Dutch expat to appeal after Thai court sides with higher hospital fees for foreigners

A Dutch national said today he will appeal a court ruling against his lawsuit challenging dual-pricing at Thailand’s public hospitals as unconstitutional.

Erwin Buse said the Administrative Court in Phetchaburi province relied on incorrect information provided by the health ministry in its Tuesday decision.

“I am very disappointed that the court mainly follows and repeat statements of the defendant without fact check,” Buse said Wednesday afternoon in a message. He noted that the ministry had changed how it defined labor costs, a key factor in determining hospital fees.

Erwin had asked the court to strike down the pricing structure in place since 2019 for violating the constitution’s equal protection guarantee, as by the ministry’s own regulations, the fees should be determined by actual costs.

In its judgment, the court said that it did not see that as discriminatory – because the higher rates charged of foreigners, who it presumes earn more than Thais, is good for the nation.

“The pricing was set on an appropriate basis of socioeconomic status, and it benefits Thailand, so it therefore doesn’t count as discrimination,” the court ruling said.

His lawsuit named the ministry and its head, who is now Minister Anutin Charnvirakul. It asked the court to annul the rate structure and order the ministry to revert to unified rates in place since 2004.

Buse first took on overcharging on a personal level several years ago when he was traveling 100 kilometers from his rural residence for cancer treatments at Hua Hin Hospital. He described being charged hundreds of baht in “additional fees” each time.

Under new rules enacted in September 2019, public hospitals were instructed to charge patients at what amounts to four tiers based on their legal status: Thai nationals, citizens of neighboring countries and working foreigners on non-immigrant visas. The fourth group consists of tourists, retirees and included foreigners married to Thai nationals.

Fees are much higher for the third group – which includes most expats – while those in the fourth pay much more, often double.

For example, according to a ministry fee structure published at the time, simple antibody screenings cost Thais and ASEAN residents THB130 and expats THB190. Retirees and tourists pay double – THB260.

On the higher end, a spinal MRI that costs citizens and their neighbors THB18,700 jumps up to THB23,375 for working expats and THB28,050 for retirees/tourists.

Additional reporting Chayanit Itthipongmaetee

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Dual-pricing for foreigners now legal at Thai public hospitals


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