Emergency patients forced to pay for ‘free’ care

[webfact]

Emergency patients forced to pay for ‘free’ care
By Chularat Saengpassa
The Nation

 

 

BANGKOK: -- MORE THAN half of the 912 patients who sought the government’s much-advertised free emergency medical help between April 1 and 9 found themselves labelled “unqualified” at hospitals.

 

Earlier this year, the Public Health Ministry vowed to ensure that all emergency patients would receive free medical services within 72 hours of developing life-threatening symptoms, from April 1 onwards.

 

But 527 of 912 people whose families believed they were in life-or-death situations were declared ineligible for free medical treatment.

 

According to hospital staff, conditions were not life-threatening, even without immediate help. Their families were told there was still time to transfer them to other hospitals, particularly those where they would have the right to free medical services.

 

“I was at a loss when hospital staff told me that my husband could not receive free emergency medical services,” Achara Saravari said yesterday.

 

Her 47-year-old husband Natree Saravari, secretary-general of the Issarachon Foundation that protects homeless people, was found unconscious in the bathroom of their Bangkok home on Sunday.

 

She took him straight to Synphaet Hospital, where she initially asked for free treatment under an accident case and then the 72 hours of free emergency treatment. But both requests were rejected.

 

“I was told he had not sustained head injuries, so his case did not qualify as an accident. As for free emergency treatment, his case did not qualify either. But doctors also told me that his condition was serious and that he might die without surgery,” Achara said. She said the hospital demanded Bt450,000 for the treatment, more than the family’s savings.

 

“In the end, I had to turn to social media to raise the funds,” she said.

 

After Natee’s case drew widespread public attention, the National Institute of Emergency Medicine (NIEM), the Health Service Support Department and Synphaet Hospital officials met for discussions. They eventually agreed to count Natee as an emergency patient and that his surgery, as well as other medical services he had already received at Synphaet, would be free.

 

Yesterday, Natee’s condition had improved. He was conscious and could move his arms. He will be transferred to another hospital where he is entitled to receive free treatment via the universal coverage healthcare scheme.

 

NIEM deputy secretary-general Dr Phumin Silaphan said the Synphaet Hospital had declared Natee as unqualified at first because it had not fully understood the process.

 

“The policy has just been introduced,” Phumin explained.

 

He vowed to increase hospitals’ understanding of the process, which offered a pre-authorisation function to make things clearer.

 

NIEM secretary-general Atchariya Pangma separately advised people to contact the Universal Coverage for Emergency Patients (UCEP) if they thought they needed free treatment related to medical emergencies.

 

“We will try to increase public understanding as to what defines medical emergencies,” he said.

 

Atchariya said emergency patients must have serious health conditions such as sudden and serious chest pains and persistent seizures to qualify for the free emergency treatment.

 

He said people could contact UCEP by phone on 02- 872- 1669 or email [email protected].

 

Speaking on condition of anonymity, a doctor said families and doctors usually had different things in mind when they thought of “serious medical emergency cases”.

 

Achara said had her husband’s case not made the news, she might have had to shoulder the huge medical expenses herself.

 

Source: http://www.nationmultimedia.com/news/national/30311932

 

-- © Copyright The Nation 2017-04-11

[starky]

So sorry we didn't understand so instead of showing compassion we asked for money instead. Mai pen rai. 

[ukrules]

It's not an emergency but he will die if not treated urgently, give us all your money or he will die.

 

I think I've got the general idea of what's going on here.

[Borzandy]

Who can believe about free hospital in Thailand. Maybe a frequent traveller...

[r136dg]

Not directly related, but many government emergency rooms & staff are overwhelmingly bogged down with life threatening headaches and stomach aches. What blows me away, is more often than not, doctors will prescribe antibiotics for just about anything.

[Thunder26]

9 minutes ago, r136dg said:

Not directly related, but many government emergency rooms & staff are overwhelmingly bogged down with life threatening headaches and stomach aches. What blows me away, is more often than not, doctors will prescribe antibiotics for just about anything.

And paracetamol!

[williamgeorgeallen]

well almost no one pays taxes in thailand so hospitals are under funded. people moan about lack of subsidized healthcare but start to tax the masses and people will moan a lot louder.

[SOUTHERNSTAR]

29 minutes ago, williamgeorgeallen said:

well almost no one pays taxes in thailand so hospitals are under funded. people moan about lack of subsidized healthcare but start to tax the masses and people will moan a lot louder.

