Health Economics And Its Role In Health Sector Reform

Published Date: 02 Nov 2017

Thailand’s economic structure is changing toward more industrialization and the Gross Domestic Product (GDP) increased about 7-9% annually from the late 1980s until 1996.

The Thai economy took an unexpected downturn in 1996. The Bank of Thailand forecast the growth rate of Thai economy would expand at a rate of 2.0-3.0 percent only, caused by the poor performance of exports and private sector investment. Import growth also declined during 1996. Slowing the growth in imports alone cannot improve the country's current account deficit significantly.

The deficit remains an economic problem of major concern. However, the economic stability believes to be improved as a result of harshness policies or expenditure cuts and savings acceleration. The budget deficit will be about 40,000 million baht.

Factors Determining Health

Health and Health Status are influenced by various factors namely the situations and trends of economic, social, political, administrative, physical environment, infrastructure development and technology development.

In sum, the economic growth and structure have made changes in the consumption pattern of Thai people. People need more health care and spend more for health services, both necessary and unnecessary care.

The national health expenditure has been increasing gradually, at a rate faster than the Gross Domestic Product (GDP), from 3.5% of GDP in 1979 to 6.3% of GDP in 1991. In the year 2000 it’s expected to be at a rate of 8.1% of GDP. With the worst scenario of Thai economy it is expected to be more than 10% of GDP in future.

The expenditure mostly covered by the household and the poor have a higher share of expenditure to income than the rich. The expense is for curative rather than preventive and primitive care.

Moreover, the technologies for medical services are freely imported with some special tax exemption. This results in greater purchase and competition in importing the high cost equipment and unbalanced utilization of this equipment nationwide.

The Thai economic structure has changed from agriculture based industry to more manufacturing and service based industries. This caused people to move to industrially based areas or to migrate from rural to urban areas and society faces many social problems including occupational health. There is a great economic loss due to road accidents and accidents in the factory because of inadequate attention to industrial safety.

The problem of air, water, noise and sight pollution in factory and environment and under standard working conditions is increasing. The increasing rate of using modern technology and chemicals in agricultural activities, i.e., pesticides, herbicides, artificial fertilizer has resulted in people receiving substances toxic to their health.

Income disparity between the poor and the rich, the rural and the urban areas, the agricultural and manufacturing sectors affect the health system in terms of inequity in health resource allocation. The free trade system also has impact on pharmaceutical industry: higher price of drugs because of the patent regulations.

Due to the problem of changes in education many people have limited abilities to adjust to the information received through the various media. Some change their health behaviour to adopt more risk to their health. There are also the problems of communicable diseases, chronic disease, and elderly disease among the people.

Economic Crisis from mid-1997

The current economic crisis has enormous impact on the country and this impact will persist for at least 4-5 years.

The immediate effects are unemployment, reduced household income and reduced consumption expenditure. These have social and health consequences.

Social Impact and Responses

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Economic Crisis and Health Impacts

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Some Elements of Reforms in Health Sector

Soft loans from World Bank (WB) and Asian Development Bank (ADB) were offered to the Government to replenish the foreign reserves, and to support essential programs. These loans came with certain conditions to preserve the safety net to save the vulnerable groups, especially those unemployed.

Under the recent loan from the Asian Development Bank (ADB), there are also elements of reforms in the health sector as conditions of the loan, namely

Redeployment of health personnel to the rural areas

Reform of the referral systems

Development of autonomous hospitals

Policy reform of various health insurance schemes, i.e., Civil Service Medical Benefit Scheme (CSMBS), Free Medical Care for the Low Income Household Scheme (FC/L), Free Medical Care for the Elderly Scheme (FC/E), Workmen Compensation Scheme (WCS), the Social Security Scheme (SSS) and the Voluntary Health Card Scheme (VHCS) (Wibulpolprasert, et al, 1998).

Economic Crisis:

Necessity and Opportunity to reassess priorities of Health Services Resources

What the crisis has already told us:

The most carefully laid plans are suddenly undermined by unpredicted national economic loss

We have suddenly to make new priorities

Health sector versus other sectors

Within health sector

Salaries

Health services facilities

Capital investment

Disease control / preventive activities

Health education / media

Short term versus long term

Local, national, regional

New initiatives, i.e., Health Care Financing, Health Care Investment, etc.

Equity, i.e., the rich and the poor, between sectors, between regions.

Major shifts:

Financial crisis

Private hospitals, some are running out of money, bankruptcy.

Drainage of manpower from public to private:

Private health sector interrupted results in the potential improvement of manpower situation in public sector conditional upon the availability of money to pay them.

Shift of clientele from private to public health sector services, due to fall in income or unemployment of people.

