Healthcare in Thailand: Getting Healthcare in Bangkok
Is it expensive to avail of healthcare in Thailand? It's important to ask such questions before you even start calling the movers. Will it be easier to get access to healthcare in Bangkok compared to other Thai cities? Are medical services more expensive than what you need to pay back home? How does Thailand's healthcare system work? Here's what you need to know about getting healthcare in Thailand as an expat and all about healthcare in Bangkok.
The Healthcare System in Thailand
Thailand adopted a universal public healthcare system in 2002 that automatically enrolled its entire population of 69 million into a universal health coverage scheme. At present, there are nearly 1,000 government hospitals in Thailand, over 350 private hospitals, 10,000 government health centers, and some 25,000 private clinics that provide residents with health services.
Previously, a comprehensive health insurance scheme was launched called the "30 baht project" which charged a co-payment fee of THB 30 for treatment, which was popular with low-income Thai citizens in rural areas. Those who joined the program received a gold card that gave them access to medical services in their health district. The scheme also allowed them to be referred for specialist treatment elsewhere if necessary.
The 30-baht fee was abolished by the then head of the Ministry of Public Health Mongkol Na Songkhla after the 2006 military coup and made the entire scheme free. A proposal in 2012 to relaunch the 30-baht program was opposed by many civil groups.
Thailand's universal multi-payer healthcare system carries two types of health insurance: public health insurance under the auspices of the National Health Security Office (NHSO), and private insurance. All Thai citizens are required to be enrolled in an insurance scheme, either in the national health insurance or through an employees' health insurance scheme. The national health insurance is primarily for people who are not eligible for any employment-based health insurance schemes.
How does the country's universal healthcare system work? The "gold card" system covers the majority of Thai nationals, which number approximately 50 million people. Private employees, around 10 million, come under the umbrella of social security while the country's 5 million civil servants and their dependents are given coverage through the civil service welfare system. Public hospitals are included in the network, as well as some private hospitals but not all.
The World Health Organization (WHO) has noted that the country's adoption of universal health coverage has resulted in a more optimistic outcome for the 10 percent of adults affected by diabetes among Thailand's 68 million residents. Those with diabetes may avail of free treatment under the national healthcare scheme. They can also go for routine tests at local health centers, and may also be referred to a district hospital for further treatment. The scheme also provides free screening for cataracts to those aged 60 or older.
Public hospitals are under the authority of the Ministry of Public Health (MOPH), including general and community hospitals, and some select specialist hospitals. These hospitals generally offer good service and are part of the public healthcare system.
There are also other hospitals that are operated by health organizations or other similar organizations independent of the MOPH where Thai citizens can avail of health care services without additional charges. These include the Thai Red Cross Society, the respective Medical Departments of the Royal Thai Army, Royal Thai Navy and the Royal Thai Air Force; and the Office of the Surgeon General of the Royal Thai Police.
As these public facilities provide free to low-cost treatment, it's often difficult to secure medical appointments, and queueing may sometimes take hours. While basic English is understood by most of the staff, accurate communication may prove to be difficult for expats. It may be prudent to ask the help of an interpreter should you need to seek treatment at public hospitals.
Most, if not all, expatriates choose to have private medical insurance during their stay in Bangkok. This provides an added safety net to the mandatory health insurance provided by companies. Many private hospitals in Bangkok are also affiliated with local and international health insurance companies, making it easier to seek treatment and to reimburse claims.
Most hospitals expect you to pay the costs upfront for basic consultations, medication, and minor treatments, or make a down payment for any in-patient treatment or surgery. Thus, it's a good idea to have a separate cash account available or a separate credit card for such expenses.
Many expats also advise carrying your insurance documents and health card at all times, plus a copy of your passport and work permit, in case of emergencies. Once you've settled into your new home, make a list of the nearest private hospitals in your area, your workplace or your child's school, and note down the hospitals' emergency numbers. Should you have any particular illnesses or allergies, make sure to have a copy of it on hand as well. The public emergency number for Thailand is 1154 for medical emergencies. The tourist police can be reached at 1155 for emergencies.
Primary Care and Vaccinations
Unlike in other countries where primary care and secondary care are available, Thailand does not have something similar. Those who have private health insurance choose to go to a private clinic for their health concerns. Finding a general practitioner (GP) to serve as your primary care doctor may be easier by asking for recommendations from friends and fellow expats.
However, even before you make the move, it's advisable to get vaccinations for some tropical diseases. As Thailand has a tropical climate, you may become more susceptible to illnesses such as influenza, hepatitis, dengue fever, malaria or encephalitis. Do ask your doctor for advice on what diseases you should be immunized for, as well as any other illnesses that you may catch. It's also best to get a prescription for a supply of any necessary medicines that should last you for the first few months in Bangkok in case you're unable to purchase them in Thailand.
Lately, Bangkok has been experiencing extremely hazardous levels of air pollution, which had residents scrambling to purchase masks, air filters, air purifiers and the like. If you suffer from asthma or allergies, please ask your primary physician for advice or see a specialist when you arrive in Bangkok.
Thailand is also a popular retiree destination. A recent report from the Thai Examiner in December 2018 stated that a government committee made a proposal that will require expatriates holding Non-Immigrant O-X or O-A long-stay visas to have mandatory health insurance. The proposal is awaiting presentation in the Thai cabinet.
However, this plan is seen to adversely affect the expat retirees who have made Thailand their home for a good number of years since it will be undoubtedly difficult to secure health insurance due to their age and any medical conditions they may have. This will also affect their visa status in Thailand.
Thailand is one of the many countries in Asia known for its medical tourism*. Many foreigners hailing from Western countries go to Thailand to avail of a wide variety of medical treatments, including open-heart surgery, cosmetic surgery, and fertility treatments at costs significantly lower than those in their home country. Currently, there are 64 accredited hospitals – most of which are private hospitals – that cater to medical tourists, whose numbers reached 3.5 million in 2018 alone.
The country's drive to be a top medical destination also puts the spotlight on its private hospitals. The best private hospitals are located in Bangkok and have first-class facilities as well as high-quality modern equipment. Some of the most well-known private hospitals in Bangkok include the Bangkok Hospital Medical Center, Bumrungrad International Hospital, BNH Hospital, and Phyathai 2 International Hospital. A good majority of the staff at these facilities can speak English as well as other languages in order to provide assistance to a global clientele.
*Please note Now Health International does not provide cover for medical tourism.