News Forum - Court rules for Health Ministry, calls dual pricing beneficial

[Bob20]

7 hours ago, Marc26 said:

I have met well over 100 guys from these forums and maybe 5 of them I didn't like..........

I don't like the miserable guys you come across, but meeting all those people from all over the world, has been the best part of my travels......

Again we agree. Of course the interactions with people are the most important and enjoyable. I just don't like my fellow countrymen and other Europeans huddling together to complain about Thailand. I am surprised how many do that. Then again, I didn't come here for them...

[Marc26]

1 hour ago, DiJoDavO said:

Idk where you get the idea from that I am living here and not pay tax. The reason I'm upset is that I do pay tax and I'm not treated equally. 

Just so you know, I am home. I've bought a house here in Thailand, married and live here for a long time already, looking forward living here for the rest of my life. People around me treat me like a local (looking at your previous post, maybe they don't do that to you) but whenever you go somewhere else in Thailand (the country you pay tax to) they just think white skin = money. No matter if you show your passport, wp, or even speak Thai (sometimes this works) mostly you still have to pay foreign prices. 

But that kind makes you not a "local"

I get what you are saying and you have family and made the decision to live there

 

But you did make the decision to live in a country that doesn't treat you like a local 

So it's hard for any of you to complain,you willingly live there 

 

And I will likely, at some point, in the future.

 

But we live in Canada where my wife and I(both not from Canada) are treated equal

If we weren't I'd have to make the choice to accept that or not live here 

[EdwardV]

1 hour ago, LoongFred said:

Hospital not true. Price is with insurance or not. Those who are private pay probably pay double because insurance companies have deep discounts. Sure foreigners can get insurance but at a very high individual rate.

The out of state rate for UCB is probably close to Stanford. 

Foreigners with a non-immigrant visa are eligible to purchase regular health insurance in the US. You put your visa number where others put their social security number. Foreign students can get it through the school. Regardless the hospital charges everyone the same, the insurance discount comes afterward. 
 

True but it doesn’t change the fact foreigners are paying the same as US citizens. There is no two tier system for them specifically. 

[Stevejm]

If any foreigner stays in UK longer than 6 months they are obligated to pay over GBP 600 per year for NHS coverage until they apply for and receive permanent leave to remain after 5 years. If NHS hospitals put up signs saying “ Citizens and permanent residents free and everyone else pays” would that be discrimination? If private hospitals in Thailand had different pricing for locals and foreigners that would be an issue. Public hospitals in Thailand are funded by the government and if they want to give subsidized health care to citizens that is their right. Foreigners on whatever kind of visa shouldn’t feel entitled to subsidized health care. When I was working here I paid SS contributions and received free health care at the nominated hospital which was generally very good. Aren’t retirement visa holders supposed to carry medical insurance these days anyway? 

Edited September 30, 2021 by Stevejm

[LoongFred]

1 hour ago, EdwardV said:

Foreigners with a non-immigrant visa are eligible to purchase regular health insurance in the US. You put your visa number where others put their social security number. Foreign students can get it through the school. Regardless the hospital charges everyone the same, the insurance discount comes afterward. 
 

True but it doesn’t change the fact foreigners are paying the same as US citizens. There is no two tier system for them specifically. 

True students can purchase insurance through their school, sometimes. For a private individual to purchase health insurance it is very costly and restrictive. High premiums plus high deductibles. 

Insurance companies in the US are for profit companies.

[Morpheus]

4 Tiered pricing beneficial to Thailand, I think not. The only ones who benefit will be the super rich who own the private hospitals, nobody else, This is typical mentality of Thais to raise revenue by scamming foreigners and not implementing proper economical stratergies.

[Stevejm]

Just now, Morpheus said:

4 Tiered pricing beneficial to Thailand, I think not. The only ones who benefit will be the super rich who own the private hospitals, nobody else, This is typical mentality of Thais to raise revenue by scamming foreigners and not implementing proper economical stratergies.

Doesn’t the pricing just apply to government hospitals?

[Stonker]

4 hours ago, DiJoDavO said:

I'm confused here. You said earlier that tier 3 doesn't pay as much tax as tier 2, hence it's more expensive when getting treatment at the hospital. That's why I said, just let me pay as much tax, so the price of a treatment can be equal too. 

Well, you're certainly confused because I never said anything like that.