Consequent overloading of public health sector services.

Short versus long term implication issues:

Can balance between public and private health sector be legislated based on experience of instability of private sector business methods exposed by crisis.

Debt management, i.e., local and foreign investment

Investment regulations

Manpower policy adjustment

Equity consideration

Can disease controls / preventive activities are

Streamlined, then

Protected against cuts in crisis so to safeguard against costly increases in disease out breaks (communicable diseases) which would result in increasing debt burden.

Time to readdress matter of comprehensive national health insurance encompassing all sectors. This might spread costs equitably.

This would probably necessitate reducing the benefits of CSMBS, i.e., co-payment mechanism, maintaining the principle of the health card scheme and introducing a compulsory health insurance scheme overall etc.

The urgency of this is highlighted by the rise in unemployment with loss of employee contributed benefits and sudden increase in the number of eligible persons for Social welfare health services to the poor.

Health Economics: Thai Experience

This list summarizes on going and completed health economics research throughout Thailand.

National Health System Research, i.e.

Social Movements and Economic Transformation: to study the historical development of Thai health care system.

Private Hospital Survey

Cigarettes and Excise Tax: to study the impact of a change in the rate of cigarette excise tax.

Political Economy of Tobacco Products and Optimal Cigarette Taxation

Diagnostic Related Group Study

Information System for Health Improvement

Computer System for Health Care Providers

Government Information Network (GINet)

Rapid Provincial Health Survey

Law and Regulation

Decentralization and Health Systems Change

Public-Private Mix

Essential Health Package

Thai Burden of Diseases

The Economics of Traffic Accidents: to calculate the economics loss and causes of accident.

Sources of Economic Growth in Thailand

Development, Environment and Health in the Eastern Seaboard Area

Healthy City Project

Health Financing Research

Health insurance in various schemes, i.e.,

Voluntary Health Insurance.

Social Security Scheme.

Civil Service Medical Benefit Scheme (CSMBS).

National Health Account

National Drug Account

Hospital Costing: various levels

Resource Allocation: Merging Sources of Finance and Reforming Payment Mechanisms for Health Services

Cost, Resource Use and Financing of District Health Services in Thailand

Technology Assessment

Quality Improvement Research, i.e.

Assessment the Health Welfare (Low income) Card Scheme of Thailand

Economics of Social Welfare Project Management

Total Quality Management Study

Health Manpower Development Research, i.e.

Scientific and Technical Manpower for Economic Growth: to study the human resource development impinges upon technical capacity in many sectors including those which directly and indirectly affect health.

Future Pattern of Health Manpower Needed at each level

Forecast the Disease Pattern in Thailand

Health Behaviour Research, i.e.

Economic Evaluation alongside WHO Antenatal Care Trial

Cost Effectiveness, Cost / Performance techniques in various health programmes

Quality of Life Study

Alcohol Consumption Study

Elderly Care

Health Situation and Trend Research, i.e.

General Agreement on Trade in Services and the Effects on Health System and Services in Thailand

Quantitative Approaches to Analysis and Redefinition of Market Roles in Changing Options for Health Services

Strategy for Research in Health Economics: Present and Future" in Enabling Mechanisms for Health

The diseases control program, i.e.,

Economics of Leprosy

Social and Economic Impact of Dengue Hemorrhagic Fever

Economic Evaluation of Village Malaria Volunteer Programme

Economic Analysis of Malaria Diagnostic Technology

Economics of Screening for Thalassemia

Demographic Impact of the HIV/AIDS Epidemic in Thailand

Survey of Elderly in Thailand

Summary of Health Economics Research Targets

Issues

Equity

Efficiency

Quality

Health Insurance

Universal Health Insurance

Accessibility to Health Care

Health Care Behaviour and Utilization

Types of Health Care Financing Impact on Utilization and Health Expenditure

Essential Package and Expenditure

Resource Allocation at Various Levels

Assess the Standard for Quality of Care

Technology Assessment

Technology Diffusion and Distribution

Cost-effectiveness for Drug, Medical Equipment and Technology

Consumer Protection for Using Health Care/ and Health Services

Health Manpower

Health Manpower Distribution

Cost and Number of Health Manpower

Quality of Personnel, Standard of Providing Care

Role of Private and Public

Impacts of GATS on Prices and Accessibility

Earmarked Taxes

Public-Private Mix

Optimum use of Various collaboration, i.e., Joint-venture, Contract out

Referral System and Network

Assess the Standard and its Applications

Health impacts of rapid economic changes in Thailand

The economic crisis in Thailand in July 1997 had major social implications for unemployment, under employment, household income contraction, changing expenditure patterns, and child abandonment. The crisis increased poverty incidence by 1 million, of whom 54% were the ultra-poor. This paper explores and explains the short-term health impact of the crisis, using existing data and some special surveys and interviews for 2 years during 1998±99.

