Foundatiion Ambulances. 

 

That is why the first responders that responds to a cadaver, look like they are performing religous rituals prior to collecting the body. They are merely preparing the spirit to commence it's journey to a new life.

 

So next time you see Thai's "stopping and gawking", see it as a sign of respect to the deceased - not as a sideshow. Yes they will be laughing and smiling. For the Thai's, the spirit has the opportunity to go on to better things - and that is a cause for celebration.

 

Thai's are actually celebrating at a funeral, even though it is a very somber and highly emotial time. Everyone still mourns the loss of loved ones and cries. But all the rituals you see are a celebration and transition of the spirit to the next life.

 

If I was Christian's family and friends, I would be Thanking them for overseeing the safe transfer of Christian's spirit at a time when they could not be there to do it themselves.

 

Hey Telecom66...thanks for your explanation...i was aware and am aware of how to treat a deceased at the scene of a sudden death having had an extensive career in that area, which embraced not only Christians or Buddhists...Respect and dignity are paramount regardless of what religion they maybe (a detail you would not necessarily be aware of at  the scene). 

My point was the growing vehicle  and pedestrian traffic congestion on both levels...i think the fact the rider was thrown from the flyover to the ground below was the main reason an almost all male crowd had gathered...

Regardless..this is 2017 and modern traffic control measures should be in place here so as to perhaps lessen the risk of further death and injury. 

[farang62]

I went through the same problem, small leg burn turned into a mega infection, most of the bacteria were treatable, but most were not . MSRA type 3 different strains. After 3 years of treatment with every antibiotic in the arsenal, pills, IV's, soaks, washes, you name it they tried it. Pain medication from hell, yes the pain was unbearable at times, wanted my leg removed many times just to stop the pain.

 

In the hospital on many occasions due to drug related reactions, painful dressing changes, cleaning the wound (by nurse Rachatt) . Looking back on my experience I was as much at fault as anyone. No time to follow doctors instructions, missing dressing changes, getting the wound dirty or wet. It all added up to a condition that I had come to live with.

 

I had a refrigerator just for the drugs I was taking.

None of this treatment, drugs, cost me 1 baht as I am on Thai Social Insurance, When I finally realized that I needed get this problem out of my life, I began following the doctors instructions and following the dressing changing routines like clock work, things improved. Being a registered Paramedic also interfered with the treatment as I did not agree with some of the things they did. But than I realized we were not in Kansas anymore, limited expertise immediately available, constraints on lab tests, as well as limited testing for certain things, and lastly lack of trained staff in this particular area.

 

I have to say the treatment I received was here on Samui was equal to if not better than I would have gotten at home given the same constraints.

 

Than my guardian angle appeared, I doctor came by my ward bed and ask me if I wanted to save my leg or keep suffering like I was it the time. "Do what I tell you and in 2 months the leg will be healed" well it is almost 3 months and it is 99% healed, the 1% problems are caused by me not being careful when out and about. keeping the leg dry and clean.

 

The doctor happened to be a specialists in Reconstructive surgery, as well as a general surgeon at Natorn Hospital after 2 surgeries to remove all of the infected rotten tissue, the last surgery of the day due to the bacterial contamination of the O.R.that had to be considered. Skin grafts to cover the open wounds, 2 weeks in the hospital I now have a fully functional, "New Leg" yes it took a while, and required cooperation between doctors and concerned staff but it has been 3 months with virtually no complications.

 

Things take longer here mainly due to lack of resources, language barriers, cultural differences, you just have to have patience and not give up.

 

To end the story it did not cost me 1 baht for the treatment, but 1000 a day for the private room I had to pay.

 

So the system does work it has worked for me in many other instances, but you have to have patience and accept the limitations that exist.

[cyberfarang]

2 hours ago, billd766 said:

 

The downside is there is no such thing as a free lunch. All medical costs have to be paid for by somebody somewhere down the line or the whole system will collapse and there will be no healthcare for anyone other than the rich.