Tier 1 is for Thais, fully subsidised, Tier 2 is for local migrants (Laos, Vietnam, Myanmar, Cambodia), also fully subsidised, Tier 3 is for foreigners working and paying tax,  partly subsidised, and Tier 4 is for all other visitors and retirees, who pay no tax, and who aren't subsidised.

As you are a foreigner the only way you can pay tax is to work here and be on Tier 3, but obviously you can't "pay as much tax" as the amount of tax varies depending on what you're earning.

I now see that you say you "do pay tax" so you must be working as paying VAT on your beer doesn't really count as "paying tax" here or anywhere else.  If so then you're Tier 3, so I can't understand what you're complaining about, since unless your country has a reciprocal health agreement with Thailand (which it doesn't unless you're from Laos, Vietnam, Myanmar, Cambodia or China) you can't be Tier 2, and unless you're Thai (a nationalised Thai also counts) you can't be Tier 1.

What, exactly, aren't you happy about with the Tiers and which one one you're on?

4 hours ago, DiJoDavO said:

People around me treat me like a local (looking at your previous post, maybe they don't do that to you) but whenever you go somewhere else in Thailand (the country you pay tax to) they just think white skin = money. No matter if you show your passport, wp, or even speak Thai (sometimes this works) mostly you still have to pay foreign prices. 

I'd be deluding myself if I thought the people around me treat me as a local, here or anywhere else I've been where I've been the only white face around. It's all comparative, but even someone who comes from the next village a few kms away isn't fully a "local" even if they've married a local and lived here for decades. That's always been the case everywhere I've been, apart from in big cities, mainly in the West, where there's a much more diverse and heterogenous mix.

That's not to say I'm not accepted, but I'm simply not a "local".

 

5 hours ago, DiJoDavO said:

Btw, don't nitpick about my word choice. By 'local' I mean someone who has lived at a certain place for a long time already. If someone has been living somewhere for a long time already, people will know he's from that place, so he/she can be treated the same as the others who live there. 

Sorry, just noticed this as I was flipping through. I'm not "nitpicking", but while there's no definition that's simply not what most people (at least anyone I know) mean by the term "local". You could become a "local" if you moved to, say, London or Sydney, even Hong Kong, but however accepted you are you'll never be a "local" here or in many other places. That doesn't mean you're any more or less accepted, trusted or respected, just different.

[Inlandchris]

Well, that settles that! You have gov’t corruption, you have police corruption, and now, the courts are in on it too. Usually, the courts will settle with the law/constitution without emotion/corruption/selfishness. The courts are the last ditch effort of Democracy, without it, you have organized chaos and a country that will never progress or even get close to the production of Vietnam/Malaysia/Indo. Even the people voted/surveyed that corruption is okay so long as they get some trickle-down benefits.

There is no hope for Thailand to be the hub of anything in South East Asia with this ruling. Even medical tourism will be dead with this ruling.

[Morpheus]

43 minutes ago, Stevejm said:

Doesn’t the pricing just apply to government hospitals?

The government gave the green light to private hospitals last year.

[Inlandchris]

2 hours ago, Stevejm said:

Aren’t retirement visa holders supposed to carry medical insurance these days anyway? 

No. But, if over 70, you cant get insurance except COVID insurance.

[LoongFred]

2 hours ago, EdwardV said:

Foreigners with a non-immigrant visa are eligible to purchase regular health insurance in the US. You put your visa number where others put their social security number. Foreign students can get it through the school. Regardless the hospital charges everyone the same, the insurance discount comes afterward. 
 

True but it doesn’t change the fact foreigners are paying the same as US citizens. There is no two tier system for them specifically. 

If the final bill is more for someone then the price isn't the same. I worked in Healthcare for 40+ years and saw it everyday. If I had to buy something at the hospital , I also got an employee discount. Otc in pharmacy was 20%.

Health care costs in Los are very affordable and I have a hard time understanding the complainers. 

[Stonker]

38 minutes ago, Stevejm said:

Doesn’t the pricing just apply to government hospitals?

Yes, the Tier system only applies to government hospitals, and then only to those not covered by the Social Security Scheme (SSS), Health Insurance Card Scheme (HICS), Civil Servant Medical Benefit Scheme (CSMBS), or the Universal Coverage Scheme (UCS) or yellow card - which is apparently 99.95% of Thais, plus all registered migrant workers (HICS), plus all those here on work permits paying tax (SSS).

That pretty well only leaves those on retirement or marriage extensions or tourists and business visitors, illegal migrants, and 0.05% of Thais to come under the Tier System!

