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Home » Reader question » Why no mandatory contribution to state hospitals for foreigners?
Dear readers,
Why doesn't Thailand require everyone who comes to or lives in the country to pay a contribution to the state hospitals? From say 2.000 baht and then everyone is entitled to hospital care? The card that is now free for the Thai. So all foreigners have to pay. The advantage for Thailand is that they receive a lot of money every month, which should be used for the state hospitals.
People who do not want to use it must therefore still pay a contribution. And then insure yourself for a private hospital.
Regards,
Aad
Dear Adam,
A few years ago there was a (non-compulsory) insurance. Costs 2.000 baht per year. This only lasted one year. 2.000 baht is not much, as a diabetic patient I spend more.
regards Hanso
If it were that simple, it wouldn't be a problem. Healthcare costs are very expensive, especially the elderly cost a lot of money. That cannot be covered with 2.000 baht per month.
It really is that simple..
Number of expats x 2,000 is more than current unpaid hospital bills
'…Why doesn't Thailand oblige everyone who comes to or lives in the country…'
Also tourists? Also tourists who have a care and travel policy?
I am in favor of Thailand requiring a tourist to have some cover from their home country and that temporary emergency cover can be purchased in Thailand, something like Assudis offers for €450. That is so expensive for a few weeks that people prefer to buy a travel policy …….
Dear Aad, who exactly should benefit from your proposal?
Seriously ill people will cost the hospitals money – especially if they come to Thailand for cheap treatment from a neighboring country – and healthy people will generate money for the hospital.
Which way do you think the scales swing?
Furthermore, many foreigners already have insurance, so they have to pay twice.
And that is precisely a reaction that I do not understand.
My scale then goes to the total cost of healthcare in Thailand anyway.
Just like in NL, healthy people pay for, as you call, the seriously ill.
Is there something wrong with that? It will be your turn one day, which I hope not.
And of course, people who can prove that they already have health insurance in one way or another should not have to pay double.
Perhaps 2.000 Baht is too little to pay the additional costs of the state hospitals.
They not only receive money, but also new patients.
Especially if the amount is attractive enough to have you treated in Thailand for that 2.000 Baht instead of in your own country.
Then the Thai hospitals will only get worse.
If the Thai government believes that the foreigner should contribute to Thai health care, it can simply increase the price of the visas and use that money for healthcare.
Then you will not be bothered by foreigners who come to fill the hospitals.
They are already full enough.
You write:
If the Thai government believes that the foreigner should contribute to Thai health care, it can simply increase the price of the visas and use that money for healthcare.
As a Dutch citizen, you as a tourist have a visa exempt for 30 days, which means that you do not pay any visa costs. In addition, there are many other countries that have such a visa exempt.
Is it then strange that the Thai government imposes the obligation that a tourist is obliged to have a comprehensive travel insurance policy?
I do not think so.
Or are you talking about an increase in extension of stay visa prices for long-staying foreigners?
You also write:
Then you will not be bothered by foreigners who come to fill the hospitals.
They are already full enough.
You apparently assume that some tourists come to Thailand to get sick or have an accident. To Thailand? Yes for a cool illness or accident so that I can stay in a state hospital during my vacation.
If those tourists have a comprehensive travel insurance policy, it will at least not be at the expense of the Thai government financially. Do you think there are so many tourists in Thailand that overcrowd the state hospitals?
And in the case of long-stay extension of stay foreigners, in my opinion, the requirement of income or THB 800.000 should be sufficient to cover the initial costs. That was also intended for that. It remains that if those extension of stay foreigners only make up a small part of the Thai population, they will in any case not overcrowd the state hospitals.
My experience is that in the hospital where my wife works, and where she visits, there are very few foreigners to be seen.
Doesn't seem like an argument on your part to me.
