Reader question: What about elderly care in Thailand?
Dear readers,
I read several articles about health care in Thailand. An important part of the contributions is about health care for foreigners. I do read an article about health care in “rural” villages.
I live with my girlfriend and our daughter alternately in the Netherlands and Spain. Like every Dutch person, we are compulsorily insured. We can use the health care in Spain without any problems without me having to pay the bill in advance. Claims are made directly to our insurer.
Every year in winter we go to Thailand for a month to visit family. I have a continuous travel insurance for that, so that doesn't cause any problems either.
My girlfriend is from Isaan, Pak Chong to be precise. Her parents, like many people in the Isaan, are poor, very poor. Her father I was fired from the chicken farm a few years ago. He was getting too old, he was told. He is now retired, but he does not have to count on any old-age support from the government. He has no state pension or state pension. The family (5 daughters) must support the parents.
So far it goes. Too little to live, too much to die. But old people get physical problems, such as worn hips, knees and shoulders. But also other age-related diseases. As far as I understand they have to pay for any consultation or treatment in the state hospitals themselves. Like a few months ago. Then the daughters, who also each have a family, have to patch up to get the money together. And then it turns out that the father also has to spend the night outdoors because there was no room left inside.
No, I do not agree that health care in Thailand is well organized for the Thai population. So much for my story as information for my question. I would like information from other readers of this forum.
My questions are:
- Is there any support from the government for the Thai people if they no longer have any income due to old age?
- Is there the possibility for the Thai population to use government health care, whether or not free of charge?
- Are the elderly in Thailand affordable to insure for health care?
I hope there are readers who can provide me with information.
Yours faithfully,
Nico
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Dear Nico, A Thai who turns 65 receives a monthly amount of, I thought, Baht 800-. Then he/she can insure himself from an early age with the SSO (Social Security Office) by paying a premium against Unemployment, Sickness, Pension. This is voluntary. My daughter works in the account department of Bill Heinecke (the pizza farmer) and is deducted from her salary every month. If she continues to pay voluntarily, if she no longer works, she will simply receive a retirement pension when she turns 60. The key word is VOLUNTARY and not done by the average Thai. Why do you think it's all mandatory in NL? If it was voluntary there too, no one paid his premiums. Is in human nature.
Surely there are experts who know better, but from what I've learned, there's cheap insurance for the populace. Too expensive for someone who has nothing, but very low compared to the sums you pay in Europe.
Pension exists. My in-laws receive 500 Baht per month from the state! I haven't forgotten a zero. Whole five hundred baht.
That is why there are so many complaints among the many expats that they have to support the family - the parents of their sweetheart. In the Netherlands you have to spend a large part of your income on health insurance, pensions, etc. This is not the case in Thailand. Here the state says that people should take care of their families themselves. So whoever loves his parents goes to work hard, works in a bar or marries a Farang….
The differences between rich and poor in this country are huge. Of the 80% less well off, part is poverty-stricken and the situation in neighboring countries is not much better. Now your questions.
1. No, there is no national old age provision. Since the late 90s, pensions have been accrued for a few groups of employees, including (mainly) civil servants.
2. As far as I know, above a certain age, free state care applies in state hospitals and they say, only in the city where you are registered. But I see around me that Thais just pay for treatment and medicines when I see the crowds in the state hospital where I get treated.
What you write, wear and tear on body parts occurs and replacement is possible, but in the Isan (Khon Kaen) a total hip replacement costs 2 tons of baht and in Bangkok much more and that is unimaginable for many. So they prescribe painkillers.
Example ? Experienced myself on the same day in the state hospital with me. Thai with bleeding feet and swollen leg. Diabetes. The plaster master, where I was then, tells me: that will be an amputation. A little later, foreigner, living here, with ditto. Sir goes to a private hospital in Udon Thani. Yes, sir, the foreigner can afford that, the Thai cannot.
3. Give it a try ? Thai health insurance exists, but there is often a maximum entry age.
Thanks for this comment, Eric.
Especially the amputation of the Thai diabetic. This rings a bell.
Am particularly diabetic after pancreatic disease. Have therefore already seen some hospitals in Thailand.
And seen many Thais with untreated diabetes. Who did not have access to adequate insulin therapy.
You see them again after 5 years because, for example, they have to have a leg amputated. If they're still alive.
Any European or American doctor can tell you that newly diagnosed HIV infection is more treatable than diabetes. If untreated, like so many in Thailand, ... you can fill in yourself.
Health care (diabetes care) in Thailand is poor, not to mention the rest. That is why Thailand is cataloged as a third world country. Few tourists realize this, but it is true.
