Special Report: Phuket hospitals facing huge losses from uninsured patients

[hawker9000]

On 4/18/2017 at 6:28 PM, 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.

What a supremely simpleminded idea!  'Just another excuse for a money-grab.  And if it's to be a traveler's existing insurance policies to be checked rather than just a new visa fee - which will just end up paying for chinese submarines and tanks - it WILL add incalculably to entry queues and unpredictability.  It's equally ridiculous to push it all off onto individual consulates who'll each interpret the new reqts differently.

 

This is actually really straightforward.  Address the CONSEQUENCES (of being a deadbeat).  Make it painful and predictable enough and they'll stop coming.  And if they're expats living here with property and belongings to lose and possibly even families & girlfriends, they'll think twice before risking their own summary deportation and blacklisting.

[simoh1490]

3 hours ago, SiSePuede419 said:

If these people went to a Government hospital, we wouldn't be having this discussion.  Private hospitals are expensive.  Government hospitals are cheap.  Surprising how many people don't know, don't care or think they are "too good" to wait in line. ?

Er, um, the hospital mentioned in the OP IS a governement hospital!

[bazza73]

I'm over 70, and any medical insurance I can get in Thailand is ruinously expensive. My solution is to maintain my private health insurance in Australia, and keep 500,000 baht in a sinking fund here for hospital.treatment.

Realistically, the only time I'll need high level treatment here is if I'm in a traffic accident, or have a heart attack/stroke. For anything else, get on a flight to Australia.

Possibly not the best solution; however, I refuse to shell out 250,000 baht a year to the insurers. Greedy bastards.

[teddog]

Just now, bazza73 said:

I'm over 70, and any medical insurance I can get in Thailand is ruinously expensive. My solution is to maintain my private health insurance in Australia, and keep 500,000 baht in a sinking fund here for hospital.treatment.

Realistically, the only time I'll need high level treatment here is if I'm in a traffic accident, or have a heart attack/stroke. For anything else, get on a flight to Australia.

Possibly not the best solution; however, I refuse to shell out 250,000 baht a year to the insurers. Greedy bastards.

Not the way,not the way by a mile. You are here to be cleaned out  (by BUPA) too

[teddog]

Put this comment in another thread running alongside this thread,guess its all same-same

 

Id say so too.  Had a couple of run-ins with these damned private hospitals years ago...pneumonia,ICU  nobody came all night,doctor in morning,told them this is insane Im checking out, half full oxygen bottles changed mad rush for more medications,even more of whatever to bump that bill up,yes was a bill,about70,000,   Demanded to see director of hospital,told him Im not paying for this crap and call the police.  He asked how much would I like to pay,a third I replied  OK he said

    Pharmacy ,with guy in charge would have been more than sufficient

  Another time,skin cancer, now I knew the doctor was lying  told him so   ,behind the ear stuff, on further test  no cancer

  Hope all you filled up to the brim medical insurance types,paying for "peace of mind"  hefty sum types never get to use it,you can look back at a waste of money,but then maybe not,..do govt. hospitals do insurance?

[simoh1490]

3 minutes ago, teddog said:

Put this comment in another thread running alongside this thread,guess its all same-same

 

Id say so too.  Had a couple of run-ins with these damned private hospitals years ago...pneumonia,ICU  nobody came all night,doctor in morning,told them this is insane Im checking out, half full oxygen bottles changed mad rush for more medications,even more of whatever to bump that bill up,yes was a bill,about70,000,   Demanded to see director of hospital,told him Im not paying for this crap and call the police.  He asked how much would I like to pay,a third I replied  OK he said

    Pharmacy ,with guy in charge would have been more than sufficient

  Another time,skin cancer, now I knew the doctor was lying  told him so   ,behind the ear stuff, on further test  no cancer

  Hope all you filled up to the brim medical insurance types,paying for "peace of mind"  hefty sum types never get to use it,you can look back at a waste of money,but then maybe not,..do govt. hospitals do insurance?

