Expats’ worst nightmare

According to the leading British insurance brokers’ association, the most common fear of foreigners living abroad is their health. Younger and working expats can usually insure for private hospital care as it is paid for by their employer. But what happens when expats are in their 60s,70s and 80s and living in a country such as Thailand without the safety net provided by the European Union network?

In greater Pattaya alone, there are thought to be around 40,000 expats, the majority from European countries, who are living here most or all of the year. Three-quarters are retirees and only a tiny proportion is covered by comprehensive medical insurance. This is partly because they have never been insured on the dubious belief that ill-health is something that happens to other people, or because their home-based insurer has raised their annual premiums beyond what they can afford.

British expat Phil Summers, 75, said “The fear of long-term ill-health in Pattaya has made me seriously think about returning to the UK. But expats are not automatically able to register for the National Health Service and I have nobody and nothing to return to. Like many others here, I burned my boats years ago.” He has now registered at the new Pattaya City Hospital on Soi Buakhao, a public sector institution, because the pricing structures are much lower than at private hospitals.

As regards privately-run hospitals, it is commonly claimed that they overcharge patients, but The Medical Council of Thailand points out that the prices have to cover medicines, medical equipment and hospital rooms as well as the actual treatment. Many private hospitals have invested hugely in new-tech medical machinery which has to be counted as an operating cost.

Moreover, private hospital administrators point out that elderly foreigners can sometimes obtain limited insurance following a full medical examination or can pay upfront for a discount card which reduces the cost of treatment by up to 15 percent. It is undeniable that the private sector offer friendlier staff, shorter queues and greater convenience in addition to good medical care. If patients wish to obtain these things they should be prepared to pay, goes the argument.

According to the Kasikorn Research Center, Thailand-based private hospitals listed on the stock market are doing well with business growing at 10 percent annually. Their 2015 revenue will likely go beyond 100 billion baht. The Medical Council of Thailand says that they oversee doctors’ ethics and practice but pricing in the private sector is outside their control as using the services is optional.

Last year the interim government introduced a scheme whereby foreign tourists could obtain emergency medical insurance to offset the fact that martial law precluded many foreign-based insurance companies from offering cover. The scheme is still in existence, but is not available to foreigners who are in possession of a non-immigrant visa. It’s strictly an option for bona fide tourists.

A leading Pattaya insurance agent dealing with expats said, “It’s a question of comparing an individual’s income with the costs of varying levels of medical cover. But it is certainly true that, sooner or later, everyone has to become his or her own insurer. Thailand has welcomed large number of farang on easy-to-get retirement visas, but the country is certainly not responsible for their emergency or long-term heath care.”

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