Chickungunya: a hell of a scam

 A big Money Machine !

The private hospitals in Phuket are really impressive. The better it goes, the more sophisticated they are. 

When you enter such an establishment, you enter a 5-star hotel. It's big, it's spacious, it's modern. You can even wonder if you're in a hospital or a luxury hotel... all you need now is the gaming rooms with slot machines! 

When you park in the car park, we come to pick you up in an electric cart... on the other hand I have rarely (almost never) been brought back to my car with these carts once my bills have been paid...

The staff is largely oversupplied, there are translators (German, French, Italian etc...), cleaning staff, catering services, nurses, doctors, secondary staff...

If you take a seat in one of the waiting areas... you will be able to observe the incessant passages of the staff in incredible numbers. If you come from Europe, you will be extremely surprised to see all this, because here, no problem of personnel... the expression "understaffing" in Thailand, it does not exist.

When you stay a few moments in the large hall on the ground floor, you sometimes have the impression of being in an anthill.

But all this....has a hell of a price at the end of the day! 

In consultation... for Chickungunya...

Obviously, when you don't have the knowledge or experience of this disease... you find yourself in the most complete ignorance, you don't know what's happening to you. 

Having a 39° fever is not normal, you have necessarily caught a piece of crap, but which one?

At the hospital, we will immediately take a blood test.

In Phuket... if you have a fever that has been going on since the day before, it is quite possible that you may have contracted either Dengue... or Chikungunya... it may also be something else... you'll know soon enough. 

To help you get a first idea of your illness... just ask yourself, for example, if you are in a period of epidemic, if there are many cases at that time... 

The nurses will necessarily be able to answer you. If so, it is quite possible that you are one of the victims of the tiger mosquito ! it is not 100% safe but there is a good chance.

In the case we have just lived (my wife being in this situation), the doctor shows us the result of the blood test. 

A priori, there is only a 70% chance that it is dengue fever, so there is a doubt... He tells us that he sends the blood sample to Bangkok for further analysis to find out if it is the Chikungunya... it takes two days to get the result. Yes, it seems that the Chikungunya test is only performed in Bangkok. (confirmed by another hospital later)

These private hospitals in Phuket are very expensive, as everyone knows: Doctors have a major concern to make it profitable, so they try to get you admitted by all means.

The American method obliges us, here, if you do not pay in advance, we do not treat you, even if you arrive with a leg under your arm... as long as you do not pay, we do not take care of you it is so.

In the meantime, the doctor can very easily convince you to be admitted to hospital.

You fill in some documents... and you are asked to pay immediately a sum of 20,000THB... otherwise it doesn't go any further. That's right: if you don't pay a part in advance, you won't be treated no matter how bad you get.

The deposit was paid for, all that remains is to wait for the patient to be placed in a room.

Picture above: my wife spent more than 4 hours in this small treatment room before being transferred to a single room.

Chikungunya and Dengue have one thing in common: there is no specific treatment. The only treatment is paracetamol to lower the fever. 

The next day in the late afternoon after spending the first night... the doctor comes to see you and confirms that you do have Chikungunya. Well, that's weird, he said it would take two days to get the results of the analysis...

In the meantime, he announces that, normally, the day after tomorrow you can leave the hospital... that is to say that you will have spent 3 nights in the hospital, just eating Paracetamol!

A Great Scam

Everyone here in Phuket knows that the private hospital is a money factory.

During these 3 days (admission in room Wednesday at 5pm, room out Saturday at 1pm) = 3 nights but two days of care in fact... 

There was no surgery at all... no intensive care... even less anesthesia... just a follow-up: blood pressure measurement, and two other blood tests (to do well) and then finally, the Paracetamol treatment.

Add to that poor quality Thai meals (according to my wife), in other words, hardly edible, disgusting if you prefer.

For this service.... 77,000 THB (2030€) 

I wrote to the hospital in question and said that I found this price scandalous in relation to the level of care... they answered me very calmly and very politely, asking me for my wife's phone number... 

A few weeks later, a hospital employee contacted us by phone to explain for long minutes that the blood tests sent to Bangkok for Chickungunya are very expensive and that the final bill is affected. 

We have inquired on our side... a blood test for Chikungunya is well done in Bangkok but is not that expensive: price 1,200 THB (source: Vachira Hospital).

At the same time, we called this same hospital to ask for the price of the standard room (non-VIP) per night.... 

The employee on the phone asks us: " Do you have insurance? " We answer: " Yes "
In this case the room price is more than 12,000THB/night.... Big surprise, I was not aware of such an amount since I myself had stayed in the same hospital a few years earlier.

In the meantime, we ask the same person the same question, asking for the price of the same room but without having any insurance... the employee's answer: 4,500THB/night

It simply means that for 3 nights spent with insurance the room costs 36,000THB and without insurance this price will only be 13,500THB (a difference of 22,500THB over 3 nights! and therefore our insurances which end up with huge bills... 

Who then pays the insurances that increase their rates?

For me, this price of 77,000 THB to treat a fever is completely unjustified, and I call it a scam.

