Hospital Moans About Minimum Wage

[Bob]

Here's the headline in a local story today:

 

BANGKOK: -- Siriraj Hospital plans to hike its fees this year after shouldering an additional Bt800 million in wage costs due to the Bt300 wage policy and losing Bt1 billion in income to the government's measures to reduce drug expenses, the dean of Mahidol University's Medicine Faculty said.
 

And here's the url: http://www.nationmultimedia.com/national/Bt300-wage-forces-Siriraj-to-hike-fees-30198524.html

 

Without more (like a little bit of thinking?), one might almost sympathize with the hospital; however, my only thoughts are that (1) the most likely culprit is the idiot journalist who wrote the story and/or (2) the hospital management is a bunch of cheap charlies.

 

The new minimum wage law that took effect January 1st requires most employers (many smaller enterprises are exempted) to pay their workers a minimum of 300 baht per day.  Many on the hospital's staff get one day off a week so they're working about 24-26 days a month.  That'd mean, of course, that the minimum legal gross monthly wage for each employee would be 7,200 to 7,500 baht per month.  Damn, spend your ass off hospital, you cheap charlies! (i.e, I'd hope that almost all of the hospital nurses and personnel didn't need a minimum wage law to boost their friggin' monthly salaries to that lofty level!).

 

Now, for the "additional" 800 million baht annual cost due to the "wage hikes" as asserted in the article.  Well, let's guess the hospital employs a total of 2,000 workers (I doubt if they have that many employees but what the heck, let's go for it).  If you divide 800 million by 2000, you get 400,000 baht per worker per year.  And that amounts to 33,333.33 baht per month per worker.  Now my calculator shows that figure to be about 25,000 baht per month in excess of the minimum monthly wage the new law requires.

 

What baloney. 

 

P.S.  The Nation article in parts talks about some internal policy of the hospital which relates to hospital policy to boost the wages of degree holders; regardless of that separate issue, there is almost zero possibility that the new minimum wage law requires this hospital to pay anything more to workers than what it paid them last year.

[Guest fountainhall]

I agree the stated reasons are most likely "baloney" and a smokescreen to cover other reasons.

 

Much more likely, I reckon, it's a way for the hospital to cover the costs of the government employee social security scheme and the more general Bt. 30 universal health care scheme. This has created massive deficits for most hospitals since each Bt. 30 covers not just seeing a doctor to have a minor ailment treated, it's also what most people pay for procedures like open-heart surgery. 

 

The Bt. 30 scheme was hugely popular when introduced by the first Thaksin government. But by setting the fee at such a low level, it has posed huge difficulties for hospitals, some of whom started to refuse to take expensive cases. It also now exceeds the cost of administering the scheme! And recently the present government extended coverage under the scheme to include long term treatment for, for example, HIV-AIDS patients and kidney dialysis.

 

Hospitals have to find some way to cover the costs of this scheme. Upping the fees for farang and overseas patients is the easy way to do it!

[Bob]

So to prevent any misunderstandings, the hospitals don't treat their citizens (of their given province) for only the 30-baht the patient may pay.  These hospitals are paid by the government for the care given under the the scheme (not enough, I'm sure, but a whole hell of a lot more than what the patient pays them!).  Last I knew, the hospitals (the public ones under the scheme) were paid about 5% of the GDP annually.

 

The patient fees should have been pegged to inflation, even perhaps to what might be termed the higher levels of medical expense inflation.  And I suspect the government reimbursements to the hospitals should also have been pegged to inflation.  

[Bob]

[by the way, this post should have been in the other forum and a mod is free it move it there...and delete this post.  And, for 30 baht more, I'll hire Mr. T (the actor, not the politician) to provide the mod with a free and personal colonoscopy.....]

[Guest Jovianmoon]

Hospitals have to find some way to cover the costs of this scheme. Upping the fees for farang and overseas patients is the easy way to do it!

 

Yes, that's a worry.

 

Upping the fees on the already extortionist rates for farang? Don't you just love those news articles which mention a citizen of such-and-such a country needing upwards of a thousand US dollars a day to meet their treatment costs, and the family and friends starting fund-raising campaigns to pay the bill? And guards being posted outside their hospital room to prevent them leaving without paying (often when they have such things as ruptured spleens, broken legs and similar mobility impacting injuries)?

