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Two Emergency Rooms

Michael Babcock, December 24th, 2010

How do emergency rooms in Thai hospitals compare to those in the United States?

Last year when I was in Thailand (it was January) I began having symptoms of a stroke. I went to the emergency room at Bangkok Hospital Medical Center (offsite, opens in new window) in Bangkok for treatment.

Recently, back in the United States, I had several of the major symptoms of a heart attack. I went to the emergency room at Alta Bates Hospital (offsite, opens in new window) in Berkeley, California for treatment.

The treatment at both hospitals was excellent. In both instances I was showing symptoms of something that called for immediate action. In both cases I was whisked into a treatment room and technicians, doctors and nurses descended. Symptoms were discussed, tests were made and evaluated. In both instances, since there was nothing major wrong, I was in and out in about two hours. (My visit to Alta Bates started at 5:30 a.m.; my visit to Bangkok Hospital started at about 1:00 p.m..)

One difference: in the U.S. Hospital, no treatment took place until I signed off on a financial responsibility form. In Thailand, there was no mention of payment until the very end, when I was sent to the cashier to settle up. Another difference: in the U.S. about half the nurses were male, in Thailand they were all female. The doctor is the U.S. was female (a Chinese woman) and I had two doctors, one male, one female, in Thailand.

Perhaps the most interesting comparison of the two hospitals comes from the bills. Both visits were for roughly similar conditions and required major tests – at Alta Bates (for the heart symptoms) it was an EKG and a chest x-ray; it Bangkok Hospital (for the stroke symptoms) it was a CAT scan of the brain.

Now in the U.S. I had insurance that paid for all but $50 of the ER visit; I have no idea if the hospital gave me better rates because of an arrangement with the insurance provider. In Thailand I had no insurance and paid the bill myself.

For comparison purposes, I am using the historical baht rate on 1/22/10 of 32.992.

Drug Costs: U.S. = $347.57; Thailand = $33.04 (1,090 baht)
Lab Costs: U.S. = $831.00; Thailand = $91.57 (3,021 baht)
Tests*: U.S. = $559.00; Thailand = $229.30 (7,565 baht)
ER Treatment: U.S. = $2,325.00; Thailand = $137.49 (4,536 baht)
Total Price: U.S. = $4,062.57; Thailand = $491.39 (16,212 baht)

*Tests includes all x-rays, ekg, CAT scan, etc.

Why the discrepancy in costs? Both hospital offered equivalent, excellent service but in the United States it cost me over 8 times as much. They are different economies and it is cheaper in general to live in Thailand; nonetheless, that is a huge difference. Of course, in Thailand the patients don’t have to support an entire insurance industry and pay millions and tens of millions of dollars to the insurance CEOs. I’m guessing medical malpractice costs are less. In Thailand the hospital CEOs and top administrators probably don’t make as much as in the U.S. Doctors don’t make us much, though they live a very comfortable life style.

I’d like to see the people studying medical costs take a visit to Thailand and find out how they can offer pretty much the same service for so much less.

Written by Michael Babcock, December 2010

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