Thailand To Impose Mandatory Health Insurance For Tourists & Long Term Elderly Retirees – Will It Happen This Time?

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Thailand is once again mulling the idea of charging foreigners a mandatory health insurance premium to cover alleged bad debt left behind by destitute foreign travelers who can’t pay their medical bills.

While the government has already implemented such a law for retirees (expats 50+ on the long-stay non-immigrant O-A visa) they are now discussing another regulation hitting all foreign arrivals with a mandatory 100 THB fee.

One would think that travelers who travel to another country, let alone South East Asia would actually carry travel health insurance, but seeing the clientele at various destinations including Thailand, it isn’t  hard to believe that this actually isn’t the case.

According to this article by The Nation the first individuals definitely impacted by the new laws are the elderly retirees.

Approved by the Cabinet last month, the new regulation will require expats on the long-stay non-immigrant O-A visa (Note: Retirement Visa) to have health insurance that offers Bt40,000 coverage for outpatient treatment and Bt400,000 for inpatient.

The requirement was introduced because foreign expats have piled up unpaid medical bills of more than Bt300 million since 2016.

“We will ask the Immigration Bureau, the Foreign Ministry and the Insurance Department for additional details and implementation guidelines next week,” Saowapa Jongkittipong, who leads the Health Service Support Department’s International Health Division, said yesterday.

She said that once the rule is implemented, applicants for the non-immigrant O-A visa, which is valid for one year from the date of issue, would be required to buy health insurance.

“Current holders of this visa will have to produce proof of their health insurance for visa renewal,” she said.

According to Saowapa, this requirement is necessary because medical treatments provided to many elderly long-time foreign residents have weighed heavily on the state coffers.

Last year, foreigners incurred Bt305 million in unpaid medical bills. Foreigners in 2017 left Bt346 million in unpaid medical bills. If categorised by the number of medical visits, statistics show about one-fifth of foreign patients did not pay their bills.

For instance, foreigners made 3.42 million medical visits last year, and did not pay for 680,000 of them, while in 2017, foreigners made 3.3 million medical visits and did not pay for 565,000 of them.

Saowapa said further discussions among relevant agencies would help establish which diseases would be covered under the mandatory health insurance.

So much for the retirees. The statistics above however include ALL foreigners and not those who are staying long term in the Kingdom under the relevant visa for retirement.

So now the focus is on the tourists? What to do?

As per a new article published this week by Khaosod English the government is planning to levy a 100 THB fee for each foreigner arriving.

Foreign tourists visiting Thailand will soon have to pay 100 baht on arrival on top of any visa fees for their mandatory health insurance, a tourism official said Thursday.

The fee of 100 baht levied from each traveler will be used to buy insurance to cover his or her stay in Thailand, tourism ministry secretary Chote Trachu said. He expects the measure to roll out “six months from now.”

“Based on our preliminary [study], we won’t charge them more than 100 baht per person,” Chote told the media. “But I insist that the fee will be collected based on necessity, and it will have a minimum impact on the industry.”

He expects that 3.8 billion baht will be raised from 38 million tourists who visit Thailand annually. Chote did not mention whether visitors already covered by their own insurance packages will be exempted.

Commenting on the latest proposal, Tourism Minister Weerasak Kowsurat said the government has been spending as much as 300 million baht on healthcare and even corpse transportation for foreign visitors.

“After this law is enacted, the Thai government can buy insurance to cover foreign tourists without interfering with Thai nationals’ tax money,” Weerasak said. “Each year, the state has to bear the cost of emergency vehicles, medical treatment and transport of bodily remains.”

He added, “Whenever we try to bill someone, no one would pay.”

I have several problems with these statements made by the Thai official. Let’s take the one where he mentions that “no one would ever pay” which is actually not true proven by the statistics provided in The Nation article. Only 20% of foreigners don’t pay for their medical bills – still a staggering amount but that leaves 80% who do in fact pay so that’s far away from “nobody”.

Paying 100 THB upon arrival sounds easy but it will actually prove to be a logistical nightmare to which everyone who knows Bangkok Airport can attest. Nobody will have Thai Baht in cash upon arrival, there aren’t even ATM’s – only cash exchange counters – and they can’t just tag it onto the ticket as that would impact all travelers, even transits with departures on a separate ticket and Thai citizens. Collecting cash and verifying existing insurance will take forever. There are barely enough resources and spaces to process regular arrivals by simply stamping their passports.

The quality of insurance provided will likely be a complete joke and not cover anything worthwhile, especially not at a hospital where anyone with common sense would like to be treated, such as at Bangkok Hospital or BNH. It will most likely be for Thai Clinics and Government Hospitals. Obviously, what can you expect for a $3 premium?

It’s simply a cash grab! 3.8 Billion Baht is expected to be taken in annually but the actual amount of bad medical debt per year is around 300 Mil Baht. That a 13-fold of the actual amount on unpaid medical bills. I doubt that the Thais would actually give a waiver to travelers who have their own insurance. To really verify the validity of a certificate would simply waste even more resources.

Thailand has tried many times to get this on the way as the number of tourists who don’t pay their bills do in fact present a problem. That being said there are plenty of foreigners who pay dearly (get ripped off by hospitals) for their treatments and one can argue the hospitals have already priced that in.

I have friends who work for the American Citizen Services at the U.S. Embassy as well as the German Embassy and Consulates in Thailand who told me very interesting stories about delinquent patients of all age groups. In general however it’s important to note: Your own government won’t help you out either. There are countries that have agreements with foreign governments and the reimbursement of medical costs (I believe Canada and France are two of those) but those are the exception.

Conclusion

As mentioned I believe this is a logistical nightmare that simply can’t be implemented in Thailand in the intended way. It’s a popular thing to talk and think about but the practical aspects are simply not there.

Whenever there is a shortage of money governments come up with a new tax and, as reasonable it is to eliminate medical debt of foreigners, attempting to grab a 13 fold amount to make up for it is simply without merit.

I believe it when I see it but for now this is a dead fish in the water. But regardless, get yourself a proper travel insurance people! You don’t want to be in Thailand or anywhere for that matter with no medical coverage.

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