The initial aim was for the Swedish government to provide at least state-subsidised healthcare insurance for expat retirees in Thailand to the same level of coverage that the retirees are entitled to in Sweden and while living anywhere in Europe, explains long-term Phuket expat Bo Jonsson, who serves as Chair of the Thailand Federation of Swedish Associations, known simply “SAMS”, the acronym for its name in Swedish.
“The push was also aimed at providing healthcare coverage for Swedish nationals who spend long-term stays in Thailand, flitting between Thailand and Sweden on a regular or annual basis, but who are still registered residents in Sweden, since travel insurances do neither usually cover contagious deceases nor illnesses already under treatment in the home country,” he notes.
The move further hopes to provide some relief to the Thai government hospitals spending millions of baht each year providing medical care to foreigners staying in Thailand. Last year Vachira Phuket Hospital alone revealed that it is spending about B10 million a year on treating foreigners with no medical insurance, Mr Jonsson adds.
However, the movement has since gained widespread traction and now through Bangkok Insurance Brokers Co Ltd (BIB) CFO Eric Dohlon is aiming to garner enough support to launch healthcare policy coverage for all retirees in Thailand.
BIB cooperates with 18 Thai-registered insurance companies, Mr Dohlon explained.
“We will initially choose one insurance company to issue the group policy. When there is sufficient volume of members, more companies will be asked to join,” he said.
“Regardless of how many insurance companies are involved, the premiums and benefits will be the same between all companies,” he adds.
Mr Dohlon pointed out that reaching 1,000 names in support of the policy was a critical factor – now easily surpassed with the policy garnering more than 2,000 names in support as of Tuesday this week (April 10).
“This allows the insurance company actuary (the risk calculator) to spread the claims risk over a relatively large number and drop the premiums to a very affordable level. If we have less than 1,000 names, the actuary is obligated to offer the same health benefits at a much higher premium rate,” Mr Dohlon explained.
The policy to be proposed at this stage is aimed at costing no more than B25,000 a year, or about B2,000 a month. (See details here.)
IN THE COLD
“Retirees either cannot get any healthcare insurance, or they cannot afford it,” Mr Jonsson states plainly.
Fellow SAMS member Bjorn Bergsten from Ayutthaya adds he cannot buy any health insurance because he has had cancer. “I have contacted several insurance companies, both Thai and international ones,” he says.
“Also many Swedes have been working abroad for decades, and now have retired here to Thailand,” Mr Jonsson he says, adding that Swedes while working abroad had healthcare insurance provided through their employer or through private or public insurance, but as soon as they retired they risked having no coverage at all.
“If they were able to, they continued the insurance coverage they had, but many had to take out new more expensive policies,” he says.
Once they had finished working – they were simply left to fend for themselves. That has left a segment of society who have spent their lives working at the mercy of insurance company premiums, some of which are so high they beggar belief.
“Once you are over 70, health insurance becomes very expensive,” Mr Jonsson notes.
“One company recently offered to provide me a policy for 700 euros (about B26,900) a month. That’s ridiculous!” he laughs.
SAMS has long been fighting to highlight the issue. The group has been already formally recognised by the Swedish government as legitimate group representing Swedish nationals living in Thailand, and has been in direct correspondence with the Minister of Social Affairs in Sweden about the issue.
But the dialogue has stalled.
“It is a technocratic issue within Sweden as no bureaucrat there knows how to handle the problem,” Mr Jonsson explains.
“This is because healthcare in Sweden is mainly provided – and funded – by each province which each pay for their own government hospitals by levying taxes.
“However, this is done only through the help of the national government, which subsidises the provincial hospitals – and this is where we are focussing on.
The issue is not new to Sweden. Through international agreements, Swedish state-funded healthcare has long been supported throughout the European Union (EU).
There is even a “Reciprocal Health Care Agreement” (RHCA) between Australia and Sweden, under which Swedes in Australia are entitled to government-provided healthcare just like any Australian qualified citizen, and vice-versa (See here.)
The Australian Department of Human Services (DOHS) notes on its website, “You can get help with costs for medically necessary care when you visit any of those countries.”
The countries Australia currently has RHCAs with include Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, the Republic of Ireland, Slovenia, Sweden and the United Kingdom.
This healthcare support available includes “emergency care” and “care for an illness or injury that can’t wait till you get home”.
However, the DOHS does note, “You still need to get your own travel health insurance.”
On the Swedish front, the Swedish Government has already conducted a study about the issue. The study was called “The Security Systems & International Mobility”, but that study was limited to only within the EU.
“We are calling for the government to rightly extend the scope of this understanding to beyond the EU,” Mr Jonsson explains.
“For example, with the Brexit situation, the Swedish Government is looking into the effects of using an earlier convention with the UK to ensure that the reciprocal healthcare arrangements between Sweden and the UK are maintained just as they were when the UK was still a full EU member,” Lars-Olof Fagerström in Hua Hin adds.
“Thousands of Swedish nationals are still working and paying for their public health insurance, but are not entitled to anything while they are out here. Retirees pay the same taxes as when in Europe and we want at least something, namely subsidised healthcare for the taxes we pay even when living outside the EU,” Mr Fagerström points out.
“We also want the coverage to be available to people regardless of the their medical history, and this is why it should be the government supporting this – not private companies – just like (former US President) Obama called for,” he adds.
Meanwhile, SAMS members understand their position, their longevity and that fact that governments do not implement policy overnight.
“We working on just the possibility that a convention might be finally introduced, and we understand that at the least this could take two to three years.” Mr Jonsson notes.
To support their call, a petition of more than 2,500 signatures has been submitted with the Swedish Government, with growing support from Swedes living in expat locales around the world.
“Some of the people who signed the petition were not just in Thailand. Some were in the Philippines and some were even in Brazil,” Kjell Nystrom from Udon Thani explains.
In particular, Mr Jonsson adds, “SAMS members cannot sit with their arms crossed waiting, we are acting now. With Bangkok Insurance Brokers Co and its CFO, Eric Dohlon, SAMS has initiated a health insurance. Eric's proposal should cost no more than B25,000 a year, or about B2,000 a month.
“But eventually we don’t want this just for Swedes. This is for everyone,” Mr Jonsson says, adding that people from Ayutthaya, Nan province and elsewhere have recently joined the campaign – and not just Swedes, Mr Jonsson notes. “German and French expats are joining us, too,” he adds.
Mr Nyström points out that as of 2014 more than 227,000 foreigners in Thailand applied for long-term permits to stay (often simply called “visa extensions”) each year.
“Of those, it was estimated in 2015 that about 20,000 Swedes are actually living in Thailand, of whom much more than 1,000 retirees,” he explains.
“We are calling for retirees of all nationalities, likely to number more than 60,000 (as of 2014), to join our cause. They will know what it’s like, too. Many of them are in exactly the same situation.” Mr Nyström says.