Let's compare: 

About 7 years ago, I spent 6 days (maybe 7) in the same hospital to be treated for type 1 dengue fever. As with chikungunya, the only treatment was paracetamol to reduce fever. Dengue fever being a little more serious than chikungunya, I was entitled to a blood test every morning upon waking up (very pleasant as an alarm clock, I have already known better...) in order to monitor the level of blood platelets, because with dengue fever this rate tends to drop. So from that point of view, there were no more reasons to stay in the hospital.

When the doctor told me that the platelets were rising again, which was a good sign, I immediately asked to leave the hospital. So I had spent 6 days. 

The invoice was about 48,000THB/6 = which brought back to the day gave a result of: 6,800THB/day 
In this case.... for a similar treatment... we are at 77,000/3 = 25,700THB/day

Since... no other explanation... 

In any case I am quite angry because I have been living in Phuket for many years, I can tell you that the amount indicated above is completely unreasonable. 

Another Comparison:

If you take an average Thai employee salary.... of 14,000THB per month (which is already a not too low salary) 
this invoice for these 3 nights represents for a thai more than 5 months of work... (but I understand that Thai people are not charged the same rate as the rest of us. It's a bit like at the Phuket Zoo... a Thai will pay 80 baht for the entrance ticket, a tourist will pay 500 baht. 

An expatriate living all year round on a "Non-Imm O" visa, for example, is required to justify a monthly income of 65,000THB, this is the law. These 3 days of observation for little, cost more than a month of income to an expat.... 

is there a problem somewhere?

Objectively, I am interested in any information, clarification, explanation

  The Government intervenes...

The government is taking concrete steps to end excessive rates in private hospitals

Private hospitals will no longer be allowed to take advantage of patients with huge bills after the authorities adopted clear legal measures yesterday to reduce excessive prices.

The new regulations, which control the price of medicines, medical supplies and services, came into force yesterday.
Many patients go to private hospitals to avoid crowds and long queues in state medical centres, but many end up being "ripped off".

Now, with so many complaints against private medical facilities, the government can no longer turn a blind eye. Earlier this year, the General Secretary of the Consumer Foundation, Saree Ongsomwang, said that in one case, the medical care bill exceeded 23 million Bt.

In another case, a patient had to pay 30,000 thb for the treatment of simple diarrhoea.
"If hospitals use many specialists for simple symptoms, such as headaches or stomach aches, just to make patients pay high fees, then it can lead to a complaint and legal action," said Wichai Phochanakit, Director General of the Department of Internal Trade, yesterday.

He added that any hospital guilty of providing unnecessary treatment and overloading patients would face seven years in prison and/or a fine of 140,000 Bt.

As of yesterday, hospitals - like importers, exporters, manufacturers and distributors - are required to report the purchase and sale prices of their products. The new rules cover 3,892 drugs, medical supplies and services listed in the Universal Emergency Patient Coverage.
"If this is not done, a prison sentence of up to one year and/or a fine of 20,000 Bt plus a fine of 2,000 Bt / day will be imposed throughout the delay period," Wichai explained. He added that the prices reported by the hospitals will be posted on the websites of his department and the hospitals

"Private hospitals are also required to post a QR code on their websites so that patients can easily check prices," he continued.

A recent study found that in some private hospitals, drugs were sold at ridiculous prices. The most extravagant margin was 8,766%. The same drug can cost between 11 thb and 28,862 Bt per pill.
For example, Orfarin costs 2 bt per pill, but is sold on average in private hospitals at 13.7 Bt, and in some cases up to 36 Bt per pill. Amphotericin-B costs 452 Bt, but is sold on average for 937 Bt in some hospitals and even reaches 2,200 Bt in some places.
"Our new rules are designed to ensure fair prices. We will significantly increase the number of drugs, medical supplies and services covered by the new regulations," said Wichai.

He added that from now on, private hospitals must inform patients, if necessary, of the estimated cost of treatment.
"In addition, under the new regulations, prescriptions must include the generic and brand names of a drug, the form in which the drug is found, the quantity and instructions for use," he said. "Invoices must also specify the unit price of the drug."

Wichai added that hospitals that did not comply with the law could face five years in prison and/or a fine of 100,000 Bt.

The customers of these hospitals, like the expatriates, can only rejoice. It remains to be seen whether the law will be applied seriously because private hospitals belong to very influential conglomerates. In addition, in some cases, public hospitals charge rates, even if justified, that are not cheap for foreigners (dual pricing). Count 25,000 thb per day in the intensive care audience.

Source article: ThaiVisa The Nation 01/06/2019

 In my turn, victim of Chikungunya but at home, simply !

A few days after my wife's return... I was the victim of Chikungunya, but after the previous experience, I didn't even bother to consult a doctor. The fever lasted 3 days between 39 and 39.5.... I ate paracetamol... and 3 days later everything was back in order...

Since I consumed the rest of my wife's Paracetamol... spend= 0THB

Considering the small complications due to this disease: joint pain, I had some expenses for anti-inflammatory drugs purchased from the local super-cheap: about 220THB