Special Report: Phuket hospitals facing huge losses from uninsured patients

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Special Report: Phuket hospitals facing huge losses from uninsured patients

Phuket Gazette

 

Last year, Vachira Phuket Hospital wrote off 4.3 million baht of unpaid bills incurred by uninsured foreign patients, with the total amount over nine years being 24 million baht. Photo: Gazette file

 

PHUKET: -- There is no lack of evidence about the alarming number of tourist deaths in the 'Land of Smiles'. According to the ‘Bureau of Prevention and Assistance in Tourist Fraud’, there was a whopping 54 per cent increase in tourist deaths in 2015 as compared to 2014. This figure only counts tourists. The actual number including expats is likely higher, as can be seen in the statistics provided by the Farang Deaths project. 

The Australian Department of Foreign Affairs and Trade estimated that there were 109 deaths of Australians alone in Thailand between July 2014 and June 2015. Given the likelihood that a foreigner might be injured in Phuket, clear protocols on uninsured foreign patients are surprisingly missing.

According to Methavee Maneesri of Vachira Phuket Hospital, when foreign patients are unable to pay their bills, the hospital has to absorb the expenses. Last year alone, the hospital wrote off 4.3 million baht of unpaid bills incurred by foreign patients. Over the last nine years, Vachira Phuket Hospital says it has written off more than 24 million baht in such losses. 

“Due to medical ethics, we do not pick and choose patients before we initiate life-saving treatment. The questions of payment and insurance coverage are always secondary to saving patients’ lives,” said Ms Methavee. However, patients with non-life-threatening conditions will be asked to show proper insurance coverage or make an adequate deposit before treatment is administered. 

 

Full story: http://www.phuketgazette.net/phuket-news/Special-Report-Phuket-hospitals-facing-huge-losses/66485?desktopversion

 

-- © Copyright Phuket Gazette 2017-04-18

[LivinginKata]

I encourage forum members to read the full article .... quite illuminating. Visitors here with no insurance - who is supposed to pay in the event of an accident ?? Oh well ... always the gofundme page ... 

[smedly]

This country makes a huge amount of money from tourists, it is a vital part of GDP and has been the case for decades, the problem is that there are no safety standards or at least they are not enforced making Thailand (no matter how much they claim otherwise) and extremely dangerous place to holiday.

 

The costs quoted in the OP are not only tiny but are very likely exaggerated, when you consider the actual cost in terms of labour and materials without profit it is no where near what they are quoting.

 

Yes people should have insurance when they go on holiday but equally there is a duty of care to keep visitors safe when they visit Thailand, when they are injured through no fault of their own then Thailand should be willing to step up and compensate. 

 

They have gotten away with this for far too long, they have had decades to improve things but instead stuffed the money in their greedy pockets showing no consideration to improve their health and safety.........and yes I for once agree in this instance of that commonly used Thai phrase - well if they hadn't come to Thailand it wouldn't have happened so it must be their fault, might be time for people to rethink their holiday destinations.

 

If a Thai goes to the UK on holiday they will be treated in hospital like everyone else, the difference being that the likelihood of something happening to them is vastly different.

 

 

So a few million here and there .................so what, you are making trillions in tourism.

[hakancnx]

World be interesting to know how much these 24 millions are in percentage of the total turnover.  Think is less then 1.....

[hakancnx]

And also who is not paying. Is it migrant workers, expats or tourists?

[maewang99]

57 minutes ago, hakancnx said:

And also who is not paying. Is it migrant workers, expats or tourists?

do they have a way to tell if someone is a tourist?

isn't it like figuring out if someone is a student?

 

or is or is not a "foreign" investor ???

 

not that I know of.

Edited April 18, 2017 by maewang99

[simoh1490]

A large hospital wrote off 2.7 million baht a year for nine years as a result of unpaid medical bills, that's a very very very small amount by anyone's standards..

[maewang99]

yeah, it's relatively de minimis an amount.... 

 

but the hospitals are also increasingly in trouble.. so it's now a bigger issue and going forward doesn't get better at all very probably.

 

[simoh1490]

1 minute ago, maewang99 said:

yeah, it's relatively de minimis an amount.... 

