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Thailand - Healthcare

The sophisticated and very reasonably priced medical services in Thailand make it a particularly attractive place for older Australians to retire to. But it’s not just for retirees—medical and dental tourism is now huge in Thailand with thousands of Europeans, Australians and Americans visiting for treatments of all sorts.

‘There are three or four Australian dental tours here a week—about 100 people a week,’ said Edward, the Australian expatriate businessman living in Bangkok. ‘It is phenomenal health care—hot and cold running nurses,’ he added.

Medical services in a very modern and large hospital, where half the doctors are US-trained, can cost as little as 10 to 20 per cent of what they would cost in the United States. Charges can be as low as A$50 per day for a private room with meals, up to A$150 for a luxurious suite complete with a living room, two bathrooms, a small kitchen and bedroom. The rooms are so well furnished and the service so good that patients say it is more like staying in a hotel than a hospital.

I personally had a medical issue in Bangkok when researching for Planet-Boomer.com. I hate to admit it, but I got a terrible attack of gout – nothing to do with drinking and rich food of course.

Normally gout attacks dissipate after a couple of days with anti-inflammatories. This one just got worse. I had been walking along the beach only a week before I was hit by this problem and I had trodden on a shell, which caused a small cut.

I feared I may have had an infection rather than gout.

So I phoned SOS – the expatriate medical service there. It however only deals with members and I was not one. However they referred me to Bumrungrad Hospital in central Bangkok. I arrived on a tuk tuk. Went to the private clinic admissions counter. I then was sent to see an infectious diseases doctor – or whatever they are called. My vitals were checked by a nurse and then the doctor, who spoke perfect English and seemed completely competent, examined my foot. He concluded, I had gout.

I was sent back out to the luxurious waiting room – see photograph – and withing 20 minutes was being examined by a rheumatologist. He said I also probably had gout but he would put me on a course of antibiotics as well as gout related drugs just in case it was an infection. I got a steroid shot in my butt by a professional nurse, collected a back full of drugs – antibiotics, steroid tablets, anti-inflammatories – then paid.

The lot – two specialist doctors, the shot in the butt and the drugs …. US$140.

This was all good.

ThaiBumrungrad.jpg

However, expatriates living in Thailand, or indeed anywhere else, should have private health cover.

There are around 100 deaths of Australians in Thailand each year—one every three days. One of the biggest consular problems that the Australian embassy faces in Thailand is dealing with sick people who have not bought health cover.

‘They get cancer or whatever and they have real trouble meeting the cost of health care,’ said one Australian senior diplomat.

We met an American retiree who was living in Bangkok. He had cancer. He was fully insured. He chose to have his disease treated in Bangkok, at Bunrungrad Hospital. He said, if you get cancer you either want to get it on the steps of the Mayo Clinic or here”.

He also warned that a common problem with medical insurance coverage for Australian tourists or residents is that, if they do something illegal—like ride a motorbike without a licence—then insurance will not cover them if they have an accident.

Medical services in a very modern and large hospital where half the doctors are U.S. trained can cost as little as 10 per cent of what they would cost in the US.

The good news is that many of the major Australian health insurers are in Thailand, and the premiums are cheaper as well. Edward said he pays about A$2000 a year for health insurance, using a London-based insurance company. And, as opposed to many other countries in Asia, in Thailand you do not need medical evacuation cover. The medical facilities ‘in country’ are good enough.

Some expatriates, however, take shortcuts and this is dangerous.

For example, Glen said that he and Sal are insured, but have chosen to use travel insurance rather than a medical insurance policy. He explained: ‘We renew our travel insurance every year. It covers 100 per cent of our medical costs in Thailand—the risk is that the insurer can decide to medivac you back to Australia—and then you are on your own.’

This is because Medicare does not cover Australians, like Glen and Sal, who have been out of Australia for five or more years. (See Chapter 10 ‘Health Insurance’.) Importantly, though, it does not take long to reactivate Medicare once you are back in Australia. All you have to do is prove you are once again a resident of Australia and that you are here to stay.

Susan, aka Lady Pie, tells an instructive tale about health insurance.

‘The Medicare people in Australia took my Medicare card off me,’ she said. ‘I was horrified. I am not entitled to it because I don’t live there—but having it just made me feel part of Australia. There was girl serving me at the Medicare office in Sydney and she asked for my driver’s licence and I said, “I don’t have one but I do have this”, and stupidly showed her my Thai driver’s licence. She said, “We need to take the Medicare card off you because you are not living in Australia.”’

Susan has private health insurance through an Australian company. ‘People who don’t have it here—it is so irresponsible,’ she said. ‘Recently a guy we know got bowel cancer and all his friends took the hat around because he didn’t have insurance.’

Aged-care services

Bill not only had a great second life—a renewal—but as he became increasingly frail, he was able to stay at home. He was well looked after by the Thai carer. He was not put into an antiseptic, nursing home.

One of the great attractions for the older and less agile Western-expatriate in Asia is the old-age care that can be provided.

Moving to Thailand truly gave Sonja’s father, Bill, a second life, although the Thai health system itself had little to do with that. Bill moved to Phuket at the age of 77, after his wife’s death and a heart triple-bypass in Australia. He was lonely and unwell.

‘But he got a new lease of life when he came to Phuket,’ said Sonja. ‘He was reinvigorated.’

In Phuket, Sonja explained, Bill was looked after by a lovely Thai lady, and was very happy for the last six years of his life, before he passed away in 2013.

He was able to cover the bulk of his living costs from his Australian pension, paying A$400 a month rent for a comfortable apartment. Sonja and Tom supplemented his living costs, paid the Thai carer and bought his medication; but even this was a fraction of what it would cost in Australia.

The point here is that Bill not only had a great second life—a renewal—but as he became increasingly frail, he was able to stay at home. He was well looked after by the Thai carer, and he didn’t end up in the antiseptic environment of aged-care accommodation.

Bill did not have medical insurance, and when he fell ill and finally needed hospital care, it ended up costing A$18,000. But, according to Sonja, Bill would say his new life and ongoing independence was worth every cent.

Sonja says she is living the good life in Phuket. ‘You can’t afford a maid six days a week and a gardener in Australia. You can’t afford to have a massage at your home every Sunday. And we eat out three or four times a week.’

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