Bottom line is many expats are retired military and have Trlcare insurance. Many hospitals do not do direct billing, the veteran pays and then files a claim for PARTIAL reimbursement. More often as far as foreigners are concerned it is the visitor to Thailand who rents a motorbike, has an accident and either can't or won't pay for medical care. A fee should be collected from EVERY visitor say, 500 or 1000 baht to be placed in a fund for hospitals when foreigners sustain injuries or health issues and do not pay. For the permanent expat residents, let them self insure putting 400,000 in a fixed account at the bank. These permanent residents are supporting families in Thailand, providing some electrical, plumbing and other works to others as needed around their homes and family property. Last, health insurance for anyone over the age of 70 or with preexisting conditions is either totally not available or priced beyond reason.