QUESTION
A friend of mine recently had a motorbike accident and I accompanied her to Vachira Hospital to get treatment. After the doctor saw her, she was given a list of medicines to collect at the hospital dispensary.
Some of the medicines were free, as although my friend is a Western woman, she legally works here and has Thai social security coverage.
However, she was told that if she did not want to return to see the doctor every day, she could get better medicines, but that she would have to pay “extra” to get those “better-quality medicines”.
I asked the staff present at the hospital at the time, but I could not get an answer that I could understand correctly as to why my friend would have to pay out of her own pocket for these “better medicines”. Surely, isn’t this what social security coverage is for?
By the way, I am a native Thai and although I lived abroad for many years, I am still very fluent in Thai. There was no language barrier in my understanding of what happened at the hospital. What I don’t understand is why my friend would have to pay “extra” for “better medicines”.
– Khun Art, Phuket Town
ANSWER
Yes, in some circumstances people will have to pay out of pocket for some hospital costs because social security insurance does not cover all medicines issued to hospital patients.
After examining a patient, a doctor will prescribe certain medicines according to which ones he or she thinks is best for the patient and which the doctor knows we have in stock here at the hospital “Pharmacy”.
Then, when the patient presents the list at our dispensary, the pharmacist on duty will check to make sure that all the medicines prescribed are covered by social security or insurance.
If they are not covered, then the pharmacist will ask the patient if they would prefer to pay for these medicines. If the patient chooses not to, then the prescription is returned to the doctor so he or she can write a new one including only the medicines that are covered by social security and any insurance the patient may claim against.
If the patient was involved in a road accident, then the pharmacist on duty may ask to see any vehicle insurance (PorRorBor) for the vehicles involved in case that may help costs of any treatment or medicines at the hospital.
We are a public hospital, and our goal is to serve the public. But in many cases we can offer only basic treatments and medicines. Any specialist treatments or medicines must be paid for by the patient or their insurance, and good medical insurance is always the best policy.
– Chawaluk Kittitornkul, Head of Social Security Department, Vachira Hospital.