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What free health care do Thai people get.


mommysboy

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I am assessing how best to cope with my family's potential health care costs.

 

I know that all Thai citizens are covered by universal health care at a government hospital, but am not sure how this pans out in reality.  

 

For instance, what about if a Thai needs an appendectomy, or chemotherapy- would that be free too?

 

 

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Yes.

 

Virtually everything is covered. A few very new or rare medications or tests not yet on the standard list are about all that is not. And hemodialysis is restricted to patients unable to do peritoneal dialysis.

 

They have to use the government hospital which covers the area where they are listed in a tabian ban. That hospital can as necessary refer them to higher level or more specialized hospitals but they must get the referral letter for it to be covered.

 

It is well worth choosing  where you live with an eye to the level/quality of the hospital. The best situation is to live in the ampur where a regional level hospital is located. Second best is to be in any other Ampur Muang (provincial capital). Living further out you may have to utilize a community level hospital as first point of call and  their capacities are limited so you end up having to constantly get referrla letters to go elsewhere.

 

And make sure your family are not still listed in tabian bans in some other province far away...not unusual as Thais dislike having to deal with the bureaucracy so often don't change their listing when they move,It will be a problem when they need medical care. Change the listing to where you actually live.

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Where they are registered determines what primary hospital they are allowed to use for normal medical needs.  There is nothing to prevent them moving their home register location to where they actually live (they should do this) and that would make it a local hospital.  They can pay for treatment at other hospitals so for most things the costs would be low - but much better to move home to where you actually live. 

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it also seems to depend where the Thais are registered, i get told they get free healthcare back home in Isaan but not Pattaya
The people you hear that from are registeted in a tabian ban in Issan. So of course barring absolute emergency they can't get free care in Pattaya (or anywhere elde, other than the hospital where they sre listed in Issan).

If they changed their tabian ban listing to Pattaya, they'd get free care in Pattaya.

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Where they are registered determines what primary hospital they are allowed to use for normal medical needs.  There is nothing to prevent them moving their home register location to where they actually live (they should do this) and that would make it a local hospital.  They can pay for treatment at other hospitals so for most things the costs would be low - but much better to move home to where you actually live. 
They should wear crash helmets but they don't do that either
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I have noted that at my Government Hospital the folks (Thai) still have to pay for their prescriptions but at a reduced level than moi with the vaunted "Gold Card" [emoji4] 
They shoulf not unless it is a medication not on the MoPH frug list which is rate.

Ate you perhaps confusing this with the 30 baht payment for the visit?

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Like all public health systems anywhere in the world, public hospitals are beset by crowds and delays. Thai people with money (or access to money) will often pay extra for quick treatment.

 

As an example, my wife's best friend was recently diagnosed in the public system as having bowel cancer. She is an ex-teacher and therefore has government insurance. The time between the initial diagnosis and an appointment to see a specialist to recommend the best course of action was nearly 3 weeks.

 

The specialist recommended immediate surgery, but the first available slot in the public system was nearly 4 weeks. She ended up spending 100,000 Baht to arrange the operation within 1 week. The money was extra payments for the doctors, surgeon and other specialists involved to do the operation as a priority (and, I guess, bump someone else down the waiting list).

 

I'm just saying that you might need to factor in extra money if there is a real medical emergency. In addition, most public hospitals will have suites and other rooms that are much better than the public wards. The additional cost is normally small (500 - 1000 Baht per night).

 

 

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My tgf is getting a bit riled up when I mentioned this to her Hahahaha.

 

shes saying that there is no “government hospital” out in the sticks where she is registered and what they have is called a satani anamai (??) where there is a “nurse” that will give you paracetamol for any and every ailment and tell you to lie down for a few hours. It’s very entertaining watching her go off ????

 

So... my question to add to the op’s is - is it worth it? 

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18 minutes ago, ncc1701d said:

So... my question to add to the op’s is - is it worth it? 

My (former) MiL changed her house book to my place in Chiang Mai.

She gets $1,000s of free treatment at my local hospital.

(Liver flukes, Diabetes, High blood pressure, they don't even ask for the 30bht)

 

She's registered at San Sai, but they've trucked her round to NakornPing and Suan Dok depending on specialist or operation. She comes up from Petchabun every couple of months to see the grand-kids and visit the doctor.

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14 minutes ago, ncc1701d said:

So... my question to add to the op’s is - is it worth it? 

Is what worth it (free treatment)?  Her location may not have a hospital but it will tie in to a larger area hospital and anything more serious would be sent there.  

 

As for previous post re cancer that can indeed be life threatening having to wait at some locations.  They seem to try and triage but that is not an exact science.  I have personal experience as a paying customer (private hospital doctor insisted team at major Bangkok facility should do operation).  This required a 9 week queue wait and was pulled off operating room table due no ICU available (and told next queue would be 3 or 4 months later).  I proceeded to Bangkok Hospital and had operation within the week.  As this tested high grade after removal it was none too soon.  