Govt. hospitals cater for Thai insurance, particularly the 30 baht scheme. It is at the discretion of the insurer whether or not a customer can become a patient of a particular hospital and have their treatment covered, for some insurers that is a quality issue, for others it's a cost issue - major regional hospitals are set up to accept private health insurance, smaller ones may not be.

[chrissables]

On 4/18/2017 at 6:28 PM, 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.

So if you can't get insurance, you can't enter? Self insure? 

 

The problem is in fact so small, they charge enough to soak up this very minor amount. 

 

The bill they would like paid, has no relevance to the loss. The mark up is very high.

 

Maybe they should publish the total money taken per year (including cash payments) against what they lost (the cost of treatment) I doubt it is 1%.

[simoh1490]

2 minutes ago, chrissables said:

So if you can't get insurance, you can't enter? Self insure? 

 

The problem is in fact so small, they charge enough to soak up this very minor amount. 

 

The bill they would like paid, has no relevance to the loss. The mark up is very high.

 

Maybe they should publish the total money taken per year (including cash payments) against what they lost (the cost of treatment) I doubt it is 1%.

There is no mark up in government hospitals per se and that is what's being discussed in the OP, they operate on a cost recovery basis.

[chrissables]

18 minutes ago, simoh1490 said:

There is no mark up in government hospitals per se and that is what's being discussed in the OP, they operate on a cost recovery basis.

I must disagree, the government hospital in Pattaya (Soi Buakhao) charges are way to high to not be profit making. 

As an example, every month a friend was paying 1700 baht for blood pressure pills. In the chemist i bought exactly the same for 300 baht.

As a hospital that medicine would cost half i would think, the rest of the fee was to weigh, take blood pressure and profit.

I paid for medical certificate for a driving licence, a pathetic test. The doctor did not even examine me. It was just a little more at an international hospital with real tests and a doctor consultation.

[chrissables]

On 4/19/2017 at 5:52 AM, 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.

 

 

 

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.

 

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;

 

Which comment do we take as correct? You can't state insurance is available and then can't and remain credible.

[chrissables]

On 4/19/2017 at 7:40 AM, henry15 said:

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.

Not if a Thai car driver knocked him off the bike! The car driver or his insurance should pay.

[chrissables]

On 4/19/2017 at 7:54 AM, simoh1490 said:

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.

If it is foreign workers, their THAI employers should be forced to pay for insurance or hospital costs. But it's easier to pick on expats who spend the most here.

[simoh1490]

2 minutes ago, chrissables said:

If it is foreign workers, their THAI employers should be forced to pay for insurance or hospital costs. But it's easier to pick on expats who spend the most here.

Why do you think they are picking on expats, the article just refers to foreigners?

[chrissables]

On 4/19/2017 at 7:54 AM, RigPig said:

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

Why did you think it is your business to give advise to  them? Really why do you think your thoughts atter. I am surprised he did not knee you in the balls and then ask why you were not wearing a box, as it's very dangerous poking your nose into others business.

[chrissables]

Just now, simoh1490 said:

Why do you think they are picking on expats, the article just refers to foreigners?

I was replying to a quote that stated is was foreign workers (150,000) who are not paying.

[simoh1490]

8 minutes ago, chrissables said:

I was replying to a quote that stated is was foreign workers (150,000) who are not paying.

Sorry I was just trying to understand who you include within the term expat. Typically I wouldn't have referred to those 150k foreign workers as expats in order to differentiate between them and say resident foreigners who are retired, although I suppose technically they can be regarded as such.

[chrissables]

23 hours ago, abrahamzvi said:

Why can't Thailand adopt the same procedure like the EU countries and many other countries in the world, insisting on tourists proving having medical insurance before being allowed in. This would be in the interest of Thailand as well as that of the tourists. They would know that in case of accident or illness they would enjoy one of the best medical treatment available worldwide.

