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

[JamesE]

1 hour ago, Marc said:

§1 Me first and me only! If it is beneficial, you can do anything, even if it's discriminatory or illegal.

It starts with lies to save face and avoid consequences (e.g. how many Thai children grow up without fathers?).

Discriminatory double pricing might be one thing, but what about corruption, nepotism, and extortion? Or how about coups, human rights abuses, human trafficking, torture, missing people, rich and free cop killers, convicted drug smugglers in the government, unusually wealthy cops and officials, etc.

Everything is based on a lack of values, moral compass/authority and accountability.

Thailand, everything is possible ... but it has a high price, it prevents development. Just compare Thailand with successful and prosperous nations, especially those without natural resources.

Btm line is: this ruling is not beneficial, it is damaging the country.

Stupid and sad!

But with this: "Btm line is: this ruling is not beneficial, it is damaging the country." you're just confirming it's one tiny part of a system your previous arguments say is much more flawed than mere dual-pricing and incapable of "improvement".

I'm in the camp that, once I've left my dangerous shores behind, I expect and hope everything is going to be different than what I leave behind. Expecting things to be different for the sole reason that they're different back home is a toxic mix of hubris, naivete, and The White Man's Burden. It's our place to adapt, enjoy and get used to it, or try to find someplace more amenable to our delicate sensitivities.

Edited September 30, 2021 by JamesE
missed something...

[JamesE]

1 hour ago, Soidog said:

like Taiwan, Japan or South Korea if it was a more equal and fair society.

Given that your three examples have all been built up from literally nothing within living memory, I'd say that being bombed into the stone age and having billions poured into your economy may be a prerequisite for the success seen. Germany, France, the Low Countries? Check! The former Soviet Republics? Check! Well, except Poland and Hungary seem to be sliding back in authoritarianism. There are very few examples in history, distant or recent, of systems casting off the yoke of authoritarianism in favor of democracy and having it stick long term. Expecting that to happen in Thailand is wishful thinking. The entrenched system of the type you see in Thailand is both extremely hard to displace and also, as can be seen in what's happening in the US, very appealing to a larger percentage of the population than you might think.

Now, I'm not arguing in favor of that system but just pointing out that, absent some of the past 300 years or so, it represents something closer to the historical norm than we'd like to admit.

[billybob]

24 minutes ago, Soidog said:

Yes, the burning season can be very bad, especially in the North and around CM. 
 

Ive often said the same about being born Thai and living in Thailand. I think I would either be in prison or dead in a ditch. My Thai friends tell me I wouldn’t be as I would think differently. There is a saying which often recall in such situations:

If you were born where they were born. If you saw what they see. If you heard what they hear. You would think like they think and do what they do. 

There is a lot of truth in that I think. Most Thais simply accept their lot and work hard to make a living and get by. It’s harder for foreigners as we know it really doesn’t need it be like it is. 

So true. Their stoicism and general good humour and ability to try to find sanook in most things is a great and humbling strength. We falang think too much - in fact 'worry' is 'kit mahk'. The hardest lesson I have found in Thailand is you have to accept that this is the way it is and roll with it and smile. You can fall in love and out again with the country and it doesn't matter. It's just the way it is. There is less 'undergrowth' to cut through and see what really matters in the world in Thailand particularly amongst the poorer members of society. If you can help others starting with your family and do it with good grace then it's reward enough. 

If I could slow down, still my mind and see that then I would be a happier person, not that I'm that unhappy. I've been blessed to hear and experience one of the great Thai monk's Ajahn Chas's western disciples Luang Phor Sumedho talk in the UK .

The simple truth is out there to be found in the simplest ways or as the Abott at my local Thai temple said after I was extoling at length some philosophical nonsense "just do good". It's not difficult do good and it doesn't matter what others do or think. If you leave the world a better place than you founded then that's enough. 

https://www.dhammatalks.net/Books3/Ajahn_Sumedho_The_Way_it_is.htm

https://en.wikipedia.org/wiki/Ajahn_Chah

 

[Soidog]

12 minutes ago, JamesE said:

Given that your three examples have all been built up from literally nothing within living memory, I'd say that being bombed into the stone age and having billions poured into your economy may be a prerequisite for the success seen. Germany, France, the Low Countries? Check! The former Soviet Republics? Check! Well, except Poland and Hungary seem to be sliding back in authoritarianism. There are very few examples in history, distant or recent, of systems casting off the yoke of authoritarianism in favor of democracy and having it stick long term. Expecting that to happen in Thailand is wishful thinking. The entrenched system of the type you see in Thailand is both extremely hard to displace and also, as can be seen in what's happening in the US, very appealing to a larger percentage of the population than you might think.

