Uninsured foreigners burdens Thai public hospitals

[webfact]

Uninsured foreigners burdens Thai public hospitals
by Frederik Guy Hoff Sonne


Methanee Merani is on the phone with relatives to a Swedish patient(Photo: Frederik Sonne)

Three public hospitals reports of million baht expenses from unpaid hospital bills by foreigners.

BANGKOK: -- ScandAsia have gotten insight in Vachira Hospital in Phuket’s outstanding balance on unpaid bills by foreigners and it counts almost 20 million baht negative in recent 8 years. Scandinavians forms 20 percent of this loss. Banglamoong Hospital in Pattaya and Patong Hospital in Phuket claims they have the same problem.

“Our priority is always to help, we support the basic health”, Methanee Mareni tells. She’s a nurse and head of the international department at Vachira Hospital in Phuket. Her phone is ringing constantly. When ScandAsia meets her, she’s on the phone with relatives to a Swedish patient.

Vachira Hospital treat thousands of foreigners each year but it has become a costly affair. The Hospital is obligated to accommodate and treat foreigners, who can’t afford private hospitals. Often there’s a good reason why private hospitals are irrelevant for this groups – the insurance is not adequate or they don’t have an insurance at all.

Methanee Marenia and Vachira Hospital are paying the consequences for this. Since they began to account for the losses in 2008, they have a total outstanding balance on 19.827.858 baht concerning a total of 189 foreign patients. In 2015 the loss counted 3.837.583 baht.

Dr. Bancha Kakong, Director of the Phuket Provincial Health Office, assess that the expenses are approximately 10 million baht a year for the Public Hospitals in Phuket. He also claims that Patong Hospital has an outstanding on around 2-3 million baht each year. At The Banglamoong Hospital in Pattaya they had a loss of 1.918.790 baht in 2015 from unpaid bills by foreigners. They can’t provide numbers further back than 2015.

Scandinavians plays a notable part

Germans and Brits tops Vachira Hospitals list over outstanding balance since 2008 but Swedes are placed fourth with a liability for losses of 1.914.368 baht. Finns are eight with unpaid bills for 733.551 baht. Norwegians and Danes are listed 11th and 17th with respectively losses on 674.760 baht and 489.182 baht.

In total Scandinavians are guilt in a loss of 3.811.862 baht at the Vachira Hospital. In 2015 it was 742.722 baht, merged with Banglamoong Hospital numbers from 2015 it’s a total loss of 787.454 baht in 2015 caused by Scandinavians unpaid bills.

Tourists, young as old, and retirees living in Thailand are the usual suspects. People working in Thailand usually have a work insurance, so they very rarely loads the hospital, Methanee Mareni explains.

Problems occurs when the patient doesn’t have a travel or private insurance. At other times the patient has an insurance, but the insurance doesn’t cover, very often when it’s accidents occurred by drinking, which are very common among foreigners.

“We are aware of the problem”, Pär Kågeby, Senior Consular Office at the Embassy of Sweden in Bangkok, informs, adding that they are doing a lot to prevent this: “We try to inform people in Sweden with continuing campaigns to make sure that Swedes knows the importance to sign a proper insurance before going to Thailand”.

Patric Nilsson, Deputy Director at the Swedish Ministry of Foreign Affairs, is on the P4 Radio in Sweden every Thursday and has been in Morning TV several times informing Swedes of the importance of an insurance when traveling.

Mikael Hemniti Winther, Danish Ambassador in Bangkok, tells the same. They acknowledge the problem and they’re doing their best to inform about insurances. In the end no one can force people to buy an insurance.

Swedish, Danish and Finnish national health insurance doesn’t cover in Thailand. Norwegian health insurance covers Norwegian expats, who have been living in Norway in 3 of their last 5 years.

Battling to get money back

When treatment is over and the bill is unpaid Vachira Hospital uses a lot of ressources to raise the money afterwards, but it’s often a dead end.

“After the operations, we try to get the money, but it’s hard. We’ll try to get in touch with the families, embassies, governments and even though people are trying to be helpful, if they don’t pay they don’t pay and we can’t do anything about it”, Methanee Mareni tells.

“We can’t do anything to assist the hospital. It’s a matter between the hospital and the patient, who happens to be a Danish citizen. We don’t have the authority to interfere”, Mikael Hemniti Winther says.