 

but the hospitals are also increasingly in trouble.. so it's now a bigger issue and going forward doesn't get better at all very probably.

 

Indeed, I read that nineteen governement hospitals in Thailand, some quite large, are broke hence this doesn't improve the picture.

[the guest]

If the government was smart, it would make it compulsory for all foreigners to have full insurance before a visa would be granted. It solves a lot of problems.

[simoh1490]

1 minute ago, the guest said:

If the government was smart, it would make it compulsory for all foreigners to have full insurance before a visa would be granted. It solves a lot of problems.

Sensible for tourists of course - but what would you suggest for the nearly 3 million resident expats who already live here, many of whom have lived here for ten years or more, are over the 70, have pre-existing conditions and are unable to buy health insurance in Thailand.

[smedly]

7 hours ago, the guest said:

If the government was smart, it would make it compulsory for all foreigners to have full insurance before a visa would be granted. It solves a lot of problems.

actually all they have to do is charge every foreigner 500baht when they enter Thailand and the problem is solved .........................................oh wait they already do that

 

How about stop complaining and take care of visitors here, how many actually end up in hospital and how many end up in hospital because of the none existence of safety

 

 

Thailand needs to take it on the chin and realise that they have a responsibility and duty to take care of people that choose to come here for a holiday............what is 20% of GDP worth

[wakeupplease]

there was a whopping 54 per cent increase in tourist deaths in 2015

 

Only in this neck of the woods, it does not happen in L/C/V, death rate here higher than any other country (wars apart) by the looks of things.

 

A country in the grips of crime and watch it get worse

[geriatrickid]

11 hours ago, simoh1490 said:

A large hospital wrote off 2.7 million baht a year for nine years as a result of unpaid medical bills, that's a very very very small amount by anyone's standards..

Do  the math,  it's a higher number. Let's just  deal with the 4.3 million baht from last year.

The money had to come from somewhere and it was the general operating budget. The deadbeat patients inflict harm on others and are a threat to public safety.

 

Vachira Phuket Hospital is a 503 bed general hospital  providing medical care to those Thais who are unable to afford the higher end pay private hospitals. Vachira already operates on a  shoestring budget  struggling to serve a growing population with diverse and complex needs. The patients are typically the poor, and economically marginalized. They are the elderly, the low paid workers and anyone else who has limited financial means.  When  deadbeat patients fail to pay, the money has to come from somewhere and that means vulnerable sick Thais. Some poor kid is denied a non critical surgery, or an  old granny's thyroid cancer goes undiagnosed because she can't access the necessary tests.

 

The hospital has shortages of specialized  physicians and other technical specialists because the hospital cannot pay their salaries. The hospital cannot use  some tests and modern equipment to treat some patients because it does not have the funds to  pay for it. This is what happens when people do not pay their bills.

 

10 hours ago, simoh1490 said:

Sensible for tourists of course - but what would you suggest for the nearly 3 million resident expats who already live here, many of whom have lived here for ten years or more, are over the 70, have pre-existing conditions and are unable to buy health insurance in Thailand.

Where did you come up with 3 million? Try a number of legal foreign residents at less than 500,000. There may be many more, but those are illegal undocumented people like  Myanmar and Cambodian quasi slave labour.  Of the legal residents, a majority still avail themselves of their homeland's health services.

 

You are wrong when you state that people over the age of 70 who have pre-existing conditions are unable to buy health insurance in Thailand. it is available, but these people  do not accept the premium, nor the conditions of coverage.  One can obtain coverage if one   isn't greedy and and uses common sense. The way to do this is;

1. Consider the use of a large deductible or retention.

2. Accept the fact that  no insurer is going to cover  cancer if one is undergoing treatment or had a cancer in remission. Don't expect an insurer to cover a heart attack in someone who has had one already.

3. Understand that an insurance policy is a risk transfer contract where one party purchases the risk of the other for a price. If the  person trying to offload the risk thinks the insurer is charging too much, then fine, the person can keep his risk.

 

Uninsured western patients in Thailand have typically been people who should not have been in Thailand, or who have lived a hand to mouth existence..  If you want to live in a country like Thailand, you need to be able to accept the costs that go along with it. If you cannot, go home and live in a sheltered society.

