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Health care and hospitalizations (public and private) for Thai nationalities

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It seems we know different people.  Pretty much all Thais I know try to get private medical care (but often it would cost too much).

The poor because they know how they are treated in the government hospitals. 

The middle class wouldn't consider anything but private.

 

One reason for the difference may be location, I know places that fit Sheryl's description very well. 

Another reason maybe age.  I know mostly young people,  they do not like government hospitals. Many of their parents would hardly consider a private hospital,  that's true.

Edited by uhuh

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3 hours ago, Sheryl said:

 

The overwhelming majority iof medical care received by Thais occurs in government hospitals. by a very, very, very large margin, Indeed in much of the country, cost aside, there are no viable options.

That's certainly true in the countryside. 

In Bangkok, most people have Social Security and many of them go to a private hospital (of course, the private hospitals participating in Social Security offer different levels of care for Social Security patients and for patients who pay out of pocket).

And many people try places like the Police Hospital (that's where the patient from Korat I mentioned before ended up), the Military hospitals (BritMan mentioned Fort Suranaree hospital, which is just as good as Bangkok Hospital - but your average Isan farmer cannot just walk in there) or the university hospitals. They belong to the government,  but they are not always easily accessible and they are not free. 

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That's certainly true in the countryside. 

In Bangkok, most people have Social Security and many of them go to a private hospital (of course, the private hospitals participating in Social Security offer different levels of care for Social Security patients and for patients who pay out of pocket).

And many people try places like the Police Hospital (that's where the patient from Korat I mentioned before ended up), the Military hospitals (BritMan mentioned Fort Suranaree hospital, which is just as good as Bangkok Hospital - but your average Isan farmer cannot just walk in there) or the university hospitals. They belong to the government,  but they are not always easily accessible and they are not free. 

Most Thais in Bangkok get care in government hospitals, they are packed to the gills.

 

Most people under SS are registered in a government hospital. Most private hospitals do not participate in the SS scheme and the few which do are often dodgy.

 

The government university hospitals are free for those registered in them under SS or the 30 baht scheme and those who are teferred to them by their own SS or "30 baht" hospitals. They have more free than paying patients. But yes, many Thais who don't fall into those groups opt to use those hospitals on a fee basis if they can afford it.

 

I spend a LOT of time in these places helping Cambodian friends and relatives navigate the system and have done every year for more than 2 decades. They of course have to pay full price but they are a distinct minority in doing so.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

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12 hours ago, Sheryl said:

 

Most people under SS are registered in a government hospital. Most private hospitals do not participate in the SS scheme and the few which do are often dodgy.

For Bangkok,  all three of these statements are not true. 

(You know the list of private hospitals for SS as well as I do. I can think of only one private hospital for SS in Bangkok that I would call dodgy. But several government hospitals.)

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Thank you all for the info it was really helpful

 

One thing I failed to understand though. My wife is registered as living in Ayutthaya Sena district. Which public hospital she can go to? As I understand one cannot go to every hospital he chooses. So is there a list somewhere on the internet? Or where can we get such a list?

 

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Each district in the country (outside of Bangkok where things are a bit complicated due to size and overcrowding) has 1 government hosputal responsible for that district. There is never more than 1 (again Bkk adide). And virtually all Thais in the district know this and which it is.

 

There is a general hospital in Sena district. Called Sena Hospital.

 

Cases too complex for it to handle they will refer to Ayutthaya Hospital which is a regional level hospital.

 

Are you sure yoyr wife doesn't know all this? Everyone knows where their local govt hospital is unless they are very newly arrived.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

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On 2/18/2019 at 5:55 PM, Sheryl said:

Each district in the country (outside of Bangkok where things are a bit complicated due to size and overcrowding) has 1 government hosputal responsible for that district. There is never more than 1 (again Bkk adide). And virtually all Thais in the district know this and which it is.

 

There is a general hospital in Sena district. Called Sena Hospital.

 

Cases too complex for it to handle they will refer to Ayutthaya Hospital which is a regional level hospital.

 

Are you sure yoyr wife doesn't know all this? Everyone knows where their local govt hospital is unless they are very newly arrived.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

Yes she told me there's a hospital she can go in Sena but I dont understand is that really the only hospital she can go to? If we currently live in the other side of Ayutthaya in Uthai district (but not registered there) so she cannot go to a hospital which is closer to our area?

 

Also, Cant she go to Ayutthaya Hospital (regional level) without Sena hospital referring her there?

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For free (30 baht) care she can only go to Sena Hospital  or to Ayutthaya Hospital IF Sena Hospital gives her a letter of referral.

 

If she goes to Ayutthyaya Hospital on her own without referral she has to pay full price. Ditto anywhere else - she can go where she likes but has to pay full price if it is not the hospital she is coeverd at under the scheme.

 

Sena is a 160 bed general hospital and would be able to handle most non-specialized things. For anything very specialized they will readily refer to Ayutthaya Hospital.