You are right but also wrong. Yes many dont pay direct taxes but everyone pays indirect taxes such as VAT. The country has more than enough tax income if it is spend wisely, no subs, tanks, less generals, smaller effecient civil service and no tea money. If these savings are brought into account the country can have the best medical services in the world for free. 

[robblok]

35 minutes ago, williamgeorgeallen said:

well almost no one pays taxes in thailand so hospitals are under funded. people moan about lack of subsidized healthcare but start to tax the masses and people will moan a lot louder.

Your right Thailand has a real bad tax base, but they could try to spend their money better.. less on the army more on the health budget. Still your right a big group of people does not pay any taxes even though they are not poor.  Its hard to collect from people with their own business (as a private person). They just don't file all their income. Also too much is given out to the farmers.. that could go to the health budget too.. those 500billion of YL  in the rice program is TWICE the anual budget of healthcare. Not really fair that such a small group receives so much while others who pay in the system don't get much. 

[maoro2013]

39 minutes ago, williamgeorgeallen said:

well almost no one pays taxes in thailand so hospitals are under funded. people moan about lack of subsidized healthcare but start to tax the masses and people will moan a lot louder.

Anyone who buys anything in Thailand pays taxes. There is a thing called VAT, and on top of that there is excise for instance. I don't think too many people are tax free.

[williamgeorgeallen]

6 minutes ago, SOUTHERNSTAR said:

You are right but also wrong. Yes many dont pay direct taxes but everyone pays indirect taxes such as VAT. The country has more than enough tax income if it is spend wisely, no subs, tanks, less generals, smaller effecient civil service and no tea money. If these savings are brought into account the country can have the best medical services in the world for free. 

yes, you are right but you are also wrong. the VAT system is very poorly run in thailand. i know several business owners who basically avoid it. my accountant actually suggested my business just pay 1000thb VAT despite turning over about 500k/month. i agree that the military budget is basically a waste of money especially the big ticket items.

[robblok]

8 minutes ago, williamgeorgeallen said:

yes, you are right but you are also wrong. the VAT system is very poorly run in thailand. i know several business owners who basically avoid it. my accountant actually suggested my business just pay 1000thb VAT despite turning over about 500k/month. i agree that the military budget is basically a waste of money especially the big ticket items.

Yes you are right and many small shops especially in the poor area's dont charge vat at all.. That is a big problem.

[robblok]

10 minutes ago, maoro2013 said:

Anyone who buys anything in Thailand pays taxes. There is a thing called VAT, and on top of that there is excise for instance. I don't think too many people are tax free.

Many small shops don't charge VAT at all

[PatOngo]

Excellent!....the free lunch only costs 300 baht!

[maoro2013]

18 minutes ago, robblok said:

Many small shops don't charge VAT at all

Well they actually do. They have paid VAT to the wholesalers so it is part of the cost price of the goods, therefore it is in the selling price but not shown on any form of receipt. I agree that the small businesses are not marking up the VAT on their level of service, but still this tax is being collected at the wholesaler level and being paid by the ultimate retail customer.

[kiwikeith]

1 hour ago, Borzandy said:

Who can believe about free hospital in Thailand. Maybe a frequent traveller...

 

It just goes to show, what we already know, corruption is rife everywhere in this country this is a very sick example of it.

We intend to flout the law and demand 450k BHT from you or you can die, someone should be arrested over this as it is disgusting.

[jacko45k]

Quote

declared Natee as unqualified at first because it had not fully understood the process.

So people can die while they figure it out, rather than be treated until they do.

[robblok]

20 minutes ago, maoro2013 said:

Well they actually do. They have paid VAT to the wholesalers so it is part of the cost price of the goods, therefore it is in the selling price but not shown on any form of receipt. I agree that the small businesses are not marking up the VAT on their level of service, but still this tax is being collected at the wholesaler level and being paid by the ultimate retail customer.

Yes they paid VAT but then sell it at a profit and that margin is not taxed by VAT.. people buying stuff at markets don't pay VAT at all as much of the stuff is never taxed and they shop owner does not pay vat at all (talking fruits and veggies here )

[New beginnings]

"In the end, I had to turn to social media to raise the funds,” she said.

 

It will be interesting to find out if she is going to give the money raised back or keep it.

 

What do you think?

[Bluespunk]

4 hours ago, webfact said:

 

“I was told he had not sustained head injuries, so his case did not qualify as an accident. As for free emergency treatment, his case did not qualify either. But doctors also told me that his condition was serious and that he might die without surgery,” Achara said. She said the hospital demanded Bt450,000 for the treatment, more than the family’s savings.