They would know that in case of accident or illness they would enjoy one of the best medical treatment available worldwide.

 

Are you for real, honesty do you believe your statement or are you smoking  something?

[chrissables]

22 hours ago, blu said:

I am constantly embarrassed by the racist & inflamatory comments by ex pat subsribers to thia visa.  If it is so bad here then please just leave. 

Who died and left you in charge of immigration policy? <deleted>!

[bazza73]

18 hours ago, little mary sunshine said:

If everyone is required to have travel insurance, than the

hospitals will be paid if there is an accident and every

traveler is protected in Thailand...Win Win situation.

You are assuming the insurance paid will not be diverted into someone's pocket. Given Thailand's ranking on the corruption scale, I'd say that's a fairly high probability.

As another poster said, everyone's circumstances are different. Pre-existing conditions, age, and risk-taking behaviors here. The one size fits all solution you and other posters are proposing would be a dog's breakfast in practice. Lose Lose.

[little mary sunshine]

38 minutes ago, bazza73 said:

You are assuming the insurance paid will not be diverted into someone's pocket. Given Thailand's ranking on the corruption scale, I'd say that's a fairly high probability.

As another poster said, everyone's circumstances are different. Pre-existing conditions, age, and risk-taking behaviors here. The one size fits all solution you and other posters are proposing would be a dog's breakfast in practice. Lose Lose.

It would be a beginning and much better than the current

bankrupting  the hospitals and no coverage for foreigners 

[little mary sunshine]

1 hour ago, chrissables said:

I must disagree, the government hospital in Pattaya (Soi Buakhao) charges are way to high to not be profit making. 

As an example, every month a friend was paying 1700 baht for blood pressure pills. In the chemist i bought exactly the same for 300 baht.

As a hospital that medicine would cost half i would think, the rest of the fee was to weigh, take blood pressure and profit.

I paid for medical certificate for a driving licence, a pathetic test. The doctor did not even examine me. It was just a little more at an international hospital with real tests and a doctor consultation.

Hospitals MUST MARKUP medications 300-400% to cover all

the patients they treat and don't pay.    The chemist you

referred to gets his money before you leave, perhaps a 50% 

markup!!

[little mary sunshine]

2 hours ago, bazza73 said:

I'm over 70, and any medical insurance I can get in Thailand is ruinously expensive. My solution is to maintain my private health insurance in Australia, and keep 500,000 baht in a sinking fund here for hospital.treatment.

Realistically, the only time I'll need high level treatment here is if I'm in a traffic accident, or have a heart attack/stroke. For anything else, get on a flight to Australia.

Possibly not the best solution; however, I refuse to shell out 250,000 baht a year to the insurers. Greedy bastards.

I too am self insured.  Lucky to be very healthy, I started my own

savings account specifically for health/hospitalization with B300,000

seven years ago, each month I add B15,000 instead of paying insurance

current balance exceeds B1.4 M.  More than adequate!!

[bazza73]

22 minutes ago, little mary sunshine said:

I too am self insured.  Lucky to be very healthy, I started my own

savings account specifically for health/hospitalization with B300,000

seven years ago, each month I add B15,000 instead of paying insurance

current balance exceeds B1.4 M.  More than adequate!!

I doubt an insurer would look at me anyway. Pre-existing conditions of bladder cancer, chronic lymphocytic leukemia, and hypertension. None of which will kill me according to the medicos, but insurers are a different beast.

 

The local private hospital charges 4000 baht a day for a top grade room with full care. On 500,000 baht, that's approximately 4 months stay. I think I'd be asking them to top me if I had to stay in hospital that long.

[Keesters]

Recoup the loss from all the double (or greater) charging at national parks etc.

 

 

[Thaidream]

When are people going to realize medial insurance exists for only one reason- to make money for insurance companies; hospitals/doctors and Big Pharma. It does not exist to help the sick.