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Like all public health systems anywhere in the world, public hospitals are beset by crowds and delays. Thai people with money (or access to money) will often pay extra for quick treatment.
 
As an example, my wife's best friend was recently diagnosed in the public system as having bowel cancer. She is an ex-teacher and therefore has government insurance. The time between the initial diagnosis and an appointment to see a specialist to recommend the best course of action was nearly 3 weeks.
 
The specialist recommended immediate surgery, but the first available slot in the public system was nearly 4 weeks. She ended up spending 100,000 Baht to arrange the operation within 1 week. The money was extra payments for the doctors, surgeon and other specialists involved to do the operation as a priority (and, I guess, bump someone else down the waiting list).
 
I'm just saying that you might need to factor in extra money if there is a real medical emergency. In addition, most public hospitals will have suites and other rooms that are much better than the public wards. The additional cost is normally small (500 - 1000 Baht per night).
 
 
Did she arrange the 100k operation with the govt hospital? or did she go to a private hospital?

I'm just wondering if we can jump the queue at a govt hospital if we pay extra
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17 hours ago, Sheryl said:

Yes.

 

Virtually everything is covered. A few very new or rare medications or tests not yet on the standard list are about all that is not. And hemodialysis is restricted to patients unable to do peritoneal dialysis.

 

They have to use the government hospital which covers the area where they are listed in a tabian ban. That hospital can as necessary refer them to higher level or more specialized hospitals but they must get the referral letter for it to be covered.

 

It is well worth choosing  where you live with an eye to the level/quality of the hospital. The best situation is to live in the ampur where a regional level hospital is located. Second best is to be in any other Ampur Muang (provincial capital). Living further out you may have to utilize a community level hospital as first point of call and  their capacities are limited so you end up having to constantly get referrla letters to go elsewhere.

 

And make sure your family are not still listed in tabian bans in some other province far away...not unusual as Thais dislike having to deal with the bureaucracy so often don't change their listing when they move,It will be a problem when they need medical care. Change the listing to where you actually live.

I don’t think that is correct even when you are listed at your local hospital there are services for which you have to pay.

My sister in laws brother recently had to pay for a stent to be fitted at a large public hospital in Chiang Mai after suffering a heart attack and being taken there by ambulance after treatment at the local hospital.

Her mother had to pay for a CT scan after cancer treatment and the sister in law and her brother are members of a Higher level government scheme.

Going back a few years ago and the so called 30 baht scheme was in operation I took my wife’s grandmother to the local hospital for dialysis treatment and each time we paid.

Others have told me of various treatments for which they had to pay in government hospitals.

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48 minutes ago, StevieAus said:

I don’t think that is correct even when you are listed at your local hospital there are services for which you have to pay.

My sister in laws brother recently had to pay for a stent to be fitted at a large public hospital in Chiang Mai after suffering a heart attack and being taken there by ambulance after treatment at the local hospital.

Her mother had to pay for a CT scan after cancer treatment and the sister in law and her brother are members of a Higher level government scheme.

Going back a few years ago and the so called 30 baht scheme was in operation I took my wife’s grandmother to the local hospital for dialysis treatment and each time we paid.

Others have told me of various treatments for which they had to pay in government hospitals.

   I agree.  My Thai spouse and I are dealing with health issues with his 88 year old mother.  We're sharing the costs with his siblings and our share for her latest health crisis and stay in the hospital came to 41,000 baht.  It might be free if you accept long waits, forego some tests if your hospital doesn't have the equipment, forego some tests if they are not covered, and are ok with a bed in a ward.  

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6 minutes ago, newnative said:

   I agree.  My Thai spouse and I are dealing with health issues with his 88 year old mother.  We're sharing the costs with his siblings and our share for her latest health crisis and stay in the hospital came to 41,000 baht.  It might be free if you accept long waits, forego some tests if your hospital doesn't have the equipment, forego some tests if they are not covered, and are ok with a bed in a ward.  

My family have never had any problems.

Maybe yours are skimming or alternatively stupid.

What's wrong with a bed in a ward? it's where normal people in most countries stay.

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3 minutes ago, BritManToo said:

My family have never had any problems.

Maybe yours are skimming or alternatively stupid.

   Haven't been totally engaged--letting them deal with it--but I think it's more a case of wanting the best care available and as timely as possible.  Probably a big expense was the private hospital room--they didn't want her out in the public ward and a family member wanted to stay in the room with her.

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1 minute ago, newnative said:

   Haven't been totally engaged--letting them deal with it--but I think it's more a case of wanting the best care available and as timely as possible.  Probably a big expense was the private hospital room--they didn't want her out in the public ward and a family member wanted to stay in the room with her.

My (former) MiL appears to rather enjoys the public ward, instant new friends to share food and chat with all day.

My kid was also in a public ward for a week or two, every bed had a mom curled up beside the kid, lots of socialising.