The health impacts of the crisis are mixed, some being negative and some being positive. Household health expenditure reduced by 24% in real terms; among the poorer households, institutional care was replaced by self- medication. The pre-crisis rising trend in expenditure on alcohol and tobacco consumption was reversed.

Immunization spending and coverage were sustained at a very high level after the crisis, but reports of increases in diphtheria and pertussis indicate declining programme quality. An increase in malaria, despite budget increases, had many causes but was mainly due to reduced programme effectiveness.

STD incidence continued the pre-crisis downward trend. Rates of HIV risky sexual behaviour were higher among conscripts than other male workers, but in both groups there was lower condom use with casual partners. HIV sero-surveillance showed a continuation of the pre-crisis downward trend among commercial sex workers (CSW, both brothel and non-brothel based), pregnant women and donated blood; this trend was slightly reversed among male STD patients and more among intravenous drug users. Condom coverage among brothel based CSW continued to increase to 97.5%, despite a 72% budget cut in free condom distribution.

Poverty and lack of insurance coverage are two major determinants of absence of or inadequate antenatal care, and low birth weight. The Low Income Scheme could not adequately cover the poor but the voluntary Health Card Scheme played a health safety net role for maternal and child health. Low birth weight and underweight among school children were observed during the crisis.

The impact of the crisis on health was minimal in some sectors but not in the others if the pre-crisis condition is efficient and healthy and vice versa. We demonstrated some key health status parameters during the 2-year period after the 1997 crisis but do not have conclusions on the impact of the economic crisis on health status, as our observation is too short and there is uncertainty on how long the crisis will last.

Thailand has well positioned itself to become the medical hub of Asia, with more than four hundred hospitals offering the most advanced treatments by an internationally trained medical staff. The country boasts the largest hospital in Southeast Asia and the first ever to receive ISO 9001 certification, and the first hospital in Asia to be granted the prestigious Joint Commission International Accreditation (JCIA).

In 2005, the number of foreign patients arriving in Thailand, so-called medical tourists, topped one million and reached 1.4 million in 2006. The country has set a target of 2 million medical tourists by the year 2010. With millions of people without health insurance in some countries, or those just seeking the best service and care available, medical tourism continues to be a growth industry for Thailand. The annual growth rate for the sector has been 14%, with major surgical procedures increasing, as well as those seeking standard medical care. Thai Airways has taken medical tourism one step further by packaging medical check-ups as part of its Royal Orchid Holidays program.

Recognizing the available market and the country’s ability to deliver medical treatment at international standards, in 2004 Thailand’s government adopted a five-year strategic plan to develop the country’s capacity into the "Center of Excellent Health of Asia".

This strategic plan, advanced by the Ministry of Public Health, focuses on three main areas of healthcare: medical services, healthcare services, which includes spas, traditional massage and long-stay healthcare products and services, and third is Thai herbal products.

There is a serious commitment on behalf of healthcare providers and the government to ensure that international standards are met. "More recently, hospitals in Thailand have opted to also apply for Joint Commission International (JCI accreditation, which is the international accreditation arm of the U.S. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)", says Mr. Denis Meseroll of Asset Management Systems (Thailand), a company that provides healthcare management services.

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Skyrocketing costs of healthcare in many western countries, along with overloaded medical facilities in many others, has added great attraction to Thailand’s high quality low cost medical service industry. For example, elective surgery in Thailand’s best private hospitals is often one tenth the cost of the same procedure if performed in the United States. With the value of OECD nations’ health care sector having been estimated to be as high as US$3 trillion and the United States at US$ 2 trillion, the potential for Thailand is significant.

BlueCross BlueShield of South Carolina and Blue Choice of South Carolina, US based healthcare insurance providers, have formed an alliance with one of Bangkok’s premier hospitals to promote medical tourism to its 1.3 million members.

In addition to the cost saving, there is also the added benefit that treatment and aftercare services are often performed in resort like settings, with a level of hospitality not found in other of the world’s medical centers. Doctors are experts in their fields and nurses are registered and well trained. But beyond the medical attraction, patients are treated to personal service characterized by Thailand’s excellence. Patients are not left to linger in hospital waiting rooms for hours, left unattended and uninformed. Some hospitals will even assign patients a personal assistant who will walk them through the entire process from the front door, to their appointment with the doctor, to the onsite pharmacy to fill prescriptions, and to clearing all receipts for insurance reimbursement. Patients are kept informed throughout their stay. In fact one of Bangkok’s premier hospital facilities boasts a staff of doctors that can speak English, French, Spanish, German, Dutch, Japanese, Cantonese, Mandarin, Hokkien, Hainan, Arabic, Urdu and others, and has 60 interpreters on its staff. While another has interpreters in over two dozen languages, all in order to facilitate the increasing numbers of international patients. And many of the country’s hospitals have the most advanced medical equipment, including one which recently purchased the MRI 3 Tesla, the first in Asia, which offers better diagnosis without injection of contrast media.