A single payer system run by the government is the only possible solution that will work similar to what Canada; Japan; the UK and France have right now. Those working pay a percentage of their income to fund the system while the unemployed and retired get free medical care.  Hospitals/Doctors and  Big Pharma has to accept what the government reimburses them for or they won't have any business.  This takes greedy insurance out of the picture.

In most of the developing World- Medical care is recognized as a right and mus be provided.  America and a few other countries are different. They are based solely on an insurance-private hospital system which is the most expensive in the World and bankrupts tens of thousands of people each year. the same life saving medicine that is available in America is 10 times what it would cost in Thailand. I know this from personal experience. America will eventually adopt the single payer concept because eventually its citizens will become educated as o what the rest of the industrialized World is doing.

 

Those long term expats living in Thailand should be offered a buy in to the Thai Social Security system which is the way expats in Mexico are treated. The cost is low because one becomes part of a large group hat shares the cost.

 

Tourists coming to Thailand should be charged a 300 Baht fee as either part of their Visa or airline ticket which will cover any medical costs for the validity of the Visa or extension of stay. These monies should be put into a medical pool and based upon a figure of 30 Million tourists adds up to a medical pool available of 90Billion Baht per year- more than enough to cover with monies left over that can be used to purchase upgraded equipment.

 

the biggest complaints about uninsured and losses come from the very people who would gain from the continuation of the status quo- insurance companies; hospitals/doctors and Big Pharma.  These institutions are the real 'enemy' of affordable healthcare- not the uninsured or underinsured.

 

[teddog]

BacK from India a week or two ago after prostate operation, about 800 GBP ,here Thailand Ill bet its more like 8000 GBP    good op,good hospital..too good to be true

 

   Looked at price list of major ops  cheap  damned good those surgeons too

[bazza73]

35 minutes ago, teddog said:

BacK from India a week or two ago after prostate operation, about 800 GBP ,here Thailand Ill bet its more like 8000 GBP    good op,good hospital..too good to be true

 

   Looked at price list of major ops  cheap  damned good those surgeons too

Which hospital in which city in India did you go to?

[teddog]

5 minutes ago, bazza73 said:

Which hospital in which city in India did you go to?

Calcutta   two hours away,  best wait until Oct now to fly,monsoon on them  cut back on flights and upped cost,can get there at xs for just over 1000 baht.  Anyway if you look at medical section of Thaivisa  'prostate surgery'  I posted there couple of weeks ago   or just look under my activety

[Flustered]

23 hours ago, Thaidream said:

This problem is solvable only if as I mentioned you start with the premise that Healthcare is a human right just as education; freedom of thought and speech and other inalienable rights.

It's a wonderful sentiment that is fundamentally flawed. Like communism it is based on the assumption that all people will carry their own weight and work for the greater good. In reality, a very large percentage will simply take advantage of others and add nothing to the pot.

 

There is only one human right and that is the right to live. People must take responsibility for their own actions and not rely on others to do the work or pay for them.

 

I am a great believer in the NHS as an accident, emergency and maternity service only. Beyond this, a State insurance scheme with rising benefits according to payment in would be the ideal. If you are stupid enough to get drunk, drugged up or involved in some other action that requires medical help, pay for it yourself.

 

All visitors to any country (like Thailand) could pay a supplement while they are there which would act as a basic insurance policy. This would ensure that places like Phuket were able to look after the idiot tourists that need attention and cannot pay for it.

 

Too much Nanny State and Socialism in the world today. I know this will upset some, but why should others work damned hard and go without all of their lives just to pay for some free loading, snout in the trough benefit cheat?

[simoh1490]

2 hours ago, teddog said:

BacK from India a week or two ago after prostate operation, about 800 GBP ,here Thailand Ill bet its more like 8000 GBP    good op,good hospital..too good to be true

 

   Looked at price list of major ops  cheap  damned good those surgeons too

Prostate ops. have been posted at around 220,000 baht at private hospitals, so figure 5k Pounds, much less at government hospitals.