See also my post on this article dated 16-05-2019 15:08
The idea comes from a doctor here at the state hospital
We take care of a 10-year-old child who no longer has parents
That binkie now has cancer so every week we are here in the hospital for 4 days
The chemo doctor works here in the state hospital for 2 days
And 3 days a week he works in bangkok hospital
Bangkok hospital same treatment only price tag and room is different
And he told my that if there is any possibility for foreigners
Those who pay 2000 per month want a private room of another 2000 bath per night
Then extra money will come into the state hospitals
I think win-win then
Appreciation for taking care of that child. But forcing tourists, the lion's share of whom already have (travel) insurance, to pay 2000 Baht (just under €60) upon entering Thailand does not seem like a win-win situation to me. Families of 3 to 4 people will pay around 180 to 240 euros extra for their holiday and that will certainly not promote tourism to Thailand. On the other hand, patients from countries where care is less than in a Thai state hospital will probably eagerly travel to Thailand to receive free care for 2000 Baht. Making tourists pay for shortages in Thai health care is, no matter how social the idea, not the solution. Good luck to your 'binkie', hopefully he recovers from his illness!
I don't understand your story.
Can you get access to full care and treatment in a state hospital for a subscription of 2.000 Baht per month?
I have never heard of that…
If I go to a state hospital, I will take a room for 2.000 Baht whether I have insurance or not.
I'm not going to lie down.
So what the contribution of the private room to the story is, escapes me.
And a private room also has extra costs for a hospital, not just revenue.
“Can you get access to full care and treatment in a state hospital for a subscription of 2.000 Baht per month?
I've never heard of that…”
True, but it was just an idea of that doctor.
Moreover, I naively assume that the doctor means foreigners who reside here permanently and not tourists who, if they are sensible, already have travel insurance.
Maybe Aad can name it a bit better.
I have a wife and children in Thailand, all with Thai nationality. My wife has Thai health insurance, but I don't have health insurance for my children. Is there anyone who can advise me and does anyone have experience with health insurance for children in Thailand?
CeesW
Your wife undoubtedly knows that she can register her children with the tabien job for the 30th card in the region or city state hospital and/or the clinic around the corner that can forward the children to the hospital,. She herself can also apply for such a card
So if I understand correctly, every holidaymaker would have to pay 58€ pp to be able to use a state hospital “free”. If you are a family of four, that is already more than 200 euros. What a bad idea. My wife and I are traveling in Southeast Asia for 40 days, the last five days in Thailand, Bangkok to be precise. If I can tap off more than 100 €. I do not think so. I am now insured for that!
… if other countries also do this and you tour 3 countries as a tourist, you will win 3 prizes!
Mister BP, as a tourist you would normally have travel insurance and then you are excluded, I think
The same applies to visa applicants who have taken out adequate insurance
It's about those who don't want to or can't
Dear Adam,
I don't find your idea strange.
I have a slightly different opinion but I do agree with your idea.
But I would like to limit it to long-term stays of, in this case, Dutch people, who stay here permanently as glorified tourists and I am one of them.
I would leave tourists out because it seems simple to me.
If tourists are simply not allowed to enter Thailand without valid travel insurance upon arrival in Thailand, they should have taken out the well-known travel insurance. If people don't know something like that by now, I can't help them.
I don't know how to check that.
If you, as a Dutch person, would simply live in the Netherlands with only a single AOW benefit, without a discount, of € 1215.81 / month. then the personal contribution under the Zvw is 5.7% (up to a maximum income of €54.614) and that gives €69.30 / month.
On top of that comes the mandatory health insurance of say €120 / month.
And the maximum deductible is about €32 / month.
Then you come to a maximum total of € 219.30 / month. and at a rate of THB 36, that is about THB 7900 / month.
You are then insured for everything in the Netherlands until your death, even if there was an earlier medical history.
Imagine that you, as the same Dutchman, live permanently in Thailand.
You are single and cannot take out health insurance in Thailand due to age and otherwise with restrictions due to medical history.