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27 minutes ago, newnative said:

Probably a big expense was the private hospital room--they didn't want her out in the public ward and a family member wanted to stay in the room with her.

If in Government hospital a private room runs about the same as a normal hotel from my memory - not very expensive at all.  Much lower cost than at a private hospital.  But yes that would be an optional extra expense.

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20 hours ago, Sheryl said:

Yes.

 

Virtually everything is covered. A few very new or rare medications or tests not yet on the standard list are about all that is not. And hemodialysis is restricted to patients unable to do peritoneal dialysis.

 

They have to use the government hospital which covers the area where they are listed in a tabian ban. That hospital can as necessary refer them to higher level or more specialized hospitals but they must get the referral letter for it to be covered.

 

It is well worth choosing  where you live with an eye to the level/quality of the hospital. The best situation is to live in the ampur where a regional level hospital is located. Second best is to be in any other Ampur Muang (provincial capital). Living further out you may have to utilize a community level hospital as first point of call and  their capacities are limited so you end up having to constantly get referrla letters to go elsewhere.

 

And make sure your family are not still listed in tabian bans in some other province far away...not unusual as Thais dislike having to deal with the bureaucracy so often don't change their listing when they move,It will be a problem when they need medical care. Change the listing to where you actually live.

I don't get this primary hospital thing. I am covered by the Gov plan, had a heart attack and was rushed to Khon Kaen Hospital and a stent was put in.

I wasn't registered. My wife talked to the finance dept and they approved my coverage. After a week in the hospital and a B250,000 bill, I paid about B1500.

I was not feeling well and did not agree with the followup care and went to Queen Sirikit Heart Center. They found a blood clot in my heart that KK Hospital never looked for. I go there every 3 months and never had to pay more than the B280 co-pay.. no referral letter.

I also go to Khon Kaen University Hospital.. no referrals and just pay the co-pay as well.

I don't understand why some Thai's are paying all kinds of additional fees when I have never paid for more than the co-pay and private rooms.

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19 minutes ago, Jeffrey346 said:

I don't understand why some Thai's are paying all kinds of additional fees when I have never paid for more than the co-pay and private rooms.

It seems you may have insurance type coverage rather the normal (30 baht) coverage?  There is no co-pay (other than 30 baht).  But emergency service is available and paid anywhere for first several days care under current rules.

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Most Thais in my village have some form of private insurance, including my household because the free treatment is given as a last resort after the paracetamol is found not to work. My step daughter was given this treatment at the hospital after fainting spells so I took her to the village clinic, the doctor did some tests and ordered an ambulance straight away as her blood pressure was dangerously low. The Bat Tong or gold card is better than nothing (it doesn't cover for accidents, only illness) but a private insurance is better.

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4 hours ago, ncc1701d said:

My tgf is getting a bit riled up when I mentioned this to her Hahahaha.

 

shes saying that there is no “government hospital” out in the sticks where she is registered and what they have is called a satani anamai (??) where there is a “nurse” that will give you paracetamol for any and every ailment and tell you to lie down for a few hours. It’s very entertaining watching her go off ????

 

So... my question to add to the op’s is - is it worth it? 

 

Satanami anamai is a Health Center. They are indeed not good for much other than vaccinations and simple wound care.
 

 

Every single village/house in Thailand is covered by a government hospital. No exceptions.
 

There may well not be a hospital in your Gf's village but there certainly is one somewhere in her district. And a higher level hospital in the provincial hospital which the district l refer to as ended. If you can tell me what district, amour and province she lives in I can tell you what hospital.

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48 minutes ago, Jeffrey346 said:

I don't get this primary hospital thing. I am covered by the Gov plan, had a heart attack and was rushed to Khon Kaen Hospital and a stent was put in.

I wasn't registered. My wife talked to the finance dept and they approved my coverage. After a week in the hospital and a B250,000 bill, I paid about B1500.

I was not feeling well and did not agree with the followup care and went to Queen Sirikit Heart Center. They found a blood clot in my heart that KK Hospital never looked for. I go there every 3 months and never had to pay more than the B280 co-pay.. no referral letter.

I also go to Khon Kaen University Hospital.. no referrals and just pay the co-pay as well.

I don't understand why some Thai's are paying all kinds of additional fees when I have never paid for more than the co-pay and private rooms.

Are you civered ubndert= the goivernment Civil Service SS system? As that is different form regukar SS and the "gold card" (AKA "30 baht") schemes.

 

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4 hours ago, scubascuba3 said:

Did she arrange the 100k operation with the govt hospital? or did she go to a private hospital?

I'm just wondering if we can jump the queue at a govt hospital if we pay extra

 

Yes, she arranged the operation at the same public hospital and, I gather, with much the same surgical team. I understand the principles got 20,000 Baht. Now, I'm not sure if she jumped the que or whether the specialist just scheduled an extra surgical procedure at the hospital in their own time.

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