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  1. #1

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    Phuket hospitals defend fractured pricing

    Phuket hospitals defend fractured pricing
    Phuket Gazette – Sunday, October 21, 2012 8:44:00 AM

    A nurse attends to patients on the Provincial Hospital’s opening day last year. The facility received much praise from honorary consuls last month. Photo: Gazette file


    PPAO Vice President Chawalit Na Nakorn, who is also on the hospital’s board of directors. Photo: Orawin Narabal

    SPECIAL REPORT

    PHUKET: Top officials at the recently opened Phuket Provincial Hospital this week defended the facility’s practice of charging foreigners greatly inflated fees compared to its prices for Thais.

    The Phuket Gazette spoke to Phuket Provincial Administrative Organization (PPAO) Vice President Chawalit Na Nakorn, who is also on the Provincial Hospital’s board of directors, about the large gap between charges for Thai and foreign patients.

    “Our hospital aims to provide efficient health care for people and attempts to cover everyone. This is why we have different kinds of patient payment schemes, such as social security patients, the 30-baht health insurance policy patients, patients who are government employees, self-payment patients and patients with private health insurance,” Mr Chawalit explained.

    “Every hospital, even those that are government-owned and operated by the Ministry of Public Health, have different medical treatment rates for Thai and foreign patients. Our rates for foreign patients are partly based on the range of prices as set by the Ministry of Public Health.

    “However, our hospital management committee, after considering the issue, decided to adjust the prices for foreigners,” he said.

    The “decision” included inputs from the Thonburi Hospital management group, which provides the medical staff and services. It also used the range of fees that the government-run Vachira Phuket Hospital charges foreigners as a base.

    “Foreigners use our services and we do not have the funding to provide the needed treatment at the same prices that we can offer Thais. Most Thais are covered by either the 30-baht national health scheme or by the mandatory social security coverage that must be provided for any persons working, or they are government employees. That is not including Thais who are covered by their own private health insurance.

    “For patients under all these categories, the hospital receives some form of reimbursement for providing treatment,” Mr Chawalit said.

    Any foreigners who have been issued a social security number, which is mandatory for foreigners working in the Kingdom, are eligible for the same discounted rates offered to Thais claiming medical treatment under the same system, he noted.

    Mr Chawalit added that Phuket contributed much of the national income generated by tourism to the central government.

    “But when the central government allocates its annual budget, most of it goes to government hospitals,” he said.

    “We do not receive a formal budget from central government to operate the hospital, although they do partially support the 30-baht health insurance policy by paying us on average 1,900 to 2,000 baht per person per year. However, that is not enough to cover the actual treatment fees,” he added.

    “As we are not funded by the Ministry of Public Health, we receive our funding directly from the PPAO. This is one of the reasons that we have to charge foreign patients more than Thai patients,” he said.

    As the PPAO owns the hospital, he added, any profits made by the facility will be used in PPAO projects to the benefit of Phuket taxpayers.

    “If any foreign patient wants to know the cost of treatment beforehand, they can check with the staff at the international department before the treatment begins. However, the price will be approximate as it depends on how severe their malady is and what type of treatment they will receive.

    “If any foreign patients need help, or has questions or thinks he is being overcharged, the staff at the international department are available to help,” Mr Chawalit said.

    STANDARD PRACTICE

    A senior officer at the Vachira Phuket Hospital’s international department confirmed to the Gazette that this government facility, too, does impose higher charges against foreigners than Thais.

    “The rates for foreign patients are set by the hospital management committee, based on the range of medical treatment costs as set by the Ministry of Public Health and the Medical Council of Thailand,” the officer explained.

    “For a doctor’s visit of less than 10 minutes, the cost is 200 baht; between 10 and 30 minutes, 300 baht; and more than 30 minutes, 500 baht,” she said.

    “We do not charge a hospital fee as that is included in the doctor’s appointment fee, and an administrative fee is charged if the patient has private health insurance because hospital staff will have to contact the overseas insurance company.

    “We charge for the international calling costs and service. The cost will be 500 to 1,000 baht.”

    A physician evaluation or management fee will not be charged if the patient does not undergo an operation, and the prices of the medicines and treatment for foreign patients, except for operations, are the same as for Thai patients.

    “Foreigners covered by the social security health care scheme, if they are registered at the hospital, will receive treatment free or at the same cost as Thai nationals,” the officer added.

    A reader writes:
    I went yesterday to the Phuket Provincial Hospital for a doctor's visit that was only five minutes as there was nothing wrong with me.

    After that, I sat waiting in a special section for 30 minutes while staff made out a bill for 1,100 baht for that five minutes with the doctor. A physician valuation/management fee of 500 baht; a hospital fee of 200 baht, and an administrative fee of a further 400 baht.


    That is more than I pay at Bangkok Hospital Phuket or at the Phuket International Hospital.