[LoongFred]

16 minutes ago, Inlandchris said:

Well, that settles that! You have gov’t corruption, you have police corruption, and now, the courts are in on it too. Usually, the courts will settle with the law/constitution without emotion/corruption/selfishness. The courts are the last ditch effort of Democracy, without it, you have organized chaos and a country that will never progress or even get close to the production of Vietnam/Malaysia/Indo. Even the people voted/surveyed that corruption is okay so long as they get some trickle-down benefits.

There is no hope for Thailand to be the hub of anything in South East Asia with this ruling. Even medical tourism will be dead with this ruling.

I doubt it.  The quality of health care is very good and the cost very low.

Someone wants free everything. 

[Stonker]

12 minutes ago, Morpheus said:

The government gave the green light to private hospitals last year.

Sorry, I don't understand this.

What "green light"?

The Tier System, under the "Public Health Care Service Fee Rate of the Service Units under Ministry of Public Health", published in the Royal Gazette on 30 August 2019, only applies to state hospitals, which come under the Ministry of Public Health (MOPH).

[LoongFred]

4 hours ago, HiuMak said:

Some healthcare systems are more equal than others. There is no perfect system in any country. Thailand is not a developed country and may stay that way for a long time. Perhaps when it matures in its economic situation, governmental policies and GDP status, it will look into subsidizing heavily to residents who are non-citizens like some countries in Asia (e.g Singapore, Taiwan,etc). Most foreigners who pays tax (as an expatriat can be quite heavy for some) should be taken care of by the local healthcare systems in my opinion. However, not being a local (Thai citizen or even from provincial whose thai ID number can be different), no matter how long or how well you live and know Thailand, seems like it will not be equal. It's just how the game is. Ticket to play for me is to get health coverage and not rely fully on public healthcare support system. 

OK but the price is still with in reason so why complain. Is this the most important time in your life?

On and on, with no power to change things is a waste of my time.

[Spice61]

Yes Medical tier systems are ok!

But don’t think they should go over 200% more than Thais!

especially for those foreigners who pay tax here and get Thai wages?

Maybe Thailand should look at Citizinships and start to create multi cultural society?

also capping Public Parks tier pricing at 100% more than the Thai price!

sometimes 600% more?

[Stevejm]

1 hour ago, Morpheus said:

The government gave the green light to private hospitals last year.

Hadn’t noticed any changes in the pricing at the hospital I use.Can you please provide a link to that ruling?

[Stonker]

23 minutes ago, Inlandchris said:

You have gov’t corruption, you have police corruption, and now, the courts are in on it too. Usually, the courts will settle with the law/constitution without emotion/corruption/selfishness.

There seems to be an enormous amount of misunderstanding mis-rep[resentation of the details of this case (I wouldn't call them "facts" as the only source are Coconuts Bangkok, repeated elsewhere, and a few local English or Dutch language rags, none of which are reliable), but due to a lot of hype and deliberate misinformation by a couple of posters here (literally just a couple) a great deal of what's been written here and commented on is simply factually completely incorrect.

The following isn't opinion but simple detail based on the various reports, with full links:

Erwin Buse was a train engineer in Holland before moving to Thailand in 2006, aged 37, to join his Thai wife. He has no work permit and pays no tax, has no pension and no income from abroad, but works a a goatherd for his wife in the Klong Wan area of Prajuab Khiri Khan.

He developed prostate cancer in 2015 but chose not to return to Holland but to be treated in Thailand at Hua Hin Hospital from 2015 to 2019. Total costs over four years were over 20,000 baht with an initial fee of 858 baht and a basic 300 baht charge every three months.

He first protested the charges to the Prajuap Khiri Khan Damrongthan (complaints centre) in 2016, three years before the change to introduce Tiered fees at state hospitals, and was offered a refund of 12,746 baht in 2019 which he refused as he said he should have only been charged 50 baht for each quarterly visit, not 300 baht, and no initial fee.

After rejecting the offer of a 12,746 baht refund as insufficient , he registered his complaint with the police in Hua Hin on 19 July 2019, over a month before the changes to state hospital charges were even published and approved.

The 50 baht he demanded instead of 300 baht was based on charges in 2004, in force when he first came to Thailand in 2006, for migrant workers under the HICS or Thais under the UCS, neither of which he was eligible for as he was neither a registered migrant worker from ASEAN nor a Thai. The 50 baht quarterly charge demanded was to cover all doctors charges, hospital fees, equipment, tests and medication / treatment.

All sourced, all linked, all reported.