Scandinavian institutions have the same base or lack of that. “We can sit down and discuss with relatives to a Swedish citizen in a Thai hospital what there financial possibility is to pay their own costs. But if the hospital and the patient doesn’t make a deal, we can do nothing to collect the debt”, Patric Nilsson from the Swedish Ministry of Foreign Affairs tells.

In Sweden they have a so-called summary process which means that, if the hospital signs a contract with the Swedish patient they can collect the debt due to Swedish legislation, but that is also a matter between the hospital and the patient to sign such a contract.

Unclear solutions

Dr. Bancha Kakong has proposed that foreigners should sign a mandatory insurance when they arrive in Thailand. In the Phuket News 6. January 2016 he said:

“Thailand, and especially health officials in Phuket, are currently pushing to introduce compulsory travel insurance by law. Very soon, all tourists who want to enter Thailand must have travel insurance”, Dr. Bancha Kakong still suggest this, when ScandAsia spoke to him.

Another likely proposal is being raised by Phuket Governor, Chamreon Tipayapongthad. He suggest to collect a landing fee for tourists so they have a minimum insurance when they enter Thailand. Chamreon Tipayapongthad has presented his view on the topic of travel insurance for the Ministry of Foreign Affairs and the Ministry of Tourism and Sports.

Patric Nilsson comments on the proposal: “Whether they implant this or not it’s a matter of Thai politics. All I can say is, that it’s unfair to the hospitals and we are grateful for the work they do. I recommend that the hospital tries to make an arrangement on an installment plan to pay the bill over time if the patients can’t pay right away”.

At the Ministry of Tourism and Sports they don’t want to comment on these proposals. They state that they earmark around 200 million baht a year in a tourist fund to cover such losses at the hospitals and “help and support the tourists”.

Methanee Mareni is familiar with the fund, but it hasn’t had notable impact on their expenses:
“We wrote a letter to the Ministry of Tourism and Sports 7 years ago for the first time, applying for money to cover expenses. Only one time have we received money from the fund”, she says. It was concerning the case when an Italian tourist was robbed and stabbed in Karon in 2014. In that case Vachira Hospital received 100.000 baht.

Source: http://scandasia.com/uninsured-foreigners-burdens-thai-public-hospitals/


-- (c) Copyright Scandasia 2016-03-07

[Hawk]

Most of these hospitals are grossly expensive as all of them love to overcharge.

[Jools]

Just a matter of time before the government runs off more retirees by requiring that they have insurance that would wipe out a third of some monthly incomes. Universal coverage is the answer but no one is asking the question.

[Prbkk]

This is the lead-up to a new campaign for a levy on all non-citizens ( one that will raise billions of baht to cover losses in the millions). So transparently obvious it's embarrassing. It didn't get legs last time but watch this space.

[villagefarang]

So you want to blame the hospitals because foreigners rip them off. It is not the hospital’s fault if a foreigner doesn’t have any money or refuses to pay his bill. This could easily lead to restrictions on the care of foreigner, which no one wants.

[jpinx]

This is already a very old debate and has been covered many times in TV. The issue at hand in the quoted instances is that fact that the hospitals overcharge and apply inappropriate treatments in many cases. Go to a government hospital and the bill will usually be reasonable.

[TheCruncher]

At the Ministry of Tourism and Sports they don’t want to comment on these proposals. They state that they earmark around 200 million baht a year in a tourist fund to cover such losses at the hospitals and “help and support the tourists”.

Methanee Mareni is familiar with the fund, but it hasn’t had notable impact on their expenses:
“We wrote a letter to the Ministry of Tourism and Sports 7 years ago for the first time, applying for money to cover expenses. Only one time have we received money from the fund”, she says. It was concerning the case when an Italian tourist was robbed and stabbed in Karon in 2014. In that case Vachira Hospital received 100.000 baht.

So anyone an idea where the remaining 199.900.000 went for 2014 alone?

[South]

Easy - every inbound visitor must prove that he/she has valid medical insurance before being allowed entry.

[uthaithanirules]

What moron goes to Thailand without travel insurance?

I used to pay about US$60 for a single trip

I think they should be locked up after their treatment till the family or someone else pays.