Now, I'm not arguing in favor of that system but just pointing out that, absent some of the past 300 years or so, it represents something closer to the historical norm than we'd like to admit.

Interesting thoughts and I do agree we can’t expect Thailand to achieve in 70 years, what has taken 200-300 years elsewhere.
 

Let’s be clear. Im not advocating western style democracies as the way forward. In fact I feel the system in use in many western democracies are doomed to failure. They are short term, lowest common denominator systems that are slow to react and respond. While China is setting 20-30 year infrastructure and development strategies, the west is more concerned with laws to stop men wolf whistling at women and demanding all businesses allow people to chose their pronouns or face prosecution. However, it has to be wrong, when you have a relatively small handful of powerful families owning 95% of the wealth of a nation, when the majority can’t even get a decent education and a fair opportunity at a decent job unless they have the funds to bribe schools and future employers. When you have to produce children to safeguard yourself in later years.  
 

All too often, the assumption is that if you criticise Thailand’s method of government then what you are advocating is Western style democracies. To be clear, I’m not. When you criticise what you see going on in Thailand, the assumption is that you are promoting they should do everything the same as in the west. To be clear, I’m not. 
 

If we want to set up a topic of what is wrong with western democracies, I’m happy to chip in with many criticisms. If we want to set up a topic of why the U.K. is a dull and boring society that is so far up its own A-Hole, I’m more than happy to chip in with many comments. I have no problem with people coming to the U.K. and criticising what they see. If someone from Norway wants to observe a Victorian overcrowded jail and show us the data which says there are better ways, then I’m very happy to take route one to goal. I don’t see what is so wrong with constructively having the debate of what needs to change in Thailand. If so, then we may as well delete 95% of the posts on this forum and similar such forums. 

[Soidog]

14 minutes ago, billybob said:

So true. Their stoicism and general good humour and ability to try to find sanook in most things is a great and humbling strength. We falang think too much - in fact 'worry' is 'kit mahk'. The hardest lesson I have found in Thailand is you have to accept that this is the way it is and roll with it and smile. You can fall in love and out again with the country and it doesn't matter. It's just the way it is. There is less 'undergrowth' to cut through and see what really matters in the world in Thailand particularly amongst the poorer members of society. If you can help others starting with your family and do it with good grace then it's reward enough. 

If I could slow down, still my mind and see that then I would be a happier person, not that I'm that unhappy. I've been blessed to hear and experience one of the great Thai monk's Ajahn Chas's western disciples Luang Phor Sumedho talk in the UK .

The simple truth is out there to be found in the simplest ways or as the Abott at my local Thai temple said after I was extoling at length some philosophical nonsense "just do good". It's not difficult do good and it doesn't matter what others do or think. If you leave the world a better place than you founded then that's enough. 

https://www.dhammatalks.net/Books3/Ajahn_Sumedho_The_Way_it_is.htm

https://en.wikipedia.org/wiki/Ajahn_Chah

The lesson I have learned in life is this:  Too often we chase “happiness” and find stress and debt and a life of being unhappy. Chasing material things to give us a short lived buzz of being “happy”. What you need to do is learn contentment. If you are content with your life then happiness follows. If you chase happiness you may never find it. 

[JamesE]

45 minutes ago, Soidog said:

However, it has to be wrong, when you have a relatively small handful of powerful families owning 95% of the wealth of a nation, when the majority can’t even get a decent education and a fair opportunity at a decent job

Or as it's known globally, the USA.

The rest of your points are valid, from a western perspective. China can do what it does because the individual has been subsumed to the collective. You don't find work as much as be given a job to meet the 20-30 year plan. There is no expectation for personal fulfillment because that is not a concept appreciated in society. Sure, there are voices that rail against the status quo but those voices are crushed by force of arms - e.g. recent Hong Kong and Black Lives Matter demonstrations - or by force of reality - the Occupy movement of ten years ago in the US. The trick we never see is that eventually the people that rail against the system - in the US, in China, and in Thailand - realize that they're better off on the inside than on the outside. Then everything is nice and quiet until the next generation steps up.

To bring this back to the topic at hand, the way Thailand is - from dual pricing, to systemic xenophobia, to the show democracy - all tied into things being better inside the system than outside, for the people that are inside the system. If something better comes along then that will be brought inside as well. The big problem I see is that with the current administrative insularity (yes, a euphemism...) is that they have stopped looking outside for anything be it people or ideas or skills. Until that gets shaken up, those other things that @Marc mentions can never change.

[LoongFred]

11 hours ago, mickkotlarski said:

Hiu Mak Thank you for that. 