 

 

 

[simoh1490]

12 minutes ago, geriatrickid said:

Do  the math,  it's a higher number. Let's just  deal with the 4.3 million baht from last year.

The money had to come from somewhere and it was the general operating budget. The deadbeat patients inflict harm on others and are a threat to public safety.

 

Vachira Phuket Hospital is a 503 bed general hospital  providing medical care to those Thais who are unable to afford the higher end pay private hospitals. Vachira already operates on a  shoestring budget  struggling to serve a growing population with diverse and complex needs. The patients are typically the poor, and economically marginalized. They are the elderly, the low paid workers and anyone else who has limited financial means.  When  deadbeat patients fail to pay, the money has to come from somewhere and that means vulnerable sick Thais. Some poor kid is denied a non critical surgery, or an  old granny's thyroid cancer goes undiagnosed because she can't access the necessary tests.

 

The hospital has shortages of specialized  physicians and other technical specialists because the hospital cannot pay their salaries. The hospital cannot use  some tests and modern equipment to treat some patients because it does not have the funds to  pay for it. This is what happens when people do not pay their bills.

 

Where did you come up with 3 million? Try a number of legal foreign residents at less than 500,000. There may be many more, but those are illegal undocumented people like  Myanmar and Cambodian quasi slave labour.  Of the legal residents, a majority still avail themselves of their homeland's health services.

 

You are wrong when you state that people over the age of 70 who have pre-existing conditions are unable to buy health insurance in Thailand. it is available, but these people  do not accept the premium, nor the conditions of coverage.  One can obtain coverage if one   isn't greedy and and uses common sense. The way to do this is;

1. Consider the use of a large deductible or retention.

2. Accept the fact that  no insurer is going to cover  cancer if one is undergoing treatment or had a cancer in remission. Don't expect an insurer to cover a heart attack in someone who has had one already.

3. Understand that an insurance policy is a risk transfer contract where one party purchases the risk of the other for a price. If the  person trying to offload the risk thinks the insurer is charging too much, then fine, the person can keep his risk.

 

Uninsured western patients in Thailand have typically been people who should not have been in Thailand, or who have lived a hand to mouth existence..  If you want to live in a country like Thailand, you need to be able to accept the costs that go along with it. If you cannot, go home and live in a sheltered society.

 

 

 

The article states, " total amount over nine years being 24 million baht" which is 2.66 million per year!

 

I agree that it is possible for expats over 70 years of age and living in Thailand with pre-existing conditions to buy health insurance, but in most cases it is so massively expensive as to be virtually impossible for a majority who live here on fixed income, at poor exchange rates and at times of low rates of investment returns, even with high deductibles. I think it is very unlikely that a long term expat resident who has lived here for more than twenty years, someone who has a wife, children and all his economic resources in Thailand is going to be unwilling or unable to pay premiums of say 15/20k a month and a deductible of 300k - many of those people didn't come here to live hand to mouth and probably don't do so today, they suffered as a result of the global economic downturn and they weathered through it all but simply don't have enough funds today to buy the needed extras described here. Whether or not they should go home is another subject I don't wish to debate, the fact remains that annual losses of 2.7 million baht resulting from non-payment, is a small loss by anyone's standards considering it is a significant hospital..

[the guest]

12 hours ago, simoh1490 said:

Sensible for tourists of course - but what would you suggest for the nearly 3 million resident expats who already live here, many of whom have lived here for ten years or more, are over the 70, have pre-existing conditions and are unable to buy health insurance in Thailand.

3 million, hardly. Sorry to say Thailand is for Thais, and come here with your conditions expecting the taxpayer to pay for your medical bills?  This isn't Europe.

[simoh1490]

35 minutes ago, the guest said:

3 million, hardly. Sorry to say Thailand is for Thais, and come here with your conditions expecting the taxpayer to pay for your medical bills?  This isn't Europe.

You're right, it's closer to 4 million!  http://www.burning-bison.com/expats.htm

 

But that includes ALL nationalities and not just farangs, Cambodians, Chinese (14% of the population), Burmese etc. And I know from various discussions on this subject over the years that even a remotely precise answer is difficult to nail down but don't let that stop you trying!