While Thailand excels in the medical care it delivers on a daily basis to patients from over 190 countries, the Kingdom is also gaining recognition as a location for research and for clinical trials of advanced medicine and for stem cell treatments. Thailand is investing in research and development for tropical diseases, such as dengue fever and malaria, among others; areas wide open for further investment.

With the exponential growth of Thailand into becoming a medical hub in the region, considerable opportunities in related fields are being created. The medical device sector, for one, will continue to see healthy growth to meet the demands of healthcare facilities for new and upgraded medical machinery and devices. Thailand’s healthcare industry is truly growing in leaps and bounds.

Doing Business in Thailand

India has many opportunities for doing business with Thailand.

Priority areas are:

• Advanced Engineering

• Agriculture

• Education and training

• Environment

• Food and Beverage

• Railway

• Power

• Motor vehicle and motor vehicle parts

• Healthcare and Pharmaceutical, Medical Hub is targeted for Thailand

• Petro

• Renewable Energy

• Tourism, sports and leisure equipment

Healthcare Sector in Thailand

Thailand had a population of 69.51 million at the end of 2011.Life expectancy is 71 years for men and 77 years for women has increased. With a population growth rate of around 0.4%, Thailand is facing an aging society. Proportion of the population over age 60 in 2020 is expected to reach 17.51%.

Market Overview

The total healthcare market in 2012 is expected to reach U.S. $ 13.13bn, while the pharmaceutical and medical devices market forecast market for U.S. $ 4.1bn U.S. $ 9.36bn. However, some medical equipment produced for domestic consumption in Thailand, the country imported from abroad, 70% of medical devices.

Due to increasing demand from international and local patients, Thailand's world-class medical infrastructure in developed countries and at a fraction of the cost of similar procedures provides the highest possible quality of care. Thailand is ready to take a serious interest in this dynamic market; this is an exciting business opportunity for companies.

Study of the Implications of the WTO TRIPS Agreement for the Pharmaceutical Industry in Thailand Executive Summary

In 1947 twenty-three nations signed a treaty known as GATT or General Agreement on Tariffs and Trade. The primary objective of this treaty was to promote and regulate the liberalization of international trade through "rounds of trade negotiations".

Between 1986 and 1994, the eighth of these rounds, known as the Uruguay Round of Multilateral Trade Negotiations, produced the Marrakech Agreements which established the World Trade Organization (WTO) and extended rules governing commercial relations between trading partners to a number of new areas, such as agriculture, services, investment measures and the protection of intellectual property rights, that were previously excluded from trade liberalization. Since 1994, attention has focused on WTO’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) as the most far reaching international instrument ever negotiated on intellectual property rights.

It establishes minimum universal standards in all areas of intellectual property and intends to implement these standards globally through the strong enforcement mechanism established in WTO. An important critical issue of the TRIPS Agreement relates to patent. The freedom of each country to determine its national patent laws in accordance with its own objectives and interests no longer exists.

The TRIPS Agreement requires universal patent protection for any invention in any field of technology. This essentially targets pharmaceuticals, which many countries had previously excluded from patent protection. All WTO members must amend their patent legislation within a limited time or transition period.

Any nation that fails to bring its patent law into conformity with the TRIPS Agreement is subject to the WTO dispute settlement system. And if the nation fails comply with the rules of this system, it may incur WTO trade sanctions. Many studies of the TRIPS Agreement indicate that the globally uniform high standards of the TRIPS patent system will have a great impact on the health sector and may negatively affect national drug production, drug prices, availability of essential medicines and pharmaceutical technology and numerous other factors in the developing and least developed countries.

In addition, there could be a greater concentration of drug production in industrial nations rather than a transfer of technology to or foreign investment in developing countries.

The potential effects of the TRIPS provisions on pharmaceuticals in Thailand are the limited term of product and process patents, conditions of protection, broad scope for compulsory licensing and enforcement procedures in the national patent system.

This study of implications for the Thai pharmaceutical industry discovered that there has not been much technology transfer or foreign investment in the local drug industry since 1992; spending is mainly for curative care; originator firms did better than generic firms after 1989; the effect of the economic crisis on the cost of imported drugs has forced the government to more strictly control spending; the share of the original drug market has increased to 67 % of the 1997 total (with generic drugs at 33 %) ; and the gap of equivalent prices between original and generic products is varied and unpredictable.