I find that the Thai health system is very good. Of course you have to get a que and wait for service vs a defined appt., but it seems very efficient and they take serious cases first. The cost are very low compared to western countries, but you must pay because the government would be foolish to subsidize your care.

All the doctors I've seen are on a par with US licensed physicians.  I'd grade them at A+.

I willingly pay for my care. 

 

[LoongFred]

10 hours ago, Yinn said:

Male menopause affect them a lot. 
But if try to help them, they angry more! 

Just like women having a hot flash.

[LoongFred]

7 hours ago, MikeTexas said:

I agree that people shouldn't be supported by others.  My question is, do most Thai have health insurance and most non-Thai do not?  I would imagine that most Thailand residents contribute to the economics of the country equally.  Any expat living, working, and/or paying taxes had probably contributed at least on par with most Thai so you can't consider them to be leeches for wanted equal pricing.  
And if most Thai do have insurance but most non-Thai do not, then why would non-Thai asians be provided lower pricing than any other non-Thai group?  In your estimates do Vietnamese or Cambodians contribute to Thailand's economics more than Europeans?

It's the Thais system not yours.  Why would they want to help you getting subsidized care. Your a guest here and shouldn't expect freebies.  

It's not a matter of you contributions via vat tax etc. It belongs to them. You should be grateful that the price is low. 

[WilliamG]

On 9/30/2021 at 8:00 AM, 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. 

I think the opposite regarding private vs Insurance. As soon as you say you have Insurance, the treatment and therefore the price increases.

[WilliamG]

13 hours ago, Yinn said:

Do women complain? No

Do young people complain? No

Is only old men with male menopause. Their own problem. Be better if they return their country. You think we want listen to this people? 
 

Boring.

Yes it IS getting boring with you bringing up the male 'menopause' again. Please look up the meaning of that word before you use it.

And I hope that you will stay as nice as you are now when you reach the menopausal age. X

[Yinn]

1 minute ago, WilliamG said:

And I hope that you will stay as nice as you are now when you reach the menopausal age.

Female menopause different. But similar, angry, frustrated small thing, sad small reason, etc.

Need HRT.

Think the mod will give me menopause holiday a lot. Menopause leave.

[LoongFred]

3 minutes ago, Yinn said:

Female menopause different. But similar, angry, frustrated small thing, sad small reason, etc.

Need HRT.

Think the mod will give me menopause holiday a lot. Menopause leave.

Ha Ha. You might get nice a sweet. Who knows.

[LoongFred]

8 minutes ago, Yinn said:

Female menopause different. But similar, angry, frustrated small thing, sad small reason, etc.

Need HRT.

Think the mod will give me menopause holiday a lot. Menopause leave.

I'll be long gone when you reach menopause, which is probably good for me. I do feel sorry for Ranong though. 

[Stonker]

9 hours ago, MikeTexas said:

America doesn't charge medical rates based on nationality so there is at least one for you.

While true, which in itself is increasingly unusual here, 'no' it isn't at least one for me because that isn't what I asked - which was "Name any that don't charge non-residents and non-nationals more. Any at all!".

 

 

 

 

[Stardust]

On 9/29/2021 at 4:14 PM, Thaiger said:

In a closely-followed court case, the Administrative Court in Phetchaburi ruled that multi-tiered “dual pricing” in Thai hospitals are not discriminatory as they benefit Thailand. Ewrin Buse, who sued the Ministry of Public Health after discovering he was being charged more for his cancer treatment as a foreigner, vowed to appeal the decision. Erwin said the court took the Ministry at its word instead of fact-checking statements and that a recent change in how the Ministry defines labour costs allowed it to justify the dual pricing retroactively. The ruling seemed to be based solely on the assumption that foreigners have […]

The post Court rules for Health Ministry, calls dual pricing beneficial appeared first on Thaiger News.

Read the full story

So then they have to make a tier 4 pricing for the rich Thais and elites because they have more money than the average Thai people otherwise it is pure racism. And it is time for all countries then to charge double prices for all Thai tourists around the world!

[mickkotlarski]

3 hours ago, LoongFred said:

I find that the Thai health system is very good. Of course you have to get a que and wait for service vs a defined appt., but it seems very efficient and they take serious cases first. The cost are very low compared to western countries, but you must pay because the government would be foolish to subsidize your care.

All the doctors I've seen are on a par with US licensed physicians.  I'd grade them at A+.

I willingly pay for my care. 

Yes agreed. Although I do see the over pricing as discriminatory but give credit where it is due. The costs are lower than most developed nations, service and quality is good.

[Stonker]

10 hours ago, MikeTexas said:

I agree that people shouldn't be supported by others.  My question is, do most Thai have health insurance and most non-Thai do not?

