Local Government Hospital Experience

[nontabury]

5 hours ago, jumbo said:

My thinks it is the same in other countries, included western, where they have a social health care system in place for its nationals.

Me personally I have the SS card, as do many others, actually we are better of than the THai on the 30thb or gold scheme's

For us it is for free and in my case in a private hospital, and a very good one to for that matter

Reversed Tier Pricing?

 

You are obviously very fortunate in having an SS card. However the overwhelming majority of Farangs do not. I think the O.P is complaining that the charges seem to have increased by a large margin over the last few years. Furthermore a senior nurse told him, the management have instructed the administrators to ensure that the farang is charged at a much higher level.

  Another point to note,is that it is the charge for the doctor that has increased not that for the hospital bed or meals. Could it be that someone what’s to be able to afford a newer Mai Noi.

 

 O.K. So this is’t an earth shattering bill, however I would strongly advise anyone contemplating major and potentially expensive medical care in Thailand, to consider, “IF” possibly the advantage of traveling to India, where if you do your homework,you can be assured of first class medical care, by professional doctors at a fraction of the cost in Thailand

[nontabury]

4 hours ago, Sheryl said:

Most government hospitals nationwide do not have two tier pricing but those located in areas which get a comparatively large number of foreignets often do.

Most Thais, especially in rural areas, do not have to pay or pay only 30 baht whereas foreigners (and any Thai not covered under 39 baht or SS scheme at that hospital) gave to pay full price. In many rural hospitals it is infrequent that there is a need to bill the ptient so understandable that special note would need to be taken.

In Bangkok it is much more common, even among Thais as many are covered by 39 haht scheme in a home province but work in Bkk and prefer not to travel back for care so instead pay out of pocket.

Costs in any hospital very much depend upon the treatment given. 5k+ for an ER visit and some sort of respiratory support (unclear if oxygen or actual intubation but I suspect the former; intubation and use of a ventilator would require ICU admission and have cost much more) is quite reasonable and not indicative of a rise in prices just because other visits with different treatment cost less.

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 My pregnant Thai wife was scheduled to give birth in an International hospital 200kl away. However the baby decided not to waite, and so I had to rush her into the local Thai state hospital,where she gave birth and stayed for two nights in a private Vip room. They then presented her with a bill for 12,000 bht. This she was not happy with, and so went off to the administrators office,complaining that she’s a Thai person, bill reduced to 9,000bht. 

 

[Sheryl]

. Now your costings are what I was used to but now they seemed to have risen especially if you are to be admitted . To lay my cards on the table , I know of 3 falangs who are married with children and own there houses and could not afford to be in a position of paying the bill that I paid .  You would think that a guy who is married to a Thai lady would be regarded as family and treated similarly to Thais .

How the hospital "regards" you is not the issue.

They receive a per capita amount from the government for all the Thais living in their catchment area and are required to treat them either free if charge or for a token 30 baht. Neither is the case for foreigners and being married to a Thai has no bearing on it.

Government policy.

And I can assure you, the Thai government does not feel an obligation to pay for the health care of foreigners. In fact they strive to ensure that only foreigners of adequate financial means receive long term visa extensions.

The hospital bill referenced in the OP was small change compared to what the tab, even in a government hospital, will be for a really catastrophic illness or accident. 1 million baht easily (3-5 million ina private hospital) and that is without any double pricing.

It is imperative that everyone living here either have health insurance or be self insured (i.e. at least 1 million baht put aside).

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[Burma Bill]

Despite some unhelpful bickering, there are several interesting posts describing the variance in service and quality provided by Thai Government hospitals. I have lived in Thailand for over 18 years and, being an insulin dependent type 2 diabetic, I have made regular monthly visits throughout this time, as a paying patient, to local Government hospitals, first in Lanna then in Isaan, for blood and eye checks, also my medication. Personally, I have always found the medical and admin staff very helpful and, to my knowledge, I have never been scammed as a farang. My monthly cost averages around 3,000 baht which includes an admin charge, doctor and nurse fees and all my medication of which the insulin is the major expense. The private hospitals are much further away and the cost of insulin alone exceeds my total fee. My only complaint - the masses of Thai patients so I have to sit and wait my turn just like the NHS back in the UK. It is their hospital and I accept this. In case anyone is wondering, my current local hospital is brand new and is exceptional in the quality of services offered. Insulin can only be prescribed by a doctor, as in the UK.

[jesimps]

6 hours ago, superal said:

 

I will take your points one at a time

 

 1/ Where do I state I wanted preferential treatment ? Is it too much to ask for a fan in this heat ? you are giving a conflict of information as in one breath you say you were on a ward of dying people and then say your private room was 1300 baht a night ?

 

2 / Cost of a room cannot be compared between different hospitals , quite obvious really

 

3/ How is describing speaking pigeon English by a nurse making fun of her ? I have total respect for the medical profession here and there is nowhere in my post suggesting otherwise , so back off .