It was also found that there is no systematic evaluation of the effectiveness of government price regulation and how drug prices affect affordability; that public sector procurement rules and collective procurement are effective in price bargaining, but due to a lack of overall coordination, drug companies are charging different prices for the same product procured by different Thai purchasers.

Given the fact that Thailand is a member of the World Trade Organization, it has to abide by the mandates set forth in the TRIPS Agreement. To alleviate the potential negative impact resulting from such compliance, an Eleven Ps Strategies is being proposed.

The first P represents an innovative purchaser strategy to establish rational cost-effective drug selection procedures for public and private health care facilities and to create a government financing system for drugs and other health care costs.

The second P is a prescriber and dispenser strategy to promote the rational use of drugs in health facilities which would also encourage prescribing generic drugs. As a part of this effort, both national and multinational firms would be urged to develop an agreed-upon set of business practices to ensure maximum benefit to the public and punish unethical promotion of medicine.

Third is a producer strategy to support and encourage technical transfers of drug development processes to Thailand, to provide truthful information, which will allow doctors and patients to make the best and most efficient use of medicine, and to bridge the gap between developing and developed countries through "pharmaco-philanthropy".

Fourth is a product strategy promoting research and development of traditional medicines to reduce dependency on modern drugs and strengthen the country’s capacity for innovation? This would also facilitate participation in the modern drug development process (with its attendant enhancement of indigenous technical, personnel, financing, patenting, research and related capabilities) and help streamline and simplify patent registration of potential compounds.

Fifth, an effective price control system that takes into consideration global drug prices should be established. Prices for new drugs protected under patents should be set on a reasonable basis and subsidized where necessary in order to make essential drugs accessible to all segments of the population. In case standard means of price regulation are not effective, direct legal control of drug prices may be called for.

Sixth is a patent-to-third party strategy. The TRIPS Agreement permits compulsory licensing. Under certain conditions. For example the need to protect public health and nutrition, the government can grant a patent to a third party without the consent of the original patent holder.

Seventh, parallel imports theoretically could be used as a national strategy in restoring price competition for patented products including pharmaceuticals by allowing the importation of identical patented products that have a lower price.

Eighth is a power-of-the-customer strategy. It recognizes that nations must accept that everyone share the price burden of drug research and discovery as world citizens. However, government can play a key role in educating people on how to avoid illness by reducing risks, preventive health care, and avoiding irrational unnecessary use of drugs.

Ninth, nations must raise funds for R&D. It is proposed that the Thai government collect at least 10% of total drug sale revenue to build capacity for developing patent able new drugs and to strengthen price and patent management and monitoring systems.

Personnel strategy is tenth. The Thai government needs to provide better education, training, development and support in highly technical skills to ensure adequate human resources in the area of research and development. The government should also create a fair incentive system to maintain these scare human resources, prevent further brain drain, and encourage Thai Scientists and experts living abroad to return home.

Eleventh and last is prevention strategy. Primary care and preventive medicine should be the keystone of national health policy. Preventive measures and healthy life styles will eventually help relieve the demand for medical care and certainly bring a better quality of life in a more cost-effective fashion.

In conclusion, this analysis of the implications of the TRIPS Agreement for the pharmaceutical industry in Thailand and consequent recommendations is just the beginning point for a continuous process.

With ongoing change in the structure of the economy, regulations, patent laws and a myriad of other factors, further study and action will be necessary. Above all government attention is extremely important to ensure progressive development. The pharmaceutical industry has not received enough consideration.

National authorities should have a clear vision for this industry and understand the repercussions to national health in the future if nothing is done. Lessons learned from peer countries and continuing study will provide answers for solutions suitable to Thailand’s conditions. The provision and revision of pharmaceutical policies should not merely be in accord with existing general industry standards and international commitments, but should ensure improvement in the quality of life for the Thai people as a whole.

Key opportunities

Thailand in key and emerging opportunities for Indian companies in the healthcare include:

Medical equipment and instruments

Specialist treatment technology

Ageing Population

Standard Certification

Accident Emergency

E-Health

Getting into the market

Medical equipment and instruments

The most popular destinations for medical tourism in Thailand, more than 1,000 public hospitals and 400 private hospitals with international standards are powered on.

Growing medical tourism market with a 10-20% annual growth in the sector has played an important role. Both foreign and domestic patients Thai health facilities continue to expand due to the increasing demand for health treatment.

There is a new trend of mergers between private hospitals. Therefore, both private and public hospitals for medical machinery and equipment, including a growing demand continues to upgrade their facilities. Purchase of major medical equipment in public hospitals, accounting for 60% of the consumers live.