 

BTW, I don't expect anyone to pay my medical bills here or in the UK, nobody except me and I'm not one of the crowd who lives here and pretends to the UK governement that they really live back home, just so they can get free NHS access and pension payment top ups!

 

For reference re. 14% of the population: https://en.wikipedia.org/wiki/Thai_Chinese

Edited April 19, 2017 by simoh1490

[Deli]

Vachira should get reimbursed from the Taxi and Tuk Tuk cartel, as they are highly overcharging every visitor using their "services"

[schlog]

The big wigs of Phuket should indepedent take care about this subject. They generate more per day by the tourists and spend not less then this sum for a MiaNoi car.

[helloagain]

4.3 m baht is not a huge loss. What is their OVERALL PROFIT. and why are their prices sky high when everything is cheaper than england.......land hospital sits on. Staff wages are cheaper etc etc etc. And when its time to pay you are asked if you have insurance. If you do have then the price goes way up which makes insurance policies too expensive to buy.....catch 22. Hospitals stop ripping people off should be the headline news. Hospitals you really do extract the urine

[schlog]

6 minutes ago, helloagain said:

4.3 m baht is not a huge loss. What is their OVERALL PROFIT. and why are their prices sky high when everything is cheaper than england.......land hospital sits on. Staff wages are cheaper etc etc etc. And when its time to pay you are asked if you have insurance. If you do have then the price goes way up which makes insurance policies too expensive to buy.....catch 22. Hospitals stop ripping people off should be the headline news. Hospitals you really do extract the urine

Vachira is no private hospital and has for sure no sky high prices!

[simoh1490]

The following article states there is over 300,000 migrant workers in Phuket, half of whom have no medical insurance and cannot/do not pay their bills - the bill for treating migrant workers by the three main governement hospitals in 2016 was a whopping 94 million baht. A write off of 2.7 million baht per year is paltry  when you consider those numbers: http://www.nationmultimedia.com/news/national/30305745

[henry15]

15 hours ago, smedly said:

This country makes a huge amount of money from tourists, it is a vital part of GDP and has been the case for decades, the problem is that there are no safety standards or at least they are not enforced making Thailand (no matter how much they claim otherwise) and extremely dangerous place to holiday.

 

The costs quoted in the OP are not only tiny but are very likely exaggerated, when you consider the actual cost in terms of labour and materials without profit it is no where near what they are quoting.

 

Yes people should have insurance when they go on holiday but equally there is a duty of care to keep visitors safe when they visit Thailand, when they are injured through no fault of their own then Thailand should be willing to step up and compensate. 

 

They have gotten away with this for far too long, they have had decades to improve things but instead stuffed the money in their greedy pockets showing no consideration to improve their health and safety.........and yes I for once agree in this instance of that commonly used Thai phrase - well if they hadn't come to Thailand it wouldn't have happened so it must be their fault, might be time for people to rethink their holiday destinations.

 

If a Thai goes to the UK on holiday they will be treated in hospital like everyone else, the difference being that the likelihood of something happening to them is vastly different.

 

 

So a few million here and there .................so what, you are making trillions in tourism.

So if some drunk idiot on a motorbike who even don't wear an helmet, has an accident, he should not  have to pay for his medical bills.

Edited April 19, 2017 by henry15

[trawler]

In order to get a Schengen visa for my Thai wife I had to prove that we had a minimum of Euro 30000 health insurance coverage.This applies to all Thais applying for visa's to Europe.So whats wrong with requiring that tourists to Thailand have similar coverage??????

If you wish to live in a foreign country where you are ineligible for local health care then surely you have either health insurance or self cover.

This is common sense and stating that lots of expats here cannot get coverage is not a excuse for becoming a burden on a foreign country.

This nanny state mentality is becoming so pervasive that people are not thinking anything through for themselves.

[masuk]

13 hours ago, simoh1490 said:

Sensible for tourists of course - but what would you suggest for the nearly 3 million resident expats who already live here, many of whom have lived here for ten years or more, are over the 70, have pre-existing conditions and are unable to buy health insurance in Thailand.