 

4/ I have a friend who also receives regular monthly medical treatment and also zero increases . I am not a regular out patient and that is the point . It seems that casual out patients costs are/ have risen quite a bit and the staff are being instructed to ensure their care is covered .

 

I agree with what you say, costs have risen drastically for farang. Seems to be the policy these days. You waste your time on here keeping people informed, in fact I don't know why people bother. As soon as some detect the slightest criticism of Thailand or the Thais, they go all pear shaped. It's the rose coloured specs that does it.

[joebrown]

There's a lot of talk defending the Thai Government expecting expats to have their own healthcare plan, but for those over 70 years this is a big issue. However the Immigration rules say we have to have an income transfer to Thailand of 65000/40000bht per month, which for most people is used to cover living expenses, so we buy things and pay tax.

Only a very small proportion of Thai pay Income Tax (only 25 - 30% of those aged over 25 years), so about 70% of all Thais pay no income tax at all. Per capita we expats contribute significantly more to Thai taxation revenue than Thais do, but this point is mute because of the continued misguided assumption that we are walking ATMs

[BritManToo]

8 hours ago, DonDoRondo said:

You needed special care - were on a respirator - spent the night in the hospital, etc - for this the bill came to under 5000 baht ( $150, or the cost of a 10 minute office visit with a specialist in the USA ).

Normal price would be around 500bht for a foreigner in a government hospital.

Wonder how the Cambodians and Burmese pay ........ or is it just white guys that get charged more?

[colinneil]

2 minutes ago, Donaldo said:

The truth lies in the eye of the beholder. I find your reaction to the comment of Superal rather condescending and insulting. One can defend a different point of view, but their is no need for derogatory remarks, which seems to be the going trend on this forum.

You dont like me speaking the truth, as Thais would say.....Up to you.

The mans remarks about the nurse speaking pigeon English was both disgusting and downgrading.

[BritManToo]

6 hours ago, scorecard said:

n most cases folks retired here (own choice), are not paying Thai taxes (except VAT).

Less than 10% of the Thai population pay taxes (except VAT).

[bluesofa]

24 minutes ago, jesimps said:

I agree with what you say, costs have risen drastically for farang. Seems to be the policy these days. You waste your time on here keeping people informed, in fact I don't know why people bother. As soon as some detect the slightest criticism of Thailand or the Thais, they go all pear shaped. It's the rose coloured specs that does it.

Then they should be going to an optician, not a hospital...

[BritManToo]

2 hours ago, thailand49 said:

I can see if the bill was 50,000 baht but you are talking 5000 baht. You should be ashame of yourself since you most likely down more in beer a month that the hospital bill. Maybe you been here too long and becoming more like a Thai and that is you are one unappreciative guy!  5000 baht get real!

So you think it's right that Cambodian/Laos/Burmese foreigners pay 500bht, and a white guy gets charged 5,000bht?

[BritManToo]

2 hours ago, superal said:

I would be interested to know what others think with regards to an annual premium . 

Foreigners employed in Thailand pay 400bht, and the employer pays 400bht.

Let's round it up to 1,000bht/month as a fair price for foreigners joining the SS scheme.

[bluesofa]

12 minutes ago, BritManToo said:

So you think it's right that Cambodian/Laos/Burmese foreigners pay 500bht, and a white guy gets charged 5,000bht?

That's pretty fly for a white guy, even one with offspring.

 

[NCC1701A]

11 hours ago, superal said:

bill but that had grown again to 5300 baht because of medication to take home . 

thanks for conveying your experience. the last time I was in a hospital in 2009 in the USA my bill was 346,000 baht for 3.5 hours in an emergency room with kidney stone pain. no surgery. just morphine drip. 

 

Bangkok Hospital Hua Hin runs about 2000-4000 baht for flu, infections, STD. very minor stuff. 

 

last week at Bumrungrad Hospital in Bangkok dermatologist bill was 11,000 for visit, exam, and biopsy for possible skin cancer.

 

no point.  just putting this out there for comparison.          

[Sheryl]

That would be the normal price for a ward bed. It would not cover the treatments. Lab tests. IVs. Oxygen. Medication etc.

It is not possible to comment on the charges without a detailed cost breakdown.


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[Sheryl]

Referring to the post claiming faranfs pay 10 yimes morw than Lao, Khmer and Burmese wtc: What on earth makes you think that is the case?

 

I assure you, from first hand experience, that Lao and Khmer pay full fee unless they are covered by the migrant worker scheme (for which they must have a work permit and pay an annual fee). The wife of my one Cambodian worket had a nearly 200k baht at a government hospital about 2 years back.

 

As to the poster talking about a 400 baht payment plus 400 by employer those are annual Social Security fees and can be more depending on the person's salary. They are not fees paid at the time of care in a hospital; that is generally free if care obtained at the nominated social securitu hospital. SS only applies to people with work permits but can be maintained after retirement on a self pay basis.