Specialist treatment technology

Demand for special treatment in Thailand, not only because of the number of foreign patients in Thailand but also increased health-conscious consumers.

Ageing Population

According to the analysis of a death certificate, major and increasing cause of death among Thai citizens of non-communicable diseases, accidents, and HIV / AIDS. The impact of an aging population opens up many opportunities. Due to the increasing aging population, we also take care of the elderly by both the public and private sector to see an increasing number of advanced features. The Thai government is aware of the aging society and provides support for the elderly living. The National Science and Technology Development Projects Agency (NSTDA) also on new technology in these areas are done by cooperating with international organizations.

Standard Certification

An essential tool for attracting foreign patients is an internationally recognized accredited hospital. Consequently, the Joint Commission International (JCI) to improve its services to international standards strategy has gained large private hospital. However, some private hospitals to seek other options which allow more flexibility in the implementation process of the wish.

Accident Emergency

Emergency Response therapy has increasingly become a priority in Thailand, as the country's natural disasters and political unrest in recent years experienced a number. National Institute of Emergency Medical Services Emergency Medical System is to develop international standards in this area and has played a major role in natural disasters. More training and counseling as well as experts in the area, include the demand for devices that generate opportunities.

E-Health

Thailand is one of a growing number of smart phones and tablet computers have followed the global trend. Some e - health projects, health data collection, health status monitoring, etc. In the past few years has been the use of the handheld device. Commercially available from Q1 2013 due to 3G service, local hospitals, which will allow them to serve in remote e - are aware of the health benefits. National Health Information System, tele-medicine, for smart homes and independent living, the Thai Government Smart Health's National Electronics and Computer Technology Center, with focus on 3 areas NECTEC has supported the project launched by.

Comparison between Healthcare in India & Thailand

Healthcare in India

Healthcare in Thailand

Overview

Overview

Overseas health insurance in India is a significant item to explore, if a person is diversifying.

When moving to Thailand, expat health cover is an essential thing to study.

The healthcare system in India is complicated to plot a route with large variances among amenities.

The healthcare structure in Thailand is reputable and reasonable, making it frequently a hot target for "medical tourism."

Here is some information to help out better understand health insurance in India and what it means for an individual as an emigrant.

Here is some information to help out better comprehend health cover in Thailand and what it means for one as an emigrant.

Doctors in India

Doctors in Thailand

Check-ups, well visits, and essential illnesses and injuries are greatest reserved of hospitals and with a universal practitioner.

Almost all doctors in Thailand are specialists, so one will have to resolve the kind of sickness or wound one is facing and decide the suitable specialist.

Common practitioners typically have offices in health centers and can hold all essential health care. They are enclosed by most worldwide medicinal assurance in India.

Most health indemnity in Thailand will cover the expert without recommendation, since they are rare.

Although discovering a doctor is not hard in urban areas, securing an engagement may be and one may get himself coming up in the workplace for a few hours to be seen.

If anyone requires support, a classified hospital can help out to select an suitable doctor to make a meeting with. Because of their specialties, the majority doctors don't call one private clinic or hospital home base, as an alternative spending various days or weeks at a number of area amenities as desirable.

There are also small groups of specialists should one has a constant concern that requires protection.

One may have to take a trip a bit if he/she needs to carry on seeing the same expert, and a few services they work in may not allow expat health insurance in Thailand.

Doctors in rural areas are inadequate and do not have reach too much tools of medication.

One also should be conscious that social traditions in Thailand manipulate health care; doctors here are more by the reserve and the "wait and see" approach is taken frequently.

If one has questions, by all resources ask, but identify with a neighboring patient would never question a doctor's recommendation, so a physician may be taken aback or not understand faltering.

Hospitals in India

Hospitals in Thailand

India's hospitals differ very much and should be researched prior to visit. Public hospitals are worthwhile for necessary health care only.

Thailand is home to equally civic and private hospitals, both of which are open to foreigners.

If a person has to visit a public hospital for more than an outpatient process, he or she should bring his/her own foodstuff, water, and linens to make sure that these are reserved clean and germ-free.

Thailand people are settled free healthcare from the government throughout civic hospitals. It means that these can be overfull and have extended funds.

On the other hand, private hospitals are extra modern and secure and assemble traditional Western principles. They also happen to be much more luxurious, but in general admit any global health indemnity in India.

Personal hospitals have improved access to medicine and equipment, but, charge extra. These are more frequently the purpose of foreigners as the procedure is more Western-style and many employees and doctors speak English.

Civic hospitals may not agree to expat health indemnity in Thailand, so one has to be certain to verify and obtain pricing for treatments earlier, if feasible.

Expats are allowable to use civic hospitals, will have to disburse for services provided straight in spite of their health indemnity in Thailand.