How very true.  Even the airlines won't insure you for travel only,  once you are 75.

I've been zapped twice through faulty electrical wiring, wrecked a pair of expensive glasses on a Chiang Mai footpath pothole, gave up the m/bike 2 years ago.    It's never boring!!

[simoh1490]

3 minutes ago, trawler said:

In order to get a Schengen visa for my Thai wife I had to prove that we had a minimum of Euro 30000 health insurance coverage.This applies to all Thais applying for visa's to Europe.So whats wrong with requiring that tourists to Thailand have similar coverage??????

If you wish to live in a foreign country where you are ineligible for local health care then surely you have either health insurance or self cover.

This is common sense and stating that lots of expats here cannot get coverage is not a excuse for becoming a burden on a foreign country.

This nanny state mentality is becoming so pervasive that people are not thinking anything through for themselves.

Talking about not thinking things through: I don't believe it's the farang expats who are the burden, if you read the earlier link provided it seems the greater problem is the 150,000 foreign workers in Phuket who have no insurance and no money.

Edited April 19, 2017 by simoh1490

[RigPig]

16 hours ago, smedly said:

This country makes a huge amount of money from tourists, it is a vital part of GDP and has been the case for decades, the problem is that there are no safety standards or at least they are not enforced making Thailand (no matter how much they claim otherwise) and extremely dangerous place to holiday.

 

The costs quoted in the OP are not only tiny but are very likely exaggerated, when you consider the actual cost in terms of labour and materials without profit it is no where near what they are quoting.

 

Yes people should have insurance when they go on holiday but equally there is a duty of care to keep visitors safe when they visit Thailand, when they are injured through no fault of their own then Thailand should be willing to step up and compensate. 

 

They have gotten away with this for far too long, they have had decades to improve things but instead stuffed the money in their greedy pockets showing no consideration to improve their health and safety.........and yes I for once agree in this instance of that commonly used Thai phrase - well if they hadn't come to Thailand it wouldn't have happened so it must be their fault, might be time for people to rethink their holiday destinations.

 

If a Thai goes to the UK on holiday they will be treated in hospital like everyone else, the difference being that the likelihood of something happening to them is vastly different.

 

 

So a few million here and there .................so what, you are making trillions in tourism.

Fair comment, but when I see the Russian family up the road going 4 up on a scooter, the youngest probably about 2 or 3 years old, all wearing helmets but the kids helmets didn't fit (you can't get them that small) and he got annoyed when I said "so you don't love your children" well who's fault is it?  The parents have a choice but the kids don't!!  Who is going to come off worse and who will pay for it when they do?  This sort of thing doesn't happen in England or Australia or anywhere else in the civilised world.  There aren't too many motorbikes in Siberia!!  Why do they think tis is OK here, the locals do it from necessity and it is THEIR country, but when it hits the fan they (tourists) expect 1st world treatment and then go home without paying the bill

[wombat]

with the turn over of regular paying patients i find this banner hard to believe

 

[masuk]

2 minutes ago, trawler said:

In order to get a Schengen visa for my Thai wife I had to prove that we had a minimum of Euro 30000 health insurance coverage.This applies to all Thais applying for visa's to Europe.So whats wrong with requiring that tourists to Thailand have similar coverage??????

If you wish to live in a foreign country where you are ineligible for local health care then surely you have either health insurance or self cover.

This is common sense and stating that lots of expats here cannot get coverage is not a excuse for becoming a burden on a foreign country.

This nanny state mentality is becoming so pervasive that people are not thinking anything through for themselves.

The nanny state so commonly quoted here, is usually a country where one has paid taxes all of one's working life, and in return, a pension is paid and also medical care.  

 

Some of the bigger countries do not assist their poor or elderly.  What do you call them?

[williamgeorgeallen]

14 hours ago, simoh1490 said:

A large hospital wrote off 2.7 million baht a year for nine years as a result of unpaid medical bills, that's a very very very small amount by anyone's standards..

yea but it makes it look like we are a problem. sure the profit margin is very good off foreigners. actually i suspect the double pricing become quadruple pricing when an insurance company is being billed.