 

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[Benmart]

My health care bill has been cheaper than taking care of my remains when I die, based on the experience of friends that have taken the later route.

[BritManToo]

1 hour ago, Sheryl said:

As to the poster talking about a 400 baht payment plus 400 by empliyer those are annual Social Security fees and can be more depending on the person's salary. They are not fees paid at the time of care in a hospital; that is genetally free if care obtained at the nominated social securitu hospital. SS only applies to people with work permits but can be maintained after retirement on a self pay basis.

Presuming SS isn't considered a 'charity', it must reflect the cost of the treatment for members.

1000bht/month in that case doesn't seem unreasonable for a foreigner joining to pay.

[Sheryl]

15 minutes ago, BritManToo said:

Presuming SS isn't considered a 'charity', it must reflect the cost of the treatment for members.

1000bht/month in that case doesn't seem unreasonable for a foreigner joining to pay.

There is no mechanism for doing so.

 

The rates are based on people of working age and actively employed, a generally healthy cohort.

 

If a scheme were ever developed for resident expats it could either be with SS or the "30 baht" system (there already being a precedent for the latter with migrant workers). In either case considerable work would need to be done at determine appropriate premium and would likely have to vary at least  somewhat by age.

 

The idea has been mooted in the Health Ministry, just far from the top of their agenda.

 

 

 

[BritManToo]

3 minutes ago, Sheryl said:

In either case considerable work would need to be done at determine appropriate premium and would likely have to vary at least  somewhat by age.

I'd exclude chronic illness and just cover for accidents.

Old folk should be allowed to die without heroic effort being made.

[sfokevin]

The OP should be thankful his bill didn’t include any joiner fees for any chanting monks... 

[bluesofa]

5 minutes ago, sfokevin said:

The OP should be thankful his bill didn’t include any joiner fees for any chanting monks... 

Do they have double beds in the government hospitals now?

[Deerculler]

I had hernia surgery in the Surin Govt. Hospital May last year.

With all the tests, surgery and two nights in hospital it cost 36000baht.

The surgery was successful and the Dr.’s and nurses were great.

I have no complaints and I think it was damn cheap. 

Don’t understand why you are complaining.

 

[Lacessit]

23 minutes ago, BritManToo said:

I'd exclude chronic illness and just cover for accidents.

Old folk should be allowed to die without heroic effort being made.

Unfortunately, if you are unconscious for any reason, you don't get the option of refusing treatment.

IMHO the OP got off lightly. Sign me up to that hospital if it's in CM, please.

[scorecard]

3 hours ago, BritManToo said:

Less than 10% of the Thai population pay taxes (except VAT).

That makes no difference, my point still stands.

 

Most countries have a tax threshold, earn under that amount you pay no tax or it's refunded. 

[Thaiwrath]

6 hours ago, bluesofa said:

Just to stick my oar in, last year I went to Udon Thani hospital, (a government hospital) into the ER with a pain down my left side.

After the obligatory blood pressure check, being connected to an ECG for half an hour, seeing the doctor who thankfully told me there was no problem, plus being issued the compulsory drugs (paracetamol), the bill was 195 Baht.

Another occasion I went there for a tetanus booster and paid 200 Baht. Years before I'd been to a private hospital for a tetanus booster and was charged 1,000 Baht.

 

I have weekly physiotherapy in my local Government Hospital, which comprises of ultrasound, electrolysis, hot pack, and time in the exercise room after, total time, about 1 hour, total cost 180 baht.

I also see the spine specialist every 4 months, and my last visit was the consultation, and 100 Tramadol tablets, total bill was 150 baht !

Never had any complaints in 14 years here. 

[bluesofa]

Now you mention it - old codgers' ailment page...

Nearly ten years ago I went for physiotherapy at the local military hospital. I trapped a nerve in my neck.

That was ultrasound treatment too, for perhaps a dozen sessions. That was hour each time for less than 200 Baht IIRC.

[nontabury]

2 hours ago, scorecard said:

That makes no difference, my point still stands.

 

Most countries have a tax threshold, earn under that amount you pay no tax or it's refunded. 

 

I don’t beleive that the rich in any country, think that income tax is for them

[uhuh]

4 hours ago, Deerculler said:

I had hernia surgery in the Surin Govt. Hospital May last year.

With all the tests, surgery and two nights in hospital it cost 36000baht.

The surgery was successful and the Dr.’s and nurses were great.

I have no complaints and I think it was damn cheap. 

Don’t understand why you are complaining.

 

If you think this was cheap you have no idea how much this would cost in other countries. 

And please,  do not compare it to those ridiculously inflated US healthcare prices.

[Jaxxper]

I guess the $64,000 question is , had you have known it was going to cost Thb 5,300 on admittance would you have said " No, too expensive send me home, I'll take my chances there ". ? Me thinks not. Easy to critisise when the emergency is over, and you're on the road to recovery. Just my opinion!