 

Back in the west, for example if you are a Brit in Euroland  somewhere and you need emergency treatment it will be given most probably for free but you will need to provide your personal details so that eventually the UK will cover the costs and the same goes the other way. This is because you are covered by the National Insurance scheme and a percentage of your salary is deducted at source, or if you are unemployed the government pays for you. There is an agreement in place withing Europe to manage this.

 

The problem comes when you go to a country which does not have a reciprocal agreement with your government. Quite reasonably why should they foot the bill for your treatment and not you? That is what insurance is for after all.

 

Now this is where the problems really start especially if you are living in the country and not a tourist. (tourists can and should get their own insurance).

 

Living here and getting insured are not always that easy. All sorts of covenants and restrictions come into play along with age and pre-existing conditions and that is a minefield that I am not qualified to explore nor am I willing to.

 

Suffice to say that it has been covered in other topics.

The points you make are very valid. I don`t think too often because it makes my brain hurt but this thread has really got me thinking.

 

I am British and not having returned to the UK for several years nor having any homes there I am no longer eligible for medical treatment under the National Health.  I am also at the medical insurance bygone age, meaning at my age many medical insurance companies won`t even take me on or I`d have to pay a King`s ransom for premiums every month. As a retiree in Thailand I am not entitled to cheap or free medical care under the Thai social security system, so in fact I am in medical limbo and if the crunch came to the crunch I could end up at the tender mercies of the private hospitals where the final medical bills could be anything, the sky`s the limit with them.

 

So here`s some questions for anyone who maybe in the know: Could it be possible to create an expat cooperative in Thailand whereas members pay an amount of money into a fund each month that would cover medical fees for serious health issues as in the tragic case of the OP, with certain conditions imposed?

 

Here`s an example; each member could pay a sum of 5000 baht per month and considering the probably thousands of expats living in Thailand who are in similar situations as me, most would jump at the opportunity and the kitty would draw in millions of bahts each month, more than enough to give all it`s members coverage. So come on you TV experts, give us your opinion?

Edited February 26, 2017 by cyberfarang

[mommysboy]

3 hours ago, yardrunner said:

I am in Khon Kaen and i use the University Hospital (Government) every 90 days i need a blood test, see my doctor (a top cardiologist) and then am given prescriptions for blood thinning etc and less than 1000 Baht every time.

18 months ago i had  appendicitus and needed an operation with extra care and tests due to being on blood thinners and two extra days in hospital while they got my medicine levels stable again, total cost under 30000 Baht and excellent care, at least as good as the UK.

from my experience i would recommend goverment hospitals to anyone

 

I think if any good is to come out of this it is getting the message out that Thai Government Hospitals are basically ok, and probably within the budget of the majority of people who are not so well off.

[Thaidream]

While I applaud your idea- I think it would be difficult administer and it would need paid administration and paid marketing to entice enough expats to 'buy in'. It would also need the status of a non profit organization which if I am not mistaken still is  subject to a Thai yearly audit and taxed at certain levels.

I really think to start such an endeavor- you would need seed money of at least  $1million US

and possibly allowing funds to build up for 2 years before anything could be paid out. 

The hard part would be convincing expats that it was legitimate and also convince hospitals to accept the Organization as legitimate and that it will pay.  Lots of marketing; advertising and personal contact with a variety of stakeholders. 

Could it work- yes but a tough sell.

Edited February 26, 2017 by Thaidream

[ChrisY1]

Should have gone home and had treatment.....

[ajarngreg]

 

   There's really no need to badmouth Thai doctors. The poor guy's wound looks pretty much like a Staphylococcus Aureus infection, a bacteria that lives on our skin.

 

       But once it comes into our bloodstream, it's causing severe destruction.

 

          I've had a big bike accident here and the surgery didn't go well, paid by my SS insurance, the same the victim had. They paid around 100 K, without any questions, the motorcycle insurance only pays 12 K. 

 

    I was eight months on crutches until I found out that I'd never be able to walk again and decided to go to one of the best orthopedic surgery hospitals in a "developed European country".

 

      None of the Superdoctors who had a daily look at my leg after receiving an artificial knee joint was thinking about an eventually bacterial infection.

