Health

Our views on healthcare and how they relate to insurance are likely to change over the years. Hopefully, we are born relatively healthy and will go on to have our three score and ten (or thereabouts!) but only a fool would imagine that there are not going to be bumps along the way.

We’ve all heard the stories of “gran” who smoked twenty cigarettes a day for 85 years and never had a day’s sickness in her life. Well, lucky old gran is all I can say.

This blog will hopefully provide food for thought about living in Thailand and give an “indie” perspective from someone who has lived in the Kingdom for 40 years. I’ve been someone who has saved money to pay for health issues, I’ve had as many as most.

It will also look at some of the issues related to Thai expat insurance and how that might impact digital nomads, senior citizens or those about to start families in Thailand.

I’m a resident of Thailand not a citizen so despite being here virtually all my adult life I don’t qualify for the “30 baht Gold Card” Thai citizen health insurance scheme that applies to my children (I have four and have been married twice).

I pay for my health matters with cold cash. This has not always been the case as I was employed as a teacher at international schools for around half my time here so availed myself of their employee health insurance which varied considerably and never gave me much confidence. Dentistry for example, my main need, was rarely covered and when a provider rejected cover for a chronic condition my personal views on insurance were confirmed!

I felt sick.

I grew up loving to bet. I had multiple accounts with gambling firms while still a teenager. I saw insurance as a gamble that you could only win if you fell sick more than the actuaries predicted or if you had far more accidents and scrapes in cars, for example, than your fellow human.

In short, like a casino, the odds were against you ergo don’t get insurance. The caveat to this was to get insurance if the law said you had to. Advice: Get “Por Ror Bor” (3rd party insurance) for accidents while driving, I can stomach that.

My first brush with death in Thailand when I developed dysentery. The treatment I received seemed okay but was poor even though it was at a private hospital. Unbeknownst to me the disease was not cured and an amoebic abscess developed in my liver ultimately requiring a three-day hospital stay. 

Advice: Don’t assume five-star hospitals are better than smaller ones.

Most of my early dealings with doctors in Thailand revolved around catching various nasty stuff from strangers. I used to give my hard-earned money to a charming English GP nicknamed “Dr Dick” for obvious reasons. His real name was Dickson. 

He missed a trick when I caught scabies. Advice: seek out Thai health professionals with local knowledge. Get a competent Thai “GP” who can be your go to health professional for life or the duration of your stay.

Dental care in Thailand is affordable whether you go to dental hospitals or chains on the street. Thai dentists are mostly trained abroad. Superb service, few mistakes. No need for insurance.

Eyes. Riding a motorbike without a visor for 35 years and being bashed by Bangkok’s pollution has damaged the old eyes. A great ophthalmologist near my home has put me right on that. Not cheap but eyes like teeth are important.

Conjunctivitis – what the Thais charmingly call “taa daeng” or red eye – can be treated at pharmacies. 

Which brings me to a cornerstone of my healthcare. The first line of defence for me has always been to use pharmacies with their invariably well-trained staff for most initial contact. They are responsible enough to say “go to a hospital” if they are not sure. And if you want a second opinion there’s one next door. No fees.

Advice: Use pharmacists near major hospitals – drugs are cheaper. 

That brings me to another cost cutting ploy. When visiting doctors at private hospitals get prescriptions, buy elsewhere. Most doctors will connive on this.

Using the Thai healthcare system is possible for everyone and cheaper. Yes, you may wait in line longer but the care will be as good as at swanky places. Clinics and hospitals outside Bangkok have been great for me when I’ve had accidents. You pay less than the 10-20% on copay schemes.

If you do opt for health insurance check about pre-existing conditions and read the small print. Follow the links in this piece. Do policies cover diabetes, hypertension, and heart disease? 

When will they pay out?

Remember insurance is a gamble – box clever. 

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