Thats what would happen if they didnt pay their hotel bill, whats the difference?

[richard_smith237]

I see number things that are needed.

1) A fair pricing system employed by the hospitals (and overseen by an independent governing body).

2) An insistence that all foreigners have Medical Insurance before entering Thailand.

3) Fair insurance that covers the elderly with fair premiums.

One further point:

The complaints are that foreigners are burdening the health care system, however, there are many cultural aspects which also burden the healthcare system here. i.e. drinking excessively, road safety (seatbelts, motorcycle helmets, education), poor quality street foods, pesticides on veg etc etc..

Addressing some of the issues may in the long term reduce the overall burden on the healthcare system by a far greater degree than that caused by foreigners.

[Prbkk]

What moron goes to Thailand without travel insurance?

I used to pay about US$60 for a single trip

I think they should be locked up after their treatment till the family or someone else pays.

Thats what would happen if they didnt pay their hotel bill, whats the difference?

Indeed but soon wil be required to pay a levy, probably through taxes collected through air tickets, IN ADDITION to your $60 policy.

[ignis]

Most of these hospitals are grossly expensive as all of them love to overcharge.

Yes must be something to do with these Hospitals..

Had an emergence Operation in 2005 they wanted 76,000 baht up front, again another small op last year at a different Hospital [one I have been registered with + visited for some years]

[worgeordie]

The cost of doing business,the charges they levy,will cover any shortfall

when people don't pay their bills, I am sure, If the Government forces

retirees to have health insurance,while it is virtually impossible or horrendously

expensive to get cover over 70 years of age, that will effect a lot of people here.

regards Worgeordie

[meatboy]

I see number things that are needed.

1) A fair pricing system employed by the hospitals (and overseen by an independent governing body).

2) An insistence that all foreigners have Medical Insurance before entering Thailand.

3) Fair insurance that covers the elderly with fair premiums.

One further point:

The complaints are that foreigners are burdening the health care system, however, there are many cultural aspects which also burden the healthcare system here. i.e. drinking excessively, road safety (seatbelts, motorcycle helmets, education), poor quality street foods, pesticides on veg etc etc..

Addressing some of the issues may in the long term reduce the overall burden on the healthcare system by a far greater degree than that caused by foreigners.

another further point to add to the above.

all the serious injuries caused every day by uninsured thai drivers.

[thaiduncankk]

Government hospitals charge a fraction of the extortionate private hospitals, I use them, and never fail to pay the final bill.

Why doesn't the Government, or a company within Thailand, introduce an insurance for people restricted to using public hospitals only ?

I am sure the premiums would be a lot more affordable for people here.

With regards to making it compulsory for arrivals to have insurance, this would be impossible to police. With modern technology, it is not rocket science to forge a bill head,from an overseas insurance company, quoting a blag policy number, indicating that the person is insured. Proving that every document people show on arriving is genuine would be impossible.

[thaiduncankk]

Easy - every inbound visitor must prove that he/she has valid medical insurance before being allowed entry.

And how will this be policed ?

Phone every insurance company on the document to verify it is genuine ?

[Bluespunk]

Those pesky foreigners again.

[baboon]

What moron goes to Thailand without travel insurance?

I used to pay about US$60 for a single trip

I think they should be locked up after their treatment till the family or someone else pays.

Thats what would happen if they didnt pay their hotel bill, whats the difference?

The drawback with that plan is that it would cost the state even more money to lock them up.

[hkt83100]

When I stayed at the BKK HKT Hospital in Phuket a few years ago, they quoted a room price of some 5000 Baht/day. When I told them, that I have to pay from my own pocket not an insurance, the price went down to about 1900. So much about fair prices. Don't wonder why the cost of insurance goes up like crazy.

[Pib]

Just allow foreigner's to participate in the country's 30 baht medical universal coverage program by paying a fair fee. Most Thai's don't pay any income taxes and therefore don't provide funds to pay for govt services such as the free health care provides under the 30 baht program...as least a farang would be paying the fee which is more than a Thai pays.

[Prbkk]

Those pesky foreigners again.

Yes, I missed the last sentence about the Italian tourist being robbed and stabbed : perhaps Thailand can establish proper victims of crime funding, to compensate treating hospitals in addition to victims. God knows there is a crying need.