 

Ah, "travel insurance", I hear you say. Bearing in mind that the chief objective of any insurance company (in the West and everywhere else) is to find the smallest possible technicality to get out of paying a claim, I wouldn't be resting on my laurels knowing that I have it (though I always get a policy just on the off chance that they might pay out should the worst happen). 

 

Given the funding issues mentioned by FH, I guess it's hardly surprising that these hospitals leap at the chance of extorting money out of farang patients. Doesn't excuse it though, obviously.

[Guest timmberty]

ive never taken out travel insurance .. many may say its crazy but i just see it as a waste of money.

as mr moon says give them a chance no to pay and they wont ..

ill take my chances, and when the big bill comes in i just hope im not on a high floor so when i jump out the window to do a runner they dont think im a flier.

[Guest Jovianmoon]

I wasn't arguing for a boycott of travel insurance. I guess it's something of a lottery with recourse: if the insurance company refuses to pay the claim then at least you have the opportunity to challenge it. If you don't have it in the first place then all bets are off. It's worth getting a policy for the money it costs: even with my HIV status it still costs me less than AUD200 per three-week jaunt to Thailand (though they won't cover me for any HIV-related illnesses, which are very unlikely at this time anyway). That's about one fifth of my airfare, at the most. Not expensive. As my own country's Department of Foreign Affairs and Trade says: "If you can't afford travel insurance, you can't afford to travel". 

 

I should say that I'm not suggesting you can't afford it timmberty, and I was trying to make the point in my last post that travel insurance is a good idea but you shouldn't rely on it totally. To elaborate: take all due care regardless and for goodness' sake, be careful what you get up to and what/how much you drink, run as far away as possible from potential altercations, never hire motorbikes and never take motorbike taxis. In other words, have fun as sensibly as possible without detracting too much from the fun. Fingers crossed that travel insurance may, just may, take care of the accidents that are beyond your control...

 

Cheers.

[Guest timmberty]

i can afford it im pleased to say. but by now you should know why i dont have it .. its to much hassle to do ... i know its easy to do online, i just cant be bothered.

i think i suffer some sort of depression !! everythings to much bother, what can i do ?

[Guest Jovianmoon]

i can afford it im pleased to say. but by now you should know why i dont have it .. its to much hassle to do ... i know its easy to do online, i just cant be bothered.

i think i suffer some sort of depression !! everythings to much bother, what can i do ?

 

Sorry, are you kidding about the depression or not? Not really a laughing matter, and if you are depressed I really don't know how to respond to that sort of thing on an internet forum... Except to point out the obvious that arranging travel insurance online can't really be more taxing than booking hotels and an airline ticket to Thailand online... sorry, I don't get it.

[Guest timmberty]

i suffer from it a bit, thats why i cant be bothered doing anything. its not so bad it rules my life like some people .. and it never seems to last long few weeks at a time i guess ...

its sorta just like being miserable for days on end.

[Guest Jovianmoon]

Okay, I get it now. Here's wishing that your next jaunt to Thailand will be something of an antidote    It helps, by all accounts.

 

Cheers timmberty.

[Guest fountainhall]

I've always had travel insurance. So far, I doubt if it has been worth it in that the premiums paid over the years are way more than I have claimed - and had reimbursed. Perhaps strangely, I've never had a problem with reimbursement as long as all the paperwork was in order. I recently had a major flight delay in Europe which resulted in missing connecting fights and extra costs of over US$600 for a new ticket and an overnight airport hotel. I've been told that almost certainly these costs will be covered.

 

On the other hand, if I had suffered a stroke or something as serious in another part of the world, it's comforting to know that all the likely costs would have been covered. Plus, as one gets older, the odds of something serious happening tend to shorten quite considerably, unfortunately. 

 

But back to Bangkok Hospital costs. Even though they have been creeping up in recent years, I do think Thailand private hospital costs are generally way lower than many other countries for virtually a similar quality of care.

[Guest timmberty]

i dont have to worry about the cost of hospital costs in england as we have the wonderful free N.H.S.

i pay several thousands of pounds into this free service each year to get my treatment for free.

isnt the british way best ?

[Bob]

But back to Bangkok Hospital costs. Even though they have been creeping up in recent years, I do think Thailand private hospital costs are generally way lower than many other countries for virtually a similar quality of care.