 

They even sent me to rehab and nobody, except an older nurse, could see that I had this very serious infection inside my leg when most of the flesh underneath was already eaten up and gone. 

 

    Without the nurse, I'd have lost my leg and I'm thankful for her advice that immediately put me on the OP list for the next day. 

 

The poor guy needed a real professional in his/her field to find out what had caused the infection and there's nobody to blame at the hospital where he received treatment.

 

     He's just waiting way too long and might have thought that this would go away from alone.

 

     The pain was so intensive that only morphine could help me. 

 

       It might be good to know that a motorcycle insurance only covers medical expenses up to 12,000 baht.

 

       If you don't have another insurance, then you're screwed. Another biker had to go way too early. 

 

       I feel very sorry for his loved ones and friends and would really like to know if he tried to get in touch with DHV in Bangkok.

 

It's an organization that should help Germans in emergency situations.

 

      If he did get in touch with them and one of the Thai staff didn't give him the needed help/ advice, I'd be more than happy to give this information to some people who're responsible. 

 

     I don't think that the guy had no idea about this organization. Please page me if you knew him, his death really shocked me and it's hopefully an example for others/

   

 

  

 

       

 

        

 

       

 

        

 

     

 

      

 

        

 

        

Edited February 26, 2017 by ajarngreg

[catman20]

3 hours ago, TallGuyJohninBKK said:

There are WIDE / ENORMOUS / HUGE variations in the quality and competence of care among different government hospitals. Because in part, there are several different levels of government hospitals all around the country -- local, district, provincial, etc.

 

KK, perhaps because it has its own medical school, seems to have a good reputation. Other places you wouldn't want to get caught dead in.

 

KK being khon khen????????

[paulbj2]

51 minutes ago, cyberfarang said:

The points you make are very valid. I don`t think too often because it makes my brain hurt but this thread has really got me thinking.

 

I am British and not having returned to the UK for several years nor having any homes there I am no longer eligible for medical treatment under the National Health.  I am also at the medical insurance bygone age, meaning at my age many medical insurance companies won`t even take me on or I`d have to pay a King`s ransom for premiums every month. As a retiree in Thailand I am not entitled to cheap or free medical care under the Thai social security system, so in fact I am in medical limbo and if the crunch came to the crunch I could end up at the tender mercies of the private hospitals where the final medical bills could be anything, the sky`s the limit with them.

 

So here`s some questions for anyone who maybe in the know: Could it be possible to create an expat cooperative in Thailand whereas members pay an amount of money into a fund each month that would cover medical fees for serious health issues as in the tragic case of the OP, with certain conditions imposed?

 

Here`s an example; each member could pay a sum of 5000 baht per month and considering the probably thousands of expats living in Thailand who are in similar situations as me, most would jump at the opportunity and the kitty would draw in millions of bahts each month, more than enough to give all it`s members coverage. So come on you TV experts, give us your opinion?

What you are proposing is presumably a "not for profit" insurer which is what BUPA is, or at least used to be. The advantage of such an organization is that it could potentially negotiate some very good deals with local hospitals. The downside is that you would need actuarial experts to calculate the premiums such that they would be high enough to cover your risk but not so high as to make them unaffordable. The "Mutuelle" (top up insurance to cover the risks that the Social Security only partly cover) in Luxembourg that I subscribed to, massively miscalculated the demand when the introduced dental and optical cover and made a thumping loss that year, necessitating a massive premium hike and a savage cut in benefits the following year! That's the danger.

[earlinclaifornia]

On 25/02/2017 at 2:34 PM, brianwl said:

"Get treated first and worry later. Life and death should have no price tag."

This advice is old as time and DOES NOT WORK.

 

If you go for medical care, they will treat the immediate emergency, but if you have no resources to pay for it, you get no follow up treatment.  Or, you get all your money taken away and can't leave the country until the bill is paid.

 

The Governments of the countries we come from need to work with the Thai Government to ensure medical bills for those using Government insurance like Social Security or Veterans Venefits (in the case of the US) are paid promptly.

Confusing to me anyone speculating Social Security pays overseas costs? No Medicare or Social Security pays overseas costs. Period.