    I asked them why it was so expensive, to which I was told they had different prices for foreigners. I left with a bad feeling as I don’t expect to be ripped off by a decent hospital.

    If they want to charge fees like that they should at least make us aware of it beforehand.

    – Gazette reader
    (Click here to see our reader's hospital receipt)

    This report appears also in the current (October 20) issue of the hard-copy Phuket Gazette.


  2. #2
    Thailand Expat terry57's Avatar
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    Foreigners should be well insured so it would not be a problem but if there not why should they get a discounter rate same as a Thai ?

    Seems fair to me considering the difference in income, I have no problem with it.

  3. #3
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    I am registered at 3 local Thai state hospitals as not all have departments such as dermatology, cancer, etc:

    I haven't always taken my wife along when registering, merely produced my Thai driving licence and completed a personal details form and have been made to feel welcome.

    Like Thai's i queue to be examined but as i am not an emergency case then i have no problem with that.

    In my own country i have to ring for an appointment to see my own GP and again an appointment is sent to me if i require specialist treatment. The NHS get very upset if you do not attend these appointments btw, sometimes refering the patient back to their own GP rather than arranging another.

    I have never knowingly been overcharged at a state hospital in Thailand and have been treated on many occasions, including a 3.5 hrs operation for an aggressive cancer earlier this year, the bill for which was 7,500 baht for 2 days attendance.

    I do pay a small annual premium for accident insurance which covers me for treatment costing up to 100,000 baht for a single incident.

    If one registers at a state hospital as a long stay resident/patient then in my experience one will be treated similarly to a Thai.

  4. #4
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    the point seems, that you dont get a proper diagnose - to begin with...

    then you dont get proper medication...

    that makes people run there umpteenth times...

    each visit might(!) be slightly cheaper as at home, but in the end you pay much more - because of the many visits and the many (mostly useless, ineffective) medication...

    ...thats what you can take from other posters on the net... many...

  5. #5
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    ^ I suggest you read those many posts with a pinch of salt then.

    I have used two hospitals in Udon Thani. One for me and the wife and one for the wife's sister. I would say the diagnosis and treatment were second to none and the costs were very much less than I expected. I paid for each of the treatments (4 separate operations involving ICU and 3-7 days hospital care) and my insurance cover paid me back about a month later. The wife's sister I paid for since she had no insurance and I wanted her to be in a private hospital. I would guestimate the hospital visits, including operations cost less than 10% the equivalent in Germany. The surgeon, who was Thai, trained in Scotland and taught in Germany and Australia so no qualms there....

  6. #6
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    Quote Originally Posted by alitongkat View Post
    the point seems, that you dont get a proper diagnose - to begin with...

    then you dont get proper medication...

    that makes people run there umpteenth times...

    each visit might(!) be slightly cheaper as at home, but in the end you pay much more - because of the many visits and the many (mostly useless, ineffective) medication...

    ...thats what you can take from other posters on the net... many...


    There are a few posters on TD that self-medicate and i support such a view.

    One has to be in charge of one's own destiny and that includes assessing medical advice from professionals.

    Earlier this year i had jaundice and within an hour i had researched the likely causes via the internet. I popped to the local hospital 2 days later and several tests were carried out including an ultrasound scan of my liver. Their diagnoses proved correct and i was charged 1000 baht.
    The medical team asked if i wished to return in a few weeks to have a sample of my liver taken and i declined their offer as i thought it may not be necessary.

    The internet is a wonderful tool for researching ill-health issues, and can give the sufferer some knowledge of their complaint prior to seeking further advice if necessary.

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    you had for 1000 baht

    - a doctor consultation in a hospital
    - several tests (blood?)
    - ultrasound

    ?

    can you please confirm?

  8. #8
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    if you got a liver testing, then they took the liver values...

    do you remember, which ones that were? blood only or urine too?

    can you please pass on the name of the hospital, for 1000 baht i will go there too for this check...

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    Yes, exactly as you mentioned above plus some vitamin B tablets thrown in.

    The Ultrasound scan incidently was 800 baht.

    I declined the liver sample test


    I also had a full'ish medical carried out at the same hospital in September last year for 1,300 baht

  10. #10
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    This state hospital is not unique. I think that you'll find if you are registered with any state hospital then the payments are minimal

  11. #11
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    Quote Originally Posted by Mr Lick View Post
    Yes, exactly as you mentioned above plus some vitamin B tablets thrown in.

    The Ultrasound scan incidently was 800 baht.

    I decline the liver sample test


    I also had a full'ish medical carried out at the same hospital in September last year for 1,300 baht
    so you had a liver problem, but they wouldnt take your liver values?
    that would have concerned me, to be honest...

    what is a "fullish medical"... any blood/urine values ?

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    Quote Originally Posted by alitongkat View Post
    Quote Originally Posted by Mr Lick View Post
    Yes, exactly as you mentioned above plus some vitamin B tablets thrown in.