Your single, without a discount, AOW benefit will be paid AFTER wage tax in the Netherlands (and with an exemption for personal contribution under the Zvw) at the same rate of THB 36 / Euro 39.830 / month. are.
And now I'm going to guess:
Suppose that medical costs in state hospitals in Thailand are 50% lower than in the Netherlands.
Then a premium (compared to the Netherlands) of THB should just be THB about 3950 / month, right?
You will then no longer be confronted with age and/or medical history, as is the case with insurance companies in Thailand.
Now there will be people who say that as a foreigner they pay more than a Thai.
Then my answer would be:
True, but remember that you are still MUCH cheaper in Thailand and you can go to state hospitals with a well-known Thai medical care.
And is it really so wrong if you contribute a little more to medical care in Thailand (hopefully this will benefit every Thai) while on the other hand you pay much less tax on your Dutch income in Thailand? Is it really just about money?
And moreover, you are insured without restrictions of age and / or medical history, unlike the usual insurance companies.
The ridiculously high premiums of predatory insurance companies, outrageous demands and prices of private hospitals are not in the interest of Thai, only those who work for those same insurance companies / private hospitals.
Where can you get insurance in Thailand with an insurance company for THB 4000 / month. without the age restrictions/medical history?
So I find the amount of THB 2000/mo. too low and if the costs in state hospitals are not 50% lower but still 35% then it would only be a premium of THB 5150 / mo. are.
I would sign for it
And it is true what Adam says. If you want more luxury, you pay for it.
Had to, and wanted to, for my more luxurious car.
This is the last time I want to respond to this
The following: you "holidaymakers" have nothing to fear from all kinds of actions staged by the Thai regarding all kinds of insurance policies that could still come or not?
I don't understand all the fuss so far, what kind of guys are you? the world isn't coming to an end...
How long have you been coming to Thailand and not knowing what's going on?
The misery of their shortages (by many Thai conscience) is the free ministries in many cases in the hospitals and hospitals of Burmese and people from Cambodia..that is widely known by the population and is met with resistance, who understandably do not approve.
A friend of mine who is married to a girl from Cambodia ..comes to Bkk with the whole family every year for a hospital visit .. That is where the real causes of the shortages of their government hospitals lie,
The government here plays for St Niklaas … and that is where the biggest blunders are made and many shortages are born .. the whole Thai system is full of leaks and to feel guilty now as an expat or foreigner from the western world is more than a bridge to far , but they do try to pass on their own failures to others.
I'd rather argue if they want to hold us accountable for their own ignorance to take a good look in their own mirror and analyze their rules more closely before they throw their source of income on the rubbish heap..it's going to be years now up to years already worse and how could that be
is?
Just this: I have been married for years to a Thai who has lived in the west for years and who no longer recognizes her own country with the thoughtless stupid rules that will eventually break them up.
My final conclusion as a world Belgian "they bake bread all over the world". the neighboring countries are already laughing. and breaking off as a conclusion is a quick orgasm that you can't recover afterwards.
And another thing .. what I read above ... if you have no money you just stay at home it's that simple then again you shouldn't make bills for others.
Travel insurance on top of your ticket costs a few pennies more, so what's the problem!?
Best regards. Bye…..
My wife, who works in the operating rooms at a state hospital, told me the following:
Additional payment is required for some operations. Many who have undergone (minor) surgery leave without paying extra. Most are Thai.
For this hospital alone, the unpaid bills in 2018 were THB 100.000.000 (one hundred million) for the entire hospital and not just for the operating rooms.
Actions are certainly being taken to reduce this, but apparently it is not easy.
It is a state hospital and not a private case that first asks for (too much) money upon arrival.
If you are well insured as a foreigner, there will usually be nothing wrong and, at least as a tourist, the extra costs will not be for a travel insurance. Just for the holidays.
The IT department gives me monthly data about the hospital's operating rooms as registered by the staff, and I analyze it. I do this as a “hobby” because apparently the information department is not able to do that. I don't get paid for it. There are no financial data included.