[cyberfarang]

10 minutes ago, paulbj2 said:

What you are proposing is presumably a "not for profit" insurer which is what BUPA is, or at least used to be. The advantage of such an organization is that it could potentially negotiate some very good deals with local hospitals. The downside is that you would need actuarial experts to calculate the premiums such that they would be high enough to cover your risk but not so high as to make them unaffordable. The "Mutuelle" (top up insurance to cover the risks that the Social Security only partly cover) in Luxembourg that I subscribed to, massively miscalculated the demand when the introduced dental and optical cover and made a thumping loss that year, necessitating a massive premium hike and a savage cut in benefits the following year! That's the danger.

Not an insurer but a cooperative, which is more like a club than a business and those paying in would be members not customers.  A non-profit organisation does not mean people would work on a voluntary basis, as administrators and other staff would be paid for their services similar as with most charities.

 

Regarding the funds required; an example, if 2000 members paid in 5000 baht per month, that makes a total of 10 million baht yielded in every month and assuming that not all 2000 members will become seriously ill within the first month of operation then the cooperative has a good chance of succeeding. Also it would have to work on a minimum and maximum basis, meaning not covering medical under 200000 baht so that minor health issues do not place a strain on the funds and then a maximum limit of funds available to a members amounts would be estimated. There would also have to be a period limitations. Example; a long term cancer patient or those affected by long term health problems could not claim off the funds for indefinite periods.

 

I would not describe it as a downside, but yes, it would need experts in the field to setup such a scheme credible enough to convince members to pay in, maybe it could be run by a charity or what we used to call a workers cooperative.  It would be difficult to setup but certainly not impossible.

[Gary A]

I was able to retire at 59 years old. I acquired health insurance right after I got here. I made sure that I had a policy that would never cancel me because of my age. Unfortunately they said nothing about pricing me out. I dropped the policy at age 65 because it simply wasn't worth paying the premium.  I cancelled after giving it a lot of thought and looking closely at the policy, I discovered that the maximum payout per incident had dropped to 1.25 million baht. I can pay that amount myself so it made no sense to continue to pay the ridiculous premium. They went so far as to add a condition where I had to cover a deductible on any incident. During the six years I had the policy I had one claim for appendicitis.

[paulbj2]

5 minutes ago, cyberfarang said:

Not an insurer but a cooperative, which is more like a club than a business and those paying in would be members not customers.  A non-profit organisation does not mean people would work on a voluntary basis, as administrators and other staff would be paid for their services similar as with most charities.

 

Regarding the funds required; an example, if 2000 members paid in 5000 baht per month, that makes a total of 10 million baht yielded in every month and assuming that not all 2000 members will become seriously ill within the first month of operation then the cooperative has a good chance of succeeding. Also it would have to work on a minimum and maximum basis, meaning not covering medical under 200000 baht so that minor health issues do not place a strain on the funds and then a maximum limit of funds available to a members amounts would be estimated. There would also have to be a period limitations. Example; a long term cancer patient or those affected by long term health problems could not claim off the funds for indefinite periods.

 

I would not describe it as a downside, but yes, it would need experts in the field to setup such a scheme credible enough to convince members to pay in, maybe it could be run by a charity or what we used to call a workers cooperative.  It would be difficult to setup but certainly not impossible.

I was using the term "insurer" in its broadest sense but really I am playing devil's advocate here. I like the idea but I'm trying to think of reasons why it wouldn't work. 

 

If you are suggesting an excess (co-pay) of 200,000 Baht, I don't think you would get many takers at 5000Baht/month. I am enthusiastic about the idea but I would not subscribe at that cost/excess ratio.

 

Let me know if you go ahead; I was a database programmer until I retired and you will most likely need one of those.

[Sheryl]

Many posters here seem not to understand the basic principles of health insurance. It is not a form of pre-payment wherein you can expect to get back as much as you pay,and if you don't then you have somehow been scammed.