All, also, enormously and deliberately mis-interpreted and mis-represented to paint a very different picture.

[Stevejm]

13 minutes ago, Stonker said:

There seems to be an enormous amount of misunderstanding mis-rep[resentation of the details of this case (I wouldn't call them "facts" as the only source are Coconuts Bangkok, repeated elsewhere, and a few local English or Dutch language rags, none of which are reliable), but due to a lot of hype and deliberate misinformation by a couple of posters here (literally just a couple) a great deal of what's been written here and commented on is simply factually completely incorrect.

The following isn't opinion but simple detail based on the various reports, with full links:

Erwin Buse was a train engineer in Holland before moving to Thailand in 2006, aged 37, to join his Thai wife. He has no work permit and pays no tax, has no pension and no income from abroad, but works a a goatherd for his wife in the Klong Wan area of Prajuab Khiri Khan.

He developed prostate cancer in 2015 but chose not to return to Holland but to be treated in Thailand at Hua Hin Hospital from 2015 to 2019. Total costs over four years were over 20,000 baht with an initial fee of 858 baht and a basic 300 baht charge every three months.

He first protested the charges to the Prajuap Khiri Khan Damrongthan (complaints centre) in 2016, three years before the change to introduce Tiered fees at state hospitals, and was offered a refund of 12,746 baht in 2019 which he refused as he said he should have only been charged 50 baht for each quarterly visit, not 300 baht, and no initial fee.

After rejecting the offer of a 12,746 baht refund as insufficient , he registered his complaint with the police in Hua Hin on 19 July 2019, over a month before the changes to state hospital charges were even published and approved.

The 50 baht he demanded instead of 300 baht was based on charges in 2004, in force when he first came to Thailand in 2006, for migrant workers under the HICS or Thais under the UCS, neither of which he was eligible for as he was neither a registered migrant worker from ASEAN nor a Thai. The 50 baht quarterly charge demanded was to cover all doctors charges, hospital fees, equipment, tests and medication / treatment.

All sourced, all linked, all reported.

All, also, enormously and deliberately mis-interpreted and mis-represented to paint a very different picture.

Very interesting. On that basis he should be on his knees in thanks rather than wasting the courts time 

[Bob20]

1 minute ago, Stevejm said:

Very interesting. On that basis he should be on his knees in thanks rather than wasting the courts time 

My position is well documented and I'd be ashamed hiding in the corner if I were him.

His initial consultation would have cost more in Holland than his whole treatment here (his total costs are actually only about 2/3 of the compulsory health care policy excess in Holland!).

20.000 baht for years of cancer treatment. JHC!

[Stevejm]

9 minutes ago, Bob20 said:

My position is well documented and I'd be ashamed hiding in the corner if I were him.

His initial consultation would have cost more in Holland than his whole treatment here (his total costs are actually only about 2/3 of the compulsory health care policy excess in Holland!).

20.000 baht for years of cancer treatment. JHC!

Yes I checked out the links in your post. Good job!

[UncleFatBloke]

On 9/29/2021 at 2:26 AM, Stonker said:

Splendid - the only rational outcome given not only Thai law but the identical system in Australia and most Western countries, and a system in the UK that doesn't just charge foreigners 100% of the full price, as Thailand does, but 150% of it.

Sheer and utter hypocrisy on the part of Erwin Buse and his entitled supporters.

An expat in the UK would be considered someone who is 'ordinary resident' = resident in the UK for over 180 days, and would therefore be able to get FREE treatment on the NHS!

[Bob20]

2 minutes ago, UncleFatBloke said:

An expat in the UK would be considered someone who is 'ordinary resident' = resident in the UK for over 180 days, and would therefore be able to get FREE treatment on the NHS!

Oh, not again I'd rather have Sinovac!

[Stonker]

9 minutes ago, UncleFatBloke said:

An expat in the UK would be considered someone who is 'ordinary resident' = resident in the UK for over 180 days, and would therefore be able to get FREE treatment on the NHS!

Wrong.

That's tax resident, not ordinarily resident according to the NHS which could be on their first day in the country or after several months. Unless they have limited leave to remain they would also be liable for an NHS surcharge which is £624 (30,000 baht) per year, payable in advance with your visa application so £3,120 for a 5-year visa (150,000 baht) regardless of whether you use the NHS or not.

12 minutes ago, Bob20 said:

Oh, not again I'd rather have Sinovac!

IF you think you're bored of hearing this repeated over and over, what about me?