    The Ultrasound scan incidently was 800 baht.

    I decline the liver sample test


    I also had a full'ish medical carried out at the same hospital in September last year for 1,300 baht
    so you had a liver problem, but they wouldnt take your liver values?
    that would have concerned me, to be honest...

    what is a "fullish medical"... any blood/urine values ?

    I was tested for Hep B and C (negative). The ultrasound scan of my liver was also clear. I didn't feel it necessary at that time to undergo further tests. That was my choice.


    The medical consisted of blood/urine/stool samples. The usual weight, blood pressure and cholesterol tests/advice and chest x-rays.

    Following a check of the bill, i can confirm that the total cost was 1580 baht, not 1300 as previously thought.
    Last edited by Mr Lick; 21-10-2012 at 08:37 PM.

  13. #13
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    i have an entirely different experience here, and never got anything priced (even single blood tests) at the price you paid in total...

  14. #14
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    Hospitals here are cheap and OK.

    It's where YOU choose to go.

    As a whitey I go to the hospital on Sukhumvit (after ekamai towards phrakanong)

    Last time I went they charged me 40bt for a filling.

  15. #15
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    The deepest jungles of Issan has it's benefits, both fresh air and low cost health care.

    Btw, the operation i underwent was in Khon Kaen so as Troy mentioned city hospitals are not particularly expensive. Shop around in your area, you may be pleasantly surprised. State/University hospitals are probably best on price and more importantly they appear to know what they are doing.

  16. #16
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    my experience is different, as said...

    and about the proposed ways, on how to approach things or to answer questions, i can only say, i dont have any confidence in this anymore...

  17. #17
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    Quote Originally Posted by terry57 View Post
    Foreigners should be well insured so it would not be a problem but if there not why should they get a discounter rate same as a Thai ?

    Seems fair to me considering the difference in income, I have no problem with it.
    Your first point is true to the extent that a responsible foreigner ought to take precautions abroad.

    Your second point is irrelevant. Assuming a level of income based on nationality is sketchy logic and discriminatory. That said, I agree that foreigners not under the social security scheme should pay more, as they are not citizens and therefore not entitled to the prices citizens pay.

  18. #18
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    Quote Originally Posted by alitongkat View Post
    my experience is different, as said...

    and about the proposed ways, on how to approach things or to answer questions, i can only say, i dont have any confidence in this anymore...
    Could you expand on this? I am not sure what you are trying to say and guess others are equally puzzled.

    My last experience in England was dreadful. I took my wife to her GP with severe abdominal pain at 8:30 a.m. She was referred to hospital for further checks at 10 am. This escalated to immediate transfer to County Hospital at 10:30 am. I followed by car but had to park and pay and confusion at the hospital meant I didn't find her until 2pm. She was connected to a drip-on-a-stand in a Doctor's office quite alone and bemused by the goings on. About 5pm we got to sit in a corner of the ward to await the arrival of a bed. Around 9pm the bed arrived...At 3am she had an ectopic haemorrhage and was rushed into emergency surgery. I didn't get to hear what was wrong until the next day and the closest to a doctor/surgeon I got to speak to was the registrar. That was 12 or so years ago and I don't intend to use the NHS again!

    Contrast that to the hospital in Udon. We met the Surgeon who carried out an ultra-scan and explained the results and suggested surgery to remove two large cysts in the womb. He chatted to us for about an hour, explaining the operation and my wife was admitted to the hospital the next day for surgery the following morning. All went well and she spent two days in recovery before being allowed out. I stayed in a hotel close by but could have had a room at roughly the same cost as the hotel in the hospital or I could have stayed in the same room as my wife. Couldn't fault the treatment nor the service and nor the cost...

  19. #19
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    Quote Originally Posted by Mr Lick View Post
    There are a few posters on TD that self-medicate and i support such a view.
    Right here. After going into a coma and almost dying in a Thai butchery AKA hospital, I won't let these idiots touch me.

    I use wiki, other med sites and / or a call to my best friend who is a doctor back home.

    It works!

  20. #20
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    Good news is being able to buy stuff over the counter much cheaper than at the hospital! Saves you a fortune

  21. #21
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    Quote Originally Posted by Rocksteady View Post
    Good news is being able to buy stuff over the counter much cheaper than at the hospital! Saves you a fortune
    You have to be slick if you go the hospital in Thailand.

    When you get your bill, loot at it cautiously ....400 baht for seeing the doctor.....look a the prescription costs carefully....2200 baht...then quickly write down the scripts and doses they are prescribing and tell them you are passing on them and only pay the doctor bill.

    Then go to a local pharmacy and get everything for 300 to 600 baht.

    You have to be quick though, several years back, I had a nurse try to snatch the prescription info out of my hand as I wrote the info down.

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