 

She can change her house registration to Uthai if she wants, that will then make Uthai Hospital her hospital. But it is a tiny community hospital (30 beds, likley just 1-2 doctors, recent grads) with very limited capacity compared to Sena. No surgery, probably not even an Xray machine, basically they can handle simple injuries (stitch a wound etc), simple flu etc and that is about it. On the other hand, because its capacities are so limited, the range of things it will refer to Ayutthaya will be  much greater than at Sena.

 

Limiting which hospital people can go to for free care is quite typical of government health schemes around the world. They allocate budgets to hospitals according to the numbers registered in each. If patients could go anywhere, some hospitals would be completely overwhelmed and have insufficient resources to cope while others would be overfunded due to low utilization. It would be chaotic and very inefficient.

 

If you want her to have ready access to the best hospital in the province, move to the Ampur Muang and change tabian ban listing accordingly.

 

you, as a foreigner, have to pay full price wherever you go so of course, go straight to the regional hospital in Ayutthaya town.

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Thank you very much Sheryl

 

Are public hospital prices in case you go without a referral similar to private hospital prices? Or is it still cheaper?

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51 minutes ago, IBIB said:

Thank you very much Sheryl

 

Are public hospital prices in case you go without a referral similar to private hospital prices? Or is it still cheaper?

Always  cheaper, usually  by a factor of 3-4. Main exceptions are when it is for something where cost of imported medical devices are the main cost driver (e.g. stents, ortho surgery) in which case still cheaper but by a factor of more like 2 fold.

 

However, waits are long (and depending on the hospital may be quite uncomfortable e.g. hot, not enough seats etc) and red tape is considerable making it very hard to negotiate, especially on first visit, without a Thai speaker along. It is possible if you speak Thai well, though reading will still be an issue (forms, signs etc all in Thai) but you can ask for help - I have done it many times - and people usually obliging. But if you don't speak Thai well, definitely have a Thai with you at least the first time (by which I mean first time for that problem. Follow up visits are much easier).

 

Upcountry, the quality of private hospitals is often iffy and in many locations the largest government hospital is really the only trustworthy place to go. In Bangkok etc of course it is different, wide range of private hospitals. The main advantage of these from my point of view is that (1) you can choose your doctor and (2) speed, you can go direct to whom you want to see, appointed in advance, and get accomplished in an hour what might literally involve several days at a government hospital. But you pay a lot more for this.

 

Most government hospitals have "after hours" clinics ("clinic nawk wela") where you can be seen by the senior doctors, costs more and nto covered by the 30 baht or SS schemes, but  the waits are less (e.g. 1-2 hours as opposed to most of the day) and you access more time with the senior docs. In the public channel your main contact is with interns and residents. They are under senior supervision and have to present their findings and proposed treatment to senior doc for approval, but you yourself may scarcely see, much less have the chance to talk much with, the senior doc.

 

Typical cost of an after hours clinic visit is 500 baht in Bangkok, may be less upcountry.  As opposed to around 50 baht (plus meds, tests etc) in the public channel.

 

If admitted to the hospital one can request a "hong piset"  e.g. private or semi-private room. Depending on the hospital and the room these may cost anywhere from say 500 - 2000 baht a night and are usually well worth it - in many government hospitals the ward conditions are brutal, to put it mildly. Packed to the gills,  relatives sleeping on the floor underneath the beds, stifling hot and smelly, and I won't even attempt to describe the condition of the bathrooms. Though all this does vary by hospital I would be surprised if not true of Ayutthya. 

 

Patients covered by the government scheme can also get a hong piset in which case they pay only the difference between a ward room and the "special" room. In the regional hospital in the province where I live, ward rooms are priced at 400 (free of course to Thai patients, but that is the "list" price), semi-private rooms about 1000 and private around 1500 - 1800.  So a Thai covered by the "30 baht" scheme would pay 600 baht extra for staying in a semi private room. All the "special" rooms have a/c, good nurse to patient ratio (though not usually the sharpest nurses), a couch of some sort  for a relative to sit and sleep etc.

 

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18 hours ago, Sheryl said:

 

 

Patients covered by the government scheme can also get a hong piset in which case they pay only the difference between a ward room and the "special" room. In the regional hospital in the province where I live, ward rooms are priced at 400 (free of course to Thai patients, but that is the "list" price), semi-private rooms about 1000 and private around 1500 - 1800.  So a Thai covered by the "30 baht" scheme would pay 600 baht extra for staying in a semi private room. 

 

These are typical prices in most provinces. It may be a bit more expensive. 

 

Beware: some government hospitals put you in their private branch (this is not the clinic nawk wela Sheryl mentioned). Quality of care is somewhere in between a government hospital and a private hospital,  prices almost like a private hospital. A lot less price gouging though. 

 

Hospitals who do this (there are very few) are Vachira Hospital in Phuket

and Siriraj Hospital in Bangkok. The latter is highly recommended. 

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