Ok, that is a terrible situation to be in. However did the hospital actually refuse treatment before payment or say the family would eventually have to pay? 

 

One situation is more worthy of condemnation than the other. 

[SiSePuede419]

"She said the hospital demanded Bt450,000 for the treatment, more than the family’s savings.

 

“In the end, I had to turn to social media to raise the funds,” she said."

 

Nooooo.  She could take taxi to Government hospital.  Surgery only 30B.

 

You're welcome! ?

[AGareth2]

well it would seem that a heart attack is covered

Synphaet has a cath lab

[Thaidream]

Another situation where administrators and doctors simply cannot understand or don't care that medical care is a human right. Money should never be considered when a person is ill. Unfortunately Thailand is following the American Medical system where in some cases patients are transported to other hospitals even when seriously ill due to lack of funds or at other times- actually dumped on the street if they are indigent.

[janpharma]

Sew the hospital director and take him to Court!

[robblok]

6 minutes ago, Thaidream said:

Another situation where administrators and doctors simply cannot understand or don't care that medical care is a human right. Money should never be considered when a person is ill. Unfortunately Thailand is following the American Medical system where in some cases patients are transported to other hospitals even when seriously ill due to lack of funds or at other times- actually dumped on the street if they are indigent.

I don't know where you are from but even in Europe its not so that there is unlimited money. Would spending money on a young kid with a life ahead of him on a new kidney not be better then spending loads of money on a new hip for an elderly person with maybe 4 years to live. That is what is the problem with the onset of new technology healthcare is getting more and more expensive  (more is possible) and the system needs to be fed by contributions and taxes and people are already moaning about those. So even in the West its not an system that is unlimited some treatments are just too expensive. Sad but true. Otherwise premiums (by tax or otherwise) would skyrocket.

[hellstens]

I pay 20% Tax in sweden and now they want to raise it to 25%! And I don't get Nothing in return!

If I live inside EU I have health care

but we who live outside EU get Nothing at all!  Is that Fair?  

[janpharma]

Two years ago I had a very bad accident and broke my elbow on several places; I went to a local private hospital where they took an X-ray and told me that is was to bad and they couldn't help me.  So I went to a (Bangkok-) Hospital where they took a look at the X-ray and said that it needed urgent surgery...But...I had to "show the money" first.

They put me in a wheel chair and took me to the (3) ATM stands where I had to take out as much as cash as possible.

I offered to make the payment with my credit card but they refused because they wanted "cash now".  Of course the withdrawal is limited and when they saw that I did my utmost they finally agreed to operate...

[ujayujay]

Free emergency medical help program seems to be a invitation to go to hospital for every trifle in TH.

[Andrew65]

3 hours ago, robblok said:

Your right Thailand has a real bad tax base, but they could try to spend their money better.. less on the army more on the health budget. Still your right a big group of people does not pay any taxes even though they are not poor.  Its hard to collect from people with their own business (as a private person). They just don't file all their income. Also too much is given out to the farmers.. that could go to the health budget too.. those 500billion of YL  in the rice program is TWICE the anual budget of healthcare. Not really fair that such a small group receives so much while others who pay in the system don't get much. 

Around the time that the rice scheme was going on, Spectrum in the BP interviewed a rice farmer up north.

 

He stated that at 15,000 Baht a ton he was getting around 5,000, the balance going mainly to merchants., his overheads then had to come out of the 5k.

 

He was looking for other crops as an alternative

[Bob12345]

Quote

“I was told he had not sustained head injuries, so his case did not qualify as an accident. As for free emergency treatment, his case did not qualify either. But doctors also told me that his condition was serious and that he might die without surgery,”

This is very open for interpretation; if you have cancer and go without treatment (surgery and/or chemo) you will die, but there is no problem to wait with the treatment a couple of hours or days. While the illness is life threatening, it does not require immidiate treatment. In such a case the hospital would be right to refuse free treatment and demand payment.

 

Quote

After Natee’s case drew widespread public attention, the National Institute of Emergency Medicine (NIEM), the Health Service Support Department and Synphaet Hospital officials met for discussions. They eventually agreed to count Natee as an emergency patient and that his surgery, as well as other medical services he had already received at Synphaet, would be free.

So what does this mean? Are "they" saying that the hospital made a mistake by not allowing free treatment immediately or are they just saying this to avoid public scrutiny? And if the hospital made a mistake, what actions will be taken to avoid this happening again in the future? Or does this mean that you can anything as long as you get enough likes on your story in social media?

Edited April 11, 2017 by Bob12345