Medical Tourism in Thailand

The last 4 or 5 years the above mentioned hospitals have been actively (together with a general promotional attitude by the authorities) seeking medical tourists to visit Thailand. Amazingly up to 60% of patients at Bumrungrad Hospital and up to 40 % of patients at Samitivej Hospital are foreigners. We do not think that Thai patients are not accepted in these hospitals. It just so happens that while foreigners may consider the hospitals cheaper than in their home countries, for most Thais they are simply to expensive to consider.

Samitivej Hospital (part of the Bangkok General Hospital Group) is upmarket and is one of the health care providers for medical tourists in Thailand. It is located about 3 km into soi 49, Sukhumvit Road.

The Kasikorn Research Centre reported that 1.28 million expatriates visited Thai Hospitals in 2005, generating revenue for these hospitals of around 33 billion baht. On average, this means each foreign patient paid 25,800 baht for services provided. The average reflects most likely more expensive procedures such as major surgery, and a whole lot of out patient clinic visits. We assume that this includes also a lot of 'annual check-ups'.

Bumrungrad Hospital is much in the news media. It has been covered on U.S. television stations, and also in international magazines. Also the local English press seems to have an article about the hospital every few weeks. Surely, the public relations office at the hospital is doing a superb job.
An article in Newsweek (October 2006) reveals that Bumrungrad hospital treated 400,000 foreign patients in 2005. This number is astounding and must be (not clearly stated in the article) referring to total hospital visits rather than total number of patients treated.
Furthermore, the hospital is in the process of finishing a new 18-story outpatient center, which will increase the hospital's outpatient capacity to 6,000 patients per day.

Medical tourism will certainly generate further income for the hospitals involved and for Thailand in general. Thailand assets as a center for medical care for foreigners are multiple. The standard of treatment and technology is high (see : 64-Slice Computer Tomography Scanner ; Adult Stem Cell Treatment in Thailand). The prices are mostly lower than in other countries who provide similar quality and technology. The hospital environment in Thailand is clearly more hospitable. It is fair to say that all the hospitals mentioned above, also look good, are mostly new, and give a favorable impression as soon as you enter them. The tourism infrastructure is well developed (provided you are not so sick that you can not really enjoy sightseeing).

Income from medical tourism to Thailand is projected to increase in the following years. It has to be recognized that 33 billion baht of income (about 850 million US dollar) is only a small proportion of the total income generated by tourism.

Development of Thailand as a medical hub for patients from the United States, Europe, the surrounding countries, and the Middle East, also raises questions.

Possibly the most important is : does this all affect the medical care for the Thai population itself? As stated above, most Thai patients can not afford to go to private hospitals. So where to they go to? Over the last few years the Thai Government has developed the so-called '30 baht scheme'. This is a universal healtcare programme whereby everybody get treatment at public hospitals for a standard fee per visit of only just 30 baht. Basically this amounts to free health care. The hospitals who participate in the scheme, get a lump sum per patient registered. We think at present it amounts to somewhat less than 2,000 baht per patient. It has to be recognized as a major achievement, since before that there hardly was any proper healtcare available for the poorer (that is the larger) part of the population.
[the latest news : the 30 baht fee will be cancelled, making treatment fully free ; the yearly subsidy for the hospitals is under review, end 2006]
However, you have to use your own imagination as to whether the Thai population benefiting from this scheme, will receive the same standard of treatment, as the foreigners who are treated at private hospitals.

Another issue is as to where physicians will prefer to work? There is a long standing problem of a lack of medical specialists in certain provinces of Thailand. While the training of just one doctor takes quite a lot of government resources, it does not follow that the doctors trained feel obliged to go and work in some remote area. Furthermore, we are quite certain that salaries paid by physicians working at private hospitals are higher. So there will be a tendency for highly specialized doctors to work in private hospitals at the expense of the care provided in public hospitals for the general public