It works through risk sharing. The majority of people will pay more in premiums than they will get paid out in benefits; they do this knowingly as a safeguard in case they end up in the minority of people whose insurance payouts vastly exceed what they paid in premiums. The one group subsidizes the other, and since there is no way of being sure which group you'll be in, it is prudent to participate.

I have been insured here for decafes. Insurance has paid per policy provisions without fail. Many, many cases on the health forum with same to report including a man with a 3 million baht bill for cancer and heart surgery. (And no, the company did not cancel his policy nor hike up his rates right after.)
Of course not all policies and insurers are the same. One has to do due diligenve in selection and read the policy thoroughly. An astounding number of people fail to do this.

[cyberfarang]

1 minute ago, paulbj2 said:

I was using the term "insurer" in its broadest sense but really I am playing devil's advocate here. I like the idea but I'm trying to think of reasons why it wouldn't work. 

 

If you are suggesting an excess (co-pay) of 200,000 Baht, I don't think you would get many takers at 5000Baht/month. I am enthusiastic about the idea but I would not subscribe at that cost/excess ratio.

 

Let me know if you go ahead; I was a database programmer until I retired and you will most likely need one of those.

I have no intentions of going ahead as I was also a computer and database programmer by trade, I`m only throwing out an idea. Maybe you and I should get together one time?

 

Lets face it, the OP`s plight has seriously brought to light the dire need for some type of viable expat medical coverage in Thailand, considering the probably many thousands of elderly westerners that are here full time now.

[paulbj2]

59 minutes ago, earlinclaifornia said:

Confusing to me anyone speculating Social Security pays overseas costs? No Medicare or Social Security pays overseas costs. Period.

I am assuming that you are talking ONLY about the USA.There are lots of nationalities on this forum so it's probably best to be specific about which country's services you are citing. 

 

The Social Security where I was living until recently, Luxembourg, do pay all overseas costs up to the maximum fees applicable in the "home" country. I was twice treated in hospital here in Thailand, whilst on holiday and the Luxembourg Social Security paid the bills in full. I believe the same applies in Belgium, France, Germany, the Netherlands and doubtless many other European countries.

Edited February 26, 2017 by paulbj2

[the guest]

On 2017-02-25 at 6:46 PM, ajarngreg said:

 

 Nope. Too many foreigners have made the runner after very expensive treatments. 

 

      It's only common sense that they had to change their policy. 

 

Thailand is not Europe, nor are they a charity to foreigners. 

[USPatriot]

On 25/02/2017 at 0:53 AM, marinediscoking said:

Not sure where you get 250K? Looks to me like a 92 honda cb 400? So you could drop 200K off that estimate. 

 

RIP

He could have sold it and purchased a ticket home to get medical help

[cyberfarang]

40 minutes ago, USPatriot said:

He could have sold it and purchased a ticket home to get medical help

Or it could be that bike was rented or the bike was borrowed from a friend or be bought second hand from somewhere and it wasn`t worth much or he even stole it. The possibilities are endless.

[TallGuyJohninBKK]

3 hours ago, catman20 said:

KK being khon khen????????

Yes, with allowances for the spelling.

 

[TallGuyJohninBKK]

There are LOTS of medical/health insurance policies from many providers available in Thailand, both from Thai companies and internationally affiliated companies. And then on top of that, there are accident-only medical policies, which I presume would have at least covered the person who died in this situation had he fared better in the crash.

 

As some have mentioned above, however, the most common kinds of issues that prevent people from keeping local health insurance here probably include:

--getting priced out of the policy as they get older.

--waiting until they're too old to begin new coverage.

--having too many pre-existing condition exclusions to make keeping the policy sensible, etc etc.

--and probably a lot of folks who figure they're just going to take the risk and face paying future bills themselves.

 

I don't know the victim here, of course. But I can only presume, at his age (one media report said age 39), that he would have been able to obtain local medical insurance with reasonable coverage at a reasonable price -- if he either had the money to pay for it, and/or, was willing to spend the money to pay for it. Perhaps he didn't have enough money, and that's the same reason he didn't end up traveling back to his home country to seek treatment there.

 

Again, lots of things to speculate on, and not a lot of known facts.