[alfieconn]

This is already a very old debate and has been covered many times in TV. The issue at hand in the quoted instances is that fact that the hospitals overcharge and apply inappropriate treatments in many cases. Go to a government hospital and the bill will usually be reasonable.

What has that got to do with the Topic ?

[WhizBang]

This old chestnut again?

So they had 20 million baht of unpaid bills over an 8 year period, versus how many trillion baht of revenue from tourism?

Suck it up Thailand. Do the right thing, go after the deadbeats, but do not try imposing more restrictions on the rest of us.

[chiang mai]

What moron goes to Thailand without travel insurance?

I used to pay about US$60 for a single trip

I think they should be locked up after their treatment till the family or someone else pays.

Thats what would happen if they didnt pay their hotel bill, whats the difference?

Many expats who have lived here for the past ten years or more chose to self insure, I'm one of them, it's cost effective if you have savings put aside for such an emergency and my past twelve years here have proved that to be true. Forcing me to buy insurance does nothing more than improve insurance company profits and reduce the quality of my treatment and care, at age 66, pre-existing conditions are unlikely to be covered thus money spent on premiums would otherwise have been spent on treating those conditions.

I imagine what will happen with this at some point is that a government charge will be levied on those who do not have health insurance, that levy is likely to be substantial but only entitle the patient to be treated at government hospitals.

[richard_smith237]

Government hospitals charge a fraction of the extortionate private hospitals, I use them, and never fail to pay the final bill.

Why doesn't the Government, or a company within Thailand, introduce an insurance for people restricted to using public hospitals only ?

I am sure the premiums would be a lot more affordable for people here.

With regards to making it compulsory for arrivals to have insurance, this would be impossible to police. With modern technology, it is not rocket science to forge a bill head,from an overseas insurance company, quoting a blag policy number, indicating that the person is insured. Proving that every document people show on arriving is genuine would be impossible.

Quite... But that would be fraud and with it greater implications....

If someone is willing to fraudulently mislead Immigration (and the Thai Govournment) into believing that they have the require insurance cover and find themselves in the unfortunate situation of facing serious illness or being in an accident without cover they may end up facing tough consequences.

For many the deterrent may be enough. For the minority I would suggest that the consequences they face (fraud) is entirely their own fault - they will have made their own bed so to speak.

That said: Some people may find obtaining insurance difficult or expensive. I like the idea of coverage which limits treatment to government hospitals at reduced premiums.

[leeneeds]

I agree with having an insurance before leaving your home country, some people just disregard the advice and the old it will never happen to me mentality.

Having insurance tied to visa on landing of 20 baht for tourists is a small amount and would allow a visit to the hospital for them,

multiply by how many visitors @20 baht the hospital 's fund will be well in the Black.

Thats all thats needs to be done, nothing else !

[jpinx]

Links to previous threads...

http://www.thaivisa.com/forum/topic/745049-thai-private-health-insurance-to-foreigners-50-to-70-years-old/

http://www.thaivisa.com/forum/topic/884254-handle-with-care-hospital-care-for-foreigners-without-travel-insurance/

This is very old already and has come up in numerous threads. No need to regurgitate what is already well-known

[kotsak]

When I stayed at the BKK HKT Hospital in Phuket a few years ago, they quoted a room price of some 5000 Baht/day. When I told them, that I have to pay from my own pocket not an insurance, the price went down to about 1900. So much about fair prices. Don't wonder why the cost of insurance goes up like crazy.

It's similar to when you need to present proof of insurance in advance (before being treated/admitted) so that they can squeeze up to the limits with crazy fees and medicaton. Blood sucking robbers the whole lot.

[terryp]

Not this garbage again ...and how many TRILLIONS of Baht are generated from Tourism...All the gov has to do is take 0.01 percent from the hotel room tax that has been collected for years and it solved ..SIMPLE ...Oh but i forgot thats not the real reason is it .. its about some muppet making billions from selling ALL tourists medical insurance on arrival

[sunnyjim5]

The UK Government levies a "health" charge on all who seek long stay visa this charge being addition to the visa fees.

The same could be done here ------ a levy on all long term visas/extension together with an instruction to all Thai Embassy's/Consulates to insist on evidence of travel insurance being provided before issuing tourist visas.