For a number of years Thailand has been dealing with the issue of foreigners entering hospital and being unable to pay their bills for treatment. Young uninsured travellers will often suffer mishaps, while some older people who seek treatment have come to Thailand to retire and possess limited savings and no health insurance. National insurance from European countries and US Medicare generally do not extend overseas and patients are often left to pay their own bills. This has placed a considerable burden on the health care system and is increasingly becoming a concern for the government. In adhering to professional ethics, the local hospitals take care of foreign patients unable to pay, and this has left some institutions with large unpaid bills. Embassies say that the matter is private and not their responsibility, while the families of the patients will often decline to help.
The problem is becoming a policy issue for the country, and a number of players are working to come up with a compromise solution that works best for everyone. Hospitals have been asking for the government to require visitors to obtain insurance policies before entering the country, and a few different variations on that basic theme have been suggested, though none have been implemented.
In 2013 the idea was floated to add a BT500 ($15.05) fee for every tourist entering Thailand by air and a BT30 ($0.90) fee for those entering via land borders, and to use the funds to cover unpaid bills. The press reported at the time that the country was stuck with BT700m ($21.1m) a year in unpaid bills, with Phuket alone covering BT5m ($150,500). Motorcycle injuries are said to be the main reason foreigners seek medical treatment in Phuket.
Under this programme, those with health insurance policies would not have been be exempt, but people coming from visa waiver countries might have been. There was also discussion of establishing a medical mediator to handle disputes about bills between foreign visitors and the local hospitals. However, the tourism sector, which is of considerable importance to the country’s economy, resisted the move, saying that such a requirement could discourage visits. Representatives of the tourism sector said that they would support a voluntary programme.
Visitors on package tours are already required to have travel insurance, while any number of commercial solutions do exist and are highly competitive. At least one public-private scheme is available. In 2014 the Tourism Authority of Thailand (TAT) and four local insurers – Muang Thai Insurance, Chao Phaya Insurance, Siam City Insurance and Krungthai Panich Insurance – introduced a product called Thailand Travel Shield. The programme offers BT1m-2m ($30, 100- $60.200) of coverage for up to 60 days with prices starting at BT650 ($19.57) for one week and a maximum of BT1m ($860.86).
A Growing Problem
At the end of 2015 Phuket officials told the local press that the problem was getting worse on the island. Patong Hospital was seeing about 25,000 foreign patients a year but only 400-500 had health insurance. In early 2016 the issue was again discussed. Kobkarn Wattanavrangkul, the minister of Tourism and Sports, suggested that a programme should be introduced to require visitors to pay for insurance on arrival, but that they would be exempt if they could demonstrate proof of coverage. Thais are required to buy insurance when visiting Europe, the minister noted, so Europeans could be required to do the same when visiting Thailand.
Funds exist for compensating tourists in the event of an accident. The Pattaya Tourist Support Fund will pay BT20,000 ($602) for non-disabling injuries, BT50,000 ($1505) in the event of disabling injuries and BT100,000 ($3010) in the event of a tourist death on the island. However, the fund was nearly driven into bankruptcy following a boat accident that injured 18 tourists in 2013.