One should check if the ability takes his/her international health cover in Thailand before agreeing to any cure.

Hospitals which have had billing issues with Thailand expat health indemnity companies in the past may decline patients with that treatment.

Emergencies

Emergencies

The phone number for an emergency ambulance in India is 102. If one exists in a big city, this can be a feasible alternative.

Large and new hospitals in Thailand have ambulance fleets ready with medicinal tools; there is not an extensive crisis reply system.

While, in rural areas the ambulances may acquire hours to turn up and have no medical tool on plank. If feasible, it can be desirable as an alternative to utilize a cab to call a trustworthy community or personal hospital.

If one wishes to call for help the emergency number in Thailand is 191; nevertheless, if one can call a cab or friend, they may be the quickest form of transport to local hospital.

One more option is to get in touch with a close by personal hospital directly; several have their own ambulances that can turn up speedily and start cure in transportation to the ability. This may or may not be enclosed by abroad health indemnity in India.

Prescriptions in India

Prescriptions in Thailand

Most over-the-counter and prescription drugs accessible in the West are obtainable in India exclusive of a instruction, even though the regulations are varying and more pharmacies need a doctor's note.

Most over-the-counter and instruction drugs obtainable in the West are accessible in Thailand without a recommendation, counting antibiotics and antidepressants.

Pharmacists are not extremely skilled, but can regularly tip in the correct way if anyone doesn’t know what medication he/she require.

Pharmacists are not extremely skilled, but can frequently point in the correct track if one is not aware what medicine you want.

Because of this practice, one may not be capable to maintain all medications during his/her global health insurance in India.

Because of this practice, one may not be capable to maintain all medications during expatriate health cover in Thailand.

One should check with his/her plan supplier for more information.

One should constantly be certain to buy medicine from an approved pharmacy.

There is a heavy black market in India for medicines and many of them can be reasons for severe health issues.

International Health Cover

International Health Insurance

With hit or ignored treatments, one will want to keep away from minor, less contemporary public amenities in India.

With changeable regulations and dealings per facility and within a broad variety of price tags, health care in Thailand can run from reasonable to costly.

One should choose for abroad medical cover in India and admission to personal services.

Help out to maintain expenses downward and convenient by purchasing expat health indemnity while in Thailand.

One should help out maintain expenses down and convenient by purchasing universal health cover in India.

Contrast and opt from over 3,000 health insurance policies for treatment available as an expat.

One can match up and select from over 3,000 health insurance policies for treatment offered to he/she as an expat.

Health Statistics (India vs. Thailand)

Population, Total

1961

1991

2001

2011

India

456949783

891910180

1071374264

1241491960

Thailand

28149653

57711519

63898879

69518555

Population ages 0-14 (% of total)

1961

1991

2001

2011

India

40.98563631

37.722962726

34.291937254

30.213042064

Thailand

42.891054465

29.417475871

23.56460671

20.17761329

Population ages 15-64 (% of total)

1961

1991

2001

2011

India

55.981928518

58.463663367

61.410531834

64.792977399

Thailand

53.833679584

65.764081917

69.30404462

70.728464035

Population ages 65 and above (% of total)

1961

1991

2001

2011

India

3.0324351723

3.8133739068

4.2975309114

4.9939805369

Thailand

3.2752659509

4.8184422121

7.1313486695

9.0939226747

Population growth (annual %)

1961

1991

2001

2011

India

2.0128188307

2.0530568616

1.6446410498

1.3687890584

Thailand

3.0194252781

1.1142144762

1.170933678

0.57172507803

Population, female (% of total)

1961

1991

2001

2011

India

47.884285797

48.031857419

48.160758594

48.367396801

Thailand

49.814283679

50.326618527

50.837513101

50.865684658

Age dependency ratio (% of working-age population)

1961

1991

2001

2011

India

78.629073074

71.046414544

62.838518106

54.337713768

Thailand

85.75731916

52.05868779

44.291722869

41.38579335

Age dependency ratio, old (% of working-age population)

1961

1991

2001

2011

India

5.4168108398

6.5226393408

6.9980356512

7.7075953867

Thailand

6.0840462257

7.3268599997

10.289945859

12.85751472

Age dependency ratio, young (% of working-age population)

1961

1991

2001

2011

India

73.212262234

64.523775203

55.840482455

46.630118381

Thailand

79.673272934

44.731827791

34.00177701

28.52827863

Birth rate, crude (per 1,000 people)

1961

1991

2001

2011

India

40.947

30.788

25.424

21.82

Thailand

42.679

18.597

14.44

11.859

Death rate, crude (per 1,000 people)

