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I live in Thailand. Private healthcare is excellent here. In fact, hundreds of thousands of people from around the world come here every year to take advantage

by geomark 10y ago

I live in Thailand. Private healthcare is excellent here. In fact, hundreds of thousands of people from around the world come here every year to take advantage of it - Thailand is a huge medical tourism destination. There is also a public healcare system here which is quite terrible. Interestingly, some public hospitals offer "special clinic" hours where you can get treatment on a cash basis instead of using the public healthcare system. Since the "special clinics" are not so heavily oversubscribed the wait times are shorter and service is better. Not luxurious like the private hospitals (which are indeed luxurious) but solid care by excellent doctors. I had foot surgery at Siriraj Hospital (oldest and largest public hospital [0]) by an excellent specialist [1] who also practicies at Bumrungrad (pricey private hospital). Total cost of everything, including two nights in hospital, was USD700. I guess that's a sort of hybrid of public and private and is an excellent value. But the private healthcare is outstanding and (again) luxurious, and while more expensive still only a fraction of western pricing. The thing is, the prices are known and even advertised in advance and you can just pay out of pocket. Wife had surgery at Bumrungrad to remove an ovarian cyst, three nights in hospital with pampered treatment, total cost a little over USD2,000. [0] https://en.wikipedia.org/wiki/Siriraj_Hospital https://en.wikipedia.org/wiki/Siriraj_Hospital [1] https://www.bumrungrad.com/doctors/Bavornrit-Chuckpaiwong https://www.bumrungrad.com/doctors/Bavornrit-Chuckpaiwong

realusername 10y ago
I did not explain very well my thoughts on this. By "works", I mean healthcare as a commodity that everyone (including the poorest) can afford. In order to exist, the private system has to be better than the public one, which means better facilities, top doctors and therefore higher prices. The reason the public service is terrible is because the private system exists, top doctors are going private to get better salaries and the public one will never improve. I'm pretty sure the private healthcare in Thailand is very good, but the only reason it's affordable for us is the difference of the cost of life, I doubt a farmer there can afford those services.
- geomark 10y ago
  Seems strange to say the public healthcare is bad because of the existence of private healthcare. It's bad due to the fundamentals. Things like: - it is "free" so it is grossly oversubscribed (basic market forces at work) - it is taxpayer funded and government run (spending other people's money on other people, the worst way to get value) - there is no incentive to improve since there is no competition (nobody loses their job and the public system does not go bankrupt and disappear regardless of how much worse it is than the private system) And those fundamentals are why the private system is so much better. It's not free and consumers are spending their own money on themselves so seek out the best value they can. And the competition between private hospitals is pretty fierce so they are contantly upgrading, innovating, and advertising (including their prices) to attract customers. It is common here for many of the best doctors to practice in both private and public sectors. My anecdote mentioned the fact that the doctor who did my foot surgery does that. As for cost, those private hospitals, and there are lots of them, cater primarily to Thais. So plenty of Thais can afford private care. It's not a huge unknown cost going in that is potentially ruinous like in the U.S. Like you said, in order to exist the private system must be better than the public system. That is the wonderful effect of markets when they are allowed to operate.

by geomark 10y ago

realusername 10y ago

I did not explain very well my thoughts on this. By "works", I mean healthcare as a commodity that everyone (including the poorest) can afford. In order to exist, the private system has to be better than the public one, which means better facilities, top doctors and therefore higher prices. The reason the public service is terrible is because the private system exists, top doctors are going private to get better salaries and the public one will never improve. I'm pretty sure the private healthcare in Thailand is very good, but the only reason it's affordable for us is the difference of the cost of life, I doubt a farmer there can afford those services.

geomark 10y ago
Seems strange to say the public healthcare is bad because of the existence of private healthcare. It's bad due to the fundamentals. Things like: - it is "free" so it is grossly oversubscribed (basic market forces at work) - it is taxpayer funded and government run (spending other people's money on other people, the worst way to get value) - there is no incentive to improve since there is no competition (nobody loses their job and the public system does not go bankrupt and disappear regardless of how much worse it is than the private system) And those fundamentals are why the private system is so much better. It's not free and consumers are spending their own money on themselves so seek out the best value they can. And the competition between private hospitals is pretty fierce so they are contantly upgrading, innovating, and advertising (including their prices) to attract customers. It is common here for many of the best doctors to practice in both private and public sectors. My anecdote mentioned the fact that the doctor who did my foot surgery does that. As for cost, those private hospitals, and there are lots of them, cater primarily to Thais. So plenty of Thais can afford private care. It's not a huge unknown cost going in that is potentially ruinous like in the U.S. Like you said, in order to exist the private system must be better than the public system. That is the wonderful effect of markets when they are allowed to operate.