Thai court sides with higher hospital fees for foreigners

[reader]

From Coconuts Bangkok

A Dutch national said today he will appeal a court ruling against his lawsuit challenging dual-pricing at Thailand’s public hospitals as unconstitutional.

Erwin Buse said the Administrative Court in Phetchaburi province relied on incorrect information provided by the health ministry in its Tuesday decision.

“I am very disappointed that the court mainly follows and repeat statements of the defendant without fact check,” Buse said Wednesday afternoon in a message. He noted that the ministry had changed how it defined labor costs, a key factor in determining hospital fees.

Erwin had asked the court to strike down the pricing structure in place since 2019 for violating the constitution’s equal protection guarantee, as by the ministry’s own regulations, the fees should be determined by actual costs.

In its judgment, the court said that it did not see that as discriminatory – because the higher rates charged of foreigners, who it presumes earn more than Thais, is good for the nation.

“The pricing was set on an appropriate basis of socioeconomic status, and it benefits Thailand, so it therefore doesn’t count as discrimination,” the court ruling said.

His lawsuit named the ministry and its head, who is now Minister Anutin Charnvirakul. It asked the court to annul the rate structure and order the ministry to revert to unified rates in place since 2004.

Buse first took on overcharging on a personal level several years ago when he was traveling 100 kilometers from his rural residence for cancer treatments at Hua Hin Hospital. He described being charged hundreds of baht in “additional fees” each time.

Under new rules enacted in September 2019, public hospitals were instructed to charge patients at what amounts to four tiers based on their legal status: Thai nationals, citizens of neighboring countries and working foreigners on non-immigrant visas. The fourth group consists of tourists, retirees and included foreigners married to Thai nationals.

Fees are much higher for the third group – which includes most expats – while those in the fourth pay much more, often double.

For example, according to a ministry fee structure published at the time, simple antibody screenings cost Thais and ASEAN residents THB130 and expats THB190. Retirees and tourists pay double – THB260.

On the higher end, a spinal MRI that costs citizens and their neighbors THB18,700 jumps up to THB23,375 for working expats and THB28,050 for retirees/tourists.

https://coconuts.co/bangkok/news/dutch-expat-to-appeal-after-thai-court-sides-with-higher-hospital-fees-for-foreigners/

[Lonnie]

1 hour ago, reader said:

A Dutch national said today he will appeal a court ruling

I don't see much hope for this lawsuit and the increases will certainly be hurting the appeal of medical tourism.

[PeterRS]

1 hour ago, reader said:

“The pricing was set on an appropriate basis of socioeconomic status, and it benefits Thailand, so it therefore doesn’t count as discrimination,” the court ruling said.

This is merely typical Thai gobbledygook. And it's nonsense. As if retirees earn more than the Thai hi-so set or even many middle income Thais.

In the last few months, for the same condition I have seen a doctor at Bumrungrad, one at BNH and one at the public King Chulalongkorn Hospital. The first was at Bumrungrad where the doctor's fee was Bt. 1,500. At BNH it was Bt. 900. At Chulalongkorn it depends which of two options you choose. In the first which means you have to first register to see the doctor between 06:00 and 07:30 am, the fee is Bt. 250. For the more convenient and much less crowded afternoon time, it is Bt. 700.

As far as medical tourism goes, I don't think the increase will matter one jot. The fact is that most medical tourism is paid for by major insurance companies who refer patients to Thai hospitals where it is still much cheaper for many procedures than it would be at their home base. Or, as at Bumrungrad, it is very often the rich from the Middle East. 

Those put off by prices here, still have Indian clinics and hospitals where average prices are still far less than Thailand.

[Lonnie]

49 minutes ago, PeterRS said:

ndian clinics and hospitals

I'm reading more and more about Indian medical tourism...that the quality has greatly improved.

[njalondon]

We have many Indian Doctors here In the UK and the training and quality of treatment is easily on par with anyone trained here.

[PeterRS]

I'm going back on my earlier comment because I had failed to realise the Minister had specified "public" hospitals. Raising fees for expats and non-Thais in those hospitals will have zero effect on medical tourism for this is exclusively handled by the private hospitals. Much of it is also paid for by international insurance companies. Besides, getting any medical procedure in a public hospital requires first prior registration, then a general doctor's appointment, then a specialist's appointment and then a further delay because all public hospitals have some degree of waitlist. Add to that there are not many English speakers in public hospitals and medical tourism just does not work.

This was brought home to me this morning when I had to have an MRI scan at King Chulalongkorn Hospital. It was merely a check up scan following one I had 6 months ago. My doctor there is wonderful. She trained in Thailand and the USA and speaks fluent English. The medical staff in the scanning department are great even though few spoke more than a few words of English. But I when I left, I noted that all those waiting for CT and MRI scans were Thai, many of them elderly. This was true when I had my earlier scan. Given that I paid about one fifth or less of the cost of a similar procedure in a private hospital, I would be perfectly happy to pay a little more.