If I only look at the outcome of that, I would be fired immediately in the Netherlands.
What an incredible mess of administration. 90-hour work days are no exception and there is so much more.
Marc is right about that. If things go wrong, it's not the fault of course? but of the damned foreigner. Well, you know that about Thailand, don't you?
As far as I'm concerned, this does not alter the fact that despite the mess that Thai people in charge make of it, we as foreigners should just do the right thing and not look at what others are doing or rather should be doing. Doesn't make sense and it gives you a headache.
I'm a little angry, you say this:
'The misery of their shortages (conscience of many Thais) is the free in many cases ministries in the hospitals and hospitals of Burmese and people of Cambodia .. this is widely known by the population and is met with resistance, who understandably do not approve. '.
That is not true. All people from neighboring countries such as Myanmar, Cambodia and Laos with a work permit are insured, with the employer, employee and the government jointly paying the premiums.
And there are also illegal migrant workers. They, like other foreigners without insurance or money, are always helped in acute cases, or would you rather let them bleed to death? I know a few Dutch people who have been treated for free.
Nicely written Marc, I also see hospitals in my immediate vicinity full of Burmese with babies hanging in a kind of bag in front of their mothers' bodies.
My Thai spouse was still in the Lamphun state hospital last week, half of Burma seems to be walking around here for my visit to the ENT doctor.
And, as usual, I was the only pale-faced farang.
Jan Beute.
But we are not talking about Burmese, Jan Beute, but about shortages. Or can you tell by the nose of those Burmese that they don't have insurance?
What a discussion! How can you ask yourself whether the TH government should charge everyone who enters THB 2K entrance fee, and then give “the right to care for the sick”? Read his problem statement again. The idea alone? Suppose my neighbor (58 years old, diabetic, broken knees, severely obese and heart patient) comes to TH with his wife (54 years old, lung and rheumatism patient). They pay ThB 4K at passport control, and they are then health-insured? After all, that is what dear @Aad raises as a thought. Nonsense.
The only solution to this problem is to provide care only after showing the insurance policy (or paying in cash). Harsh? No, the same happens in Australia, the US and Canada! And once you know that, you act on it. However?
TH would do well to ensure that:
1- when applying for a visa, in addition to proof of sufficient income, proof of worldwide health insurance is also submitted.
2- tourists (up to 30 days visa-free) also show their “health insurance card” at passport control.
3- If not, let tourists buy TH insurance on the spot against payment of a hefty premium (in the same way that visa-on-arrivals are also sold. The longer the queue, the more annoying the situation, the better people think about another TH visit!)
A proposal was made in the article to request a contribution of 2.000 baht from foreigners:
“Why doesn't Thailand oblige everyone who comes to the country or lives there to pay a contribution to the state hospitals? From say 2.000 baht and then everyone is entitled to hospital care?”
Apparently, this must be offset by the right to care, i.e. cheap health insurance for foreigners.
Personally, that seems to me to be the real idea behind this proposal, and not so much the ups and downs of Thai hospitals.
Whether that health insurance is per visit or per time period is unclear in the story.
The risk you run with this is that the premium is so attractive that you lure seriously ill people from the surrounding countries to go to the hospital in Thailand.
Will the Thai hospitals benefit from this?
If foreigners must then be asked to pay a contribution to the state hospitals, do this through a levy on visas, extension of stay and whatever else exists, without giving you the right to hospital care.
Consider it a tax on healthcare in Thailand.
Why does Thailand not impose the same requirements/rules as the Schengen countries do for all foreigners who apply for a visa for the Schengen area? This is a mandatory demonstrable travel/health insurance with a repatriation clause (concluded wherever it is). If this is not done, then turn around. Problem solved. It only has consequences for the free monthly visas and these short-stay holidaymakers will not notice much of it financially. Fraud excluded.