1961

1991

2001

2011

India

20.659

10.437

8.876

7.969

Thailand

12.451

5.086

6.428

7.462

Mortality rate, adult, female (per 1,000 female adults)

2001

India

200.8056

Thailand

117.5368

Mortality rate, adult, male (per 1,000 male adults)

2001

India

271.6982

Thailand

234.4008

Mortality rate, infant (per 1,000 live births)

1961

1991

2001

2011

India

155.8

79.3

62.4

47.2

Thailand

94.4

26.5

15.4

10.6

Mortality rate, neonatal (per 1,000 live births)

1991

2001

2011

India

46.5

39.7

32.3

Thailand

17

10.6

7.6

Mortality rate, under-5 (per 1,000 live births)

1961

1991

2001

2011

India

233.6

111.5

85

61.3

Thailand

135.5

32

17.9

12.3

Number of neonatal deaths

1991

2001

2011

India

1276000

1082000

876000

Thailand

18000

10000

6000

Number of infant deaths

1961

1991

2001

2011

India

2651000

2139000

1663000

1273000

Thailand

112000

29000

14000

9000

Number of under-five deaths

1961

1991

2001

2011

India

4072000

3009000

2279000

1655000

Thailand

157000

35000

16000

10000

Life expectancy at birth, female (years)

1961

1991

2001

2011

India

42.205

59.007

63.049

67.084

Thailand

57.988

75.932

76.529

77.527

Life expectancy at birth, male (years)

1961

1991

2001

2011

India

43.944

58.243

60.94

63.949

Thailand

53.792

69.231

68.939

70.819

Life expectancy at birth, total (years)

1961

1991

2001

2011

India

43.095707317

58.615682927

61.968780488

65.478268293

Thailand

55.838829268

72.499780488

72.641439024

74.091195122

Survival to age 65, female (% of cohort)

2001

India

63.388155

Thailand

77.5853963

Survival to age 65, male (% of cohort)

2001

India

55.7950501

Thailand

59.0152692

Prevalence of undernourishment (% of population)

1991

2011

India

26.9

17.5

Thailand

43.8

7.3

Immunization, DPT (% of children ages 12-23 months)

1991

2001

2011

India

57

60

72

Thailand

90

96

99

Immunization, measles (% of children ages 12-23 months)

1991

2001

2011

India

43

55

74

Thailand

79

94

98

Improved sanitation facilities (% of population with access)

1991

2001

India

18

26

Thailand

85

94

Improved sanitation facilities, rural (% of rural population with access)

1991

2001

India

7

15

Thailand

81

94

Improved sanitation facilities, urban (% of urban population with access)

1991

2001

India

51

55

Thailand

94

95

Improved water source (% of population with access)

1991

2001

India

71

82

Thailand

87

92

Improved water source, rural (% of rural population with access)

1991

2001

India

65

78

Thailand

83

90

Improved water source, urban (% of urban population with access)

1991

2001

India

89

93

Thailand

96

97

External resources for health (% of total expenditure on health)

2001

India

2.251374444

Thailand

0.1099905576

Health expenditure per capita (current US$)

2001

India

22.057261258

Thailand

60.812631778

Health expenditure per capita (current US$)

2001

India

22.057261258

Thailand

60.812631778

Health expenditure, private (% of GDP)

2001

India

3.5287172039

Thailand

1.4461305596

Health expenditure, public (% of GDP)

2001

India

1.3140209482

Thailand

1.8694170179

Health expenditure, public (% of government expenditure)

2001

India

4.0276894051

Thailand

9.0326824085

Health expenditure, public (% of total health expenditure)

2001

India

27.133842611

Thailand

56.383356721

Health expenditure, total (% of GDP)

2001

India

4.8427381521

Thailand

3.3155475775

Out-of-pocket health expenditure (% of private expenditure on health)

2001

India

92.544829408

Thailand

75.81912464

Out-of-pocket health expenditure (% of total expenditure on health)

2001

India

67.433861052

Thailand

33.069757131

Hospital beds (per 1,000 people)

1991

India

0.7870000005

Thailand

1.6612999439

Fertility rate, total (births per woman)

1961

1991

2001

2011

India

5.856

3.838

3.054

2.589

Thailand

6.151

2.054

1.695

1.559

Adolescent fertility rate (births per 1,000 women ages 15-19)

2001

2011

India

102.1302

76.997

Thailand

44.0292

38.2324

Incidence of tuberculosis (per 100,000 people)

1991

2001

2011

India

216

216

181

Thailand

132

173

124

Tuberculosis case detection rate (%, all forms)

1991

2001

2011

India

81

47

59

Thailand

58

45

76

Tuberculosis treatment success rate (% of registered cases)

2001

India

54

Thailand

75