I can't comment on what "most non-Thai" have or not, or how many Thais have private health insurance, but I've given I've given the link before showing that 99.95% of Thais have free and full state medical coverage which is theirs regardless of whether they're resident in the country or not, or whether they've ever paid taxes or not, including all treatment, accommodation, food, medication (pharmacy), physiotherapy  and dental treatment.

That's probably one of the highest rates anywhere in the world with that level of coverage and puts most Western countries to shame, despite some of the utter cr@p posted here, particularly as it also covers all registered migrant workers under the HICS, and their dependants, as well as all those foreigners working here and paying tax under the Social Security Scheme (SSS).

There are a number of different schemes, including the Social Security Scheme (SSS) which covers around 25% of the population plus their dependants, in different categories, the Health Insurance Card Scheme (HICS) for registered migrant workers, the Civil Servant Medical Benefit Scheme (CSMBS) which covers not only public servants but their families as well, including parents, Police and Military and their families / dependants, and the Universal Coverage Scheme (UCS) or yellow card.

To put a personal perspective on that, I have a quarterly check up at the local hospital every quarter plus the occasional visit for any unexpected issues for myself or my Thai partner, and the only people I've ever seen at the cashier's desk in the last decade apart from myself has been the only other farang I've seen there or Thais paying for a VIP room (500 baht a night).

11 hours ago, MikeTexas said:

Any expat living, working, and/or paying taxes had probably contributed at least on par with most Thai so you can't consider them to be leeches for wanted equal pricing.  

There's a world of difference between someone who's "paying taxes" and someone "living" in a country, which is why all countries only recognise "resident" or variations of resident, not  "living".

In the case of Erwin Buse, which is what this thread is about, he was a train engineer in Holland before moving to Thailand in 2006, aged 37, to join his Thai wife who works in a salon. He has no work permit and pays no tax, has no pension and no income from abroad, but works as 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 was offered a refund of 12,746 baht in 2019 which he refused as he "wanted equal pricing"  and to only be charged 50 baht for each quarterly visit, not 300 baht, in line with migrant workers under the HICS or Thais under the UCS as had been the case for them when he arrived in 2006, although he had never been either a registered migrant worker from ASEAN nor a Thai.

If that isn't what you "consider to be a leech" then what is?

11 hours ago, MikeTexas said:

And if most Thai do have insurance but most non-Thai do not, then why would non-Thai asians be provided lower pricing than any other non-Thai group?

It's got nothing to do with health insurance, but is simply about reciprocal health agreements (RHAs), and it's not "non-Thai asians" but very specific groups as laid down in detail in the Royal Gazette order on Tiered charges - namely (Group 1.1) Burmese, Laotian, Cambodian and Vietnamese who are registered migrant workers, and (Group 1.2) Burmese, Laotian and Cambodians who aren't registered but are working in border areas.

Those are the only countries Thailand has RHAs with, AFAIK, apart from a separate limited RHA with China, so that's no different from any other country with RHAs, whether it's the USA, Australia, the UK, or anyone else.

As for any "other non-Thai group" that Thailand doesn't have an RHA with, they're dividided into two groups just as they are in most other countries, if anything rather mopre generously than some, with one Tier for "foreigner who has residence in the Kingdom of Thailand or has been granted permission for a temporary stay in the Kingdom of Thailand" and one for "a tourist or in transit".

A lot of what's said here is uninformed cr@p but those are the easily verifiable facts so what's unreasonable about that?

[LoongFred]

4 hours ago, WilliamG said:

I think the opposite regarding private vs Insurance. As soon as you say you have Insurance, the treatment and therefore the price increases.

Maybe here, but I  haven't experienced it. In the US it's not so and everything in in the computer. I've never seen a business office person that can adjust the price.  They can however correct mistakes about charging for services or supplies not received.

[Stonker]

4 hours ago, WilliamG said:

I think the opposite regarding private vs Insurance. As soon as you say you have Insurance, the treatment and therefore the price increases.

 

5 minutes ago, LoongFred said:

Maybe here, but I  haven't experienced it. In the US it's not so and everything in in the computer. I've never seen a business office person that can adjust the price.  They can however correct mistakes about charging for services or supplies not received.

I've certainly seen it exactly as @WilliamG describes in several private / international hospitals here (in Thailand) and some doctors are quite open about it.  The price per treatment doesn't go up , but the treatment offered does and any number of unnecessary tests and specialists can be included. They're not really ripping the insurance companies off as they get a discount / refund later from the hospitals, so it's really just mutual back-scratching between the hospital and the insurers with the only loser being the patient who pays the insurance premiums.