Immediately an answer to questions 1,2, and 3 from poster Erik: NO each time.
Unless you take care of it yourself, or are a dignitary?
Might write another essay on this subject: diabetes care in Thailand. But there is nothing online in English (unless tourists ask where they can buy insulin). And my late Thai friend, quite intellectually gifted, could hardly find anything on sites of interested authorities. Unless dissertations for a PhD, or participation in conferences of Thai 'invitees'. But nothing substantial from the government, or towards the population!
If anyone has any information, address known to the editors.
Most Thais don't have the money for such voluntary insurance / pension accrual. Just like in many countries, and also NL 70 years ago, it is the children or other family members who in turn take care of the elderly.
Here we pay a lot of premiums and taxes, from which many civil servants and administrative staff are paid, let alone the bonuses of the top, that is where it goes directly.
So don't complain if your Thai sweetheart asks for a contribution for the maintenance of the parents or family (etc even acquaintances)
Dear other Nico,
Every month I bring my wife's parents (husband + wife) to the district office in Lak Si (Bangkok) where they collect their AOW, I think they also get 500 Bhat each. They must report to the counter in person.
For health insurance there is something like a 30 Bhat scheme, but I don't know the details of that. Because an aunt (grandmother's sister) has to be treated “against I don't know” and that costs 6.000 Bhat every month. And as described above, the children pay that. As a farang, I pay half and the other 4 children, the other half. But that is of course up to you.
Greetings that other Nico
@ Eric, just about the cost of a new hip in the state hospital of Phetchabun, I am a foreigner 91 years old, this cost 1000 Euros and everything was perfectly placed during the examination in the Netherlands, I pre-shot this amount and after 2 weeks the Netherlands it was back on my account.
It is true that for people who have nothing, everything is too much and indeed nothing has been arranged regarding medical expenses.
My 80-year-old mother-in-law gets 700 baht a month, so as you write, sponsor the family.
Dear Nico and other bloggers!
According to my Thai other half, her parents, poor farmers from Surin, each receive THB 600.-/month “Thai state pension” (recently increased from 500 to 600). They are in their sixties. If you are in your 70s, it will be THB 700; are you in your 80s, will it be THB 800,— etc.
They have free basic state health insurance; what “basic” is covered is determined by the medical staff. Additional costs must be paid for additional procedures.
Every Thai receives a government support of 60 THB when they reach the age of 500, and this is increased by age to a maximum of 800 THB. This is a small basic care, and can only be higher, depending on their profession, or private insurance. Since most Thais cannot afford private insurance, nor are they eligible for social insurance, taken out by any employer, most Thais depend on this small basic support from the government, and the care of any children, or further relatives.
Furthermore, every Thai is entitled to health care, this is nothing more than a kind of basic care, which falls under a so-called 30THB scheme, and can only be obtained in the state hospital of their place of residence.
My experience is that most Thai people have more confidence in a private clinic in the event of actual complications, where the care is clearly better, and the waiting times are not that long. Because this care can be paid privately, and most Thai people do not have additional health insurance, these costs are usually paid by the children or other family members. An extra health insurance that pays for these private clinic costs is not affordable for most, and must also be taken out before the age of 60, as people will no longer be accepted after reaching this age.
As far as I know, care and consultation in a state hospital is free for Thais. recently, also for us falangs, there also care and consultation virtually free, only to pay 5.000 ฿ / year.
Moderator: Only responses to the reader's question please.
Haki, thank you for updating us.
The amounts for the Thai 'AOW' are minimal. From 600 baht a month, that's 20 baht a day, you can eat a bite of rice and the vegetables must come from the garden or the bush and the meat is a road-kill chicken or dried fish from the rice field. No one can live independently with this money.
In Thailand it is customary for the youngest child in the house to take care of the 'old people'. Those old people take care of the children of the youngest and partner who work after all, so grandpa and grandma take care of the children after school. I see that around me every day. There is no wealth with those old people other than the house that is given to the youngest.
Andre, a total hip replacement for 1.000 euros is a bargain! In Khon Kaen, the prosthesis alone costs 1 ton baht. The fee for the ortho surgeon was 30 k baht. I know elsewhere in Thailand this surgery is offered for less. For me Khon Kaen, still 180 km from home, was the closest option but I will keep your comment in mind for when the second hip comes up.
What falls into the basic package is subject to political posturing. Overpaid people are going to decide what the poorest will receive in terms of care, while they themselves have their problems solved in China and the USA at a high price. The differences between poor and extremely rich are too great here. And the rich are in charge, not the kl@@tjesvolk. That must continue to suck and suffer pain.