Thailand

Health

There is a distinct difference in the standard of health care between Bangkok and the provinces. In many ways, health care in Bangkok matches the standards of health care in Western cities, at least for those who have enough money. In rural areas, however, health care has to be considered barely adequate on a Western scale.

Health care in Thailand has both private and public institutions. Private institutions generally have higher standards, and one can usually say the more expensive the better.

Luxurious hospitalization is available at some private hospitals. There, some suite rooms may match luxury hotels in comfort - wall-to-wall carpeting, refrigerator, a reception area, color TV, telephone, and of course aircon.

It is a custom that when a Thai is hospitalized, family members, friends or a companion stays with the patient most of the time. Rooms in private hospitals usually provide sleeping space for at least one companion per patient. There are usually no set visiting hours and at least in the case of private rooms, there is 24 hour access.

Common opinion is that private hospitals generally require a deposit before admission. The Australian-New Zealand Women's Group advises: "Be aware that a deposit in cash of Baht 20,000 and submission of passport may be required before admission."

But of course, as provided by law and medical ethics, doctors will attend to any patient in an emergency situation, without asking for money in advance. And the experience of an expatriate member of the editorial staff of this handbook had been quite the opposite of what the Australian-New Zealand Women's Group suggests. To be admitted for delivery at the Sukhumvit Hospital on Sukhumvit Road, neither passport nor a cash deposit was required. Actually, when a few hours after admission the staff's partner approached the cashier with a pocket full of money to make a deposit before what appeared would be a Caesarian birth, the offer of any advance payment was expressly turned down and he was told that a bill would only be made upon checking out - as it later was the case.

Private hospitals in Thailand generally accept credit cards in payment of bills and credit card holders will probably never be required to make a deposit.

Most private hospitals house a number of clinics with medical specialists. On weekdays, clinic hours are usually in the late afternoons and well into the evenings while on Saturdays and Sundays clinic hours are often all day.

Doctor's fees are not regulated and physicians or hospitals set their own charges. Fees vary widely. A general practitioner in Bangkok may charge 100 to 200 Baht per consultation, while a specialist may request considerably more. In provincial cities, doctor's fees are lower, and in rural areas, they are about a fourth or less of what is charged in the capital.

Doctor's fees in hospitals are often not charged by the doctor but by the hospital that employs a physician permanently. This is in pleasant contrast to some other Asian countries (for example the Philippines) where the hospital charges the patient only for the facilities used while the doctor's fee is set by the physician. A common habit in the Philippines is that physicians set their fees not according to the services they rendered but according to what they believe a person could afford to lose. It must be noted that there is much less risk of being treated that way in Thailand than there is in the Philippines.

Emergency rooms often also function as out-patient clinics, with the advantage of immediate attention. Clinics in hospitals have more sophisticated diagnostic equipment and laboratories than doctors' offices.

Unlike in the West many medications can be bought over the counter. While prescription regulations exist in Thailand for certain drugs, they are often not observed and many drugs requiring a prescription in Western countries are sold freely. There is widespread amphetamine abuse, especially among professional drivers.

Medical drugs sold in Thailand are either manufactured by international companies which often have local subsidies, or by smaller local companies. Drug patents are not observed very strictly so there are many clones. However, it is generally assumed that the medical drugs of international companies are of a more consistent quality. They are also more expensive.

Most Thai doctors, especially in tourist areas, speak sufficient English to communicate with foreigners. Patients who do not speak English well may wish to consult physicians speaking their own languages.

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