PATTAYA, Thailand – Amid growing public concern over expensive private hospital bills, Thailand’s Consumer Council has emphasized that the real cost driver is not medications but the professional fees charged by doctors.
The Ministry of Commerce recently collaborated with the Private Hospital Association to allow patients to take prescriptions outside the hospital, a move expected to reduce living costs by up to 32.4 billion baht per year and cut essential medical supply costs by 1.1 billion baht.
However, the Consumer Council sees this as only a partial solution. Saree Ongsomwang, Secretary-General of the Council, said controlling drug costs addresses only “the tip of the iceberg.” The main factor behind exorbitant bills is the professional service fees, which have long been overlooked.
Research Highlights:
-Medications account for only 4.97% of total hospital expenses for emergency critical patients (UCEP) in 2022.
-In contrast, professional fees (mostly doctor fees) account for 45.23% of total costs — nearly half of all expenses.
-Compared to 2018, doctor fees have jumped from 30.65% to 45.23%, largely due to adjustments in the 2020 Medical Council guideline for setting professional fees. This increase alone has raised overall treatment costs by at least 13.5%.
Saree proposed that the Ministry of Commerce coordinate with the Medical Council to set more moderate doctor fees, rather than the current high-end rates.
Other Cost Concerns:
-Room charges can reach as high as 12,000 baht per night.
-Medical supplies are sometimes billed at excessive rates, even for basic items like gauze or cotton.
-Patients often face pressure to buy medications within the hospital or to accept bills as debt before discharge, even in non-critical cases.
Structural Issues Identified:
- Lack of legal framework: The Medical Council currently sets professional fees without statutory backing, raising questions about whose interests are protected — doctors’ or the public’s.
- Committee bias: The subcommittee determining fees is dominated by medical professionals, with little representation from economists, public interest groups, or the Ministry of Commerce.
- Economic imbalance: Fee rates are based on existing charges, effectively surveying the supply side only. Because health services are largely determined by physicians, this method allows prices to be set unilaterally by providers.
Saree concluded that reasonable control of doctor fees is a critical first step in curbing overall private hospital costs and reducing the financial burden on patients.