 

I agree although I have no experience with the Bangkok hospitals.  But, somewhat counter to what Jovianmoon suggested, my experiences here certainly don't support any notion that the hospitals here overcharge falang (in fact, I'm always dumbfounded how cheap it is).  For example, I spent a day and a half in a private room in Sao Paolo hospital in Hua Hin a few years back and the total charge (multiple doctors, seven IV's of various stuff, and a load of medicines to take with me) was $384.00 on my US credit card (including the credit card company's foreign transaction fee).  A month or two ago, I saw a dermatologist at Chiangmai RAM to check something out and the total (yep, total) fee for that visit was 300 baht.  And, more recently, I went over to RAM for a consultation with a few minor tests and the total charge (including three meds) was a whopping 700 baht.  Pretty damn cheap as far as I'm concerned.

[Guest Jovianmoon]

I agree although I have no experience with the Bangkok hospitals...

 

I wouldn't dispute your experiences, but my understanding is (rightly or wrongly) that as soon as emergency treatment for a farang comes into the equation, the costs rise extortionately, for want of a better word.

 

I understand that routine medical (and dental) treatment at Thailand hospitals is routinely cheaper than in the West (hence Thailand's attraction for medical tourism), I'm only saying that when a farang is suddenly seriously ill or injured, the Thai hospital 'land sharks' seem to come circling.

[Guest fountainhall]

Sorry Jovianmoon, but I think your statistics may be wrong. I cannot find up to date statistics on the web, but these are from 2007 and so will not be too out-of-date. The article is from Business-in-Asia.com.

 

Comparison between costs in USA/SIngapore/Thailand/india

 

Hip replacement

US: $24,000 - SIngapore: $15,000 - Thailand: $10,000 - India: $6,300

Spinal Fusion

US: $62,000 - Singapore: $9,000 - Thailand: $7,000 - India: $5,500

Coronary Angioplasty

US: $41,000 - Singapore: $11,500 - Thailand: $4,150 - India: $3,500

 

Apart from the lower costs, it highlights several other reasons for considering medical treatment in a first-class hospital outside the US -

 

1. Quality of service

2. Quality of doctors and nurses with most trained overseas

3. Cost of a room in is far cheaper

4. Bypass long waiting lists sometimes extending many months by having procedures undertaken at almost no notice

5. The chance to recuperate by a beach!

 

Thailand is the largest medical tourism hub in total volume and in both high-end and low-end procedures . . .  Thailand’s two largest medical tourism targets are the Bumrungrad and Bangkok Hospitals, which annually treat 400,000 and 150,000 foreign patients, respectively.  Thailand’s prices are about 20% higher than India’s, on average, with the main advantages being a better tourist experience overall and more bundling of services.  Whereas most medical tourists going to India should focus of specialty hospitals that are often in different cities, each of these Thai mega-centers is full service.  Their massive volume overall translates into high volume in each specialty, which in turn translates into more experienced doctors, better equipment and lower prices. 

 

http://www.business-in-asia.com/asia/medical_tourism.html

[Bob]

A falang neighbor just had his second emergency hip replacement (both hips are now done) here in Chiangmai.  If I can remember, I'll ask him about the total cost of both procedures and post the info here.   

[Bob]

A falang neighbor just had his second emergency hip replacement (both hips are now done) here in Chiangmai.  If I can remember, I'll ask him about the total cost of both procedures and post the info here.   

 

The neighbor I mentioned who had the hip surgery Tuesday arrived home a couple of hours ago and I had the chance to both say "welcome home" and to view his hospital bill.  I'm not sure of the name of the operation but his natural hip ball cracked, they tore that out, inserted a new hip ball (they cut off part of the femur and then stuff this thing down the center of that bone), and sewed him up.  All the while he was awake with a spinal and he could hear (but not feel) all the sawing, hammer and chiseling, etc.  (ugh!).  Okay, back to the bill - saw the entire printout and the total was 112,700 baht.  Incredibly cheap in my view. 

[Guest Jovianmoon]

I certainly stand corrected on that issue. I'd clearly been sucked in by too many sensationalist media reports, which is usually most unlike me. 

 

Cheers guys and thanks for the informative posts.