BANGKOK, Thailand – A former infectious disease specialist at Mae Sot Hospital has urged Thailand