[Stonker]

9 hours ago, Soidog said:

Ive often said the same about being born Thai and living in Thailand. I think I would either be in prison or dead in a ditch. My Thai friends tell me I wouldn’t be as I would think differently. There is a saying which often recall in such situations:

If you were born where they were born. If you saw what they see. If you heard what they hear. You would think like they think and do what they do. 

There is a lot of truth in that I think. Most Thais simply accept their lot and work hard to make a living and get by. It’s harder for foreigners as we know it really doesn’t need it be like it is. 

Rather blinkered, as it isn't a question of any one system being better than another but just they're being different.

To stay on topic with a medical perspective, Westerners generally can't get their heads around the idea that if you're a patient in a state hospital here then unless you're in a VIP room you're pretty much expected to have a friend or one of the family with you 24/7 to help you change, get to the toilet, wash up your plate and help feed you, if necessary sleeping on the floor in the corridor or by the bed.  To a Westerner that's insanity as you're in the way and that's the nurse's job.

To a Thai, the idea that you can't stay with and help a loved one when they're in hospital and need you most, and you can only see them for an hour a day at set times, is just inhuman.

It's not a question of judging but just understanding, and that seems beyond many here.

[Stonker]

18 hours ago, Guevara said:

Until the 1980's the UK NHS waived most of overseas therapeutic interventions.

That's the problem, @Guevara - you're basing your assumption on what's happening now on what happened in the past, although you're going back a bit further than the board myopic.

"the 1980's" was forty years ago, and while that may not seem that long to you (or me!) times change. Forty years before that, the NHS was in its infancy and there was no question of charging anyone or eligibility, and EVERYTHING was free to EVERYONE for a while, including dentists, dentures, prescriptions and glasses.

The idea of charging any foreigner was an anathema, as Aneurin Bevan said as it would be "unwise as well as mean to withhold the free service from the visitor to Britain. How do we distinguish a visitor from anybody else? Are British citizens to carry means of identification everywhere to prove that they are not visitors? For if the sheep are to be separated from the goats both must be classified. What began as an attempt to keep the Health Service for ourselves would end by being a nuisance to everybody."

While the free prescriptions, glasses, and dental treatment didn't last long (three years!) the liberal interpretation of eligibility lasted until until very recently and didn't start until 2016 and even then it was to be brought in gradually.

The major change wasn't until this year, when it became mandatory and was enforced far more strictly.

Obviously and all too evidently some people are still unaware of the change and in denial - understandable although disappointing in another country, but in their own country when they're living there it's a bit sad.

 

[Soidog]

6 hours ago, LoongFred said:

It's the Thais system not yours.  Why would they want to help you getting subsidized care. Your a guest here and shouldn't expect freebies.  

It's not a matter of you contributions via vat tax etc. It belongs to them. You should be grateful that the price is low. 

I guess some countries just treat their guests better than others. If I see a Thai needing A&E treatment after a fall or car accident in the U.K., I’ll be sure to point out your post to them, while asking them do they have any money on them to pay after their treatment. Seems fair don’t you think? 

[LoongFred]

4 minutes ago, Soidog said:

I guess some countries just treat their guests better than others. If I see a Thai needing A&E treatment after a fall or car accident in the U.K., I’ll be sure to point out your post to them, while asking them do they have any money on them to pay after their treatment. Seems fair don’t you think? 

Thais will treat accidents as appropriate, but you or your insurance will get billed.

[Marc]

 

First of all, I don't think there is a perfect country or system. There are flaws in each of them. My point is, I don't think that a "wild west me first and only me" approach, where everything is fine as long as it is beneficial to an individual or a group, is the best way to go. It's not even a good one.

It results in a massively divided society in which few do what they like and many suffer from it. This is the exact opposite of opportunity, freedom and justice for all.

Btw, the Thais don't believe that either. They've have given themselves a constitution with fundamental rights, check and balances and accountability (not just in the current constitution). Even the prime minister keeps talking, "You have to obey the law".

The issue is: a lot of Thais don't care. It's mainly about face and benefit, not about values or laws. And the prime minister couldn't care less about obeying the law. He only applies it when it's beneficial to him. That's double standards and hypocrisy. And that is not a healthy environment for the economy and development in the country. If you can't trust, not even in the law or the courts, many won't invest.

China is different, they don't pretend to be a democracy and most people don't even want to live in one. They walk the talk. You know it, you can trust in it. Like it or leave it.

Here you can only rely on one thing, in the end, you are on your own. If you stay under the radar or know how to handle your Colt, good for you, everything is perfect. Just don't pretend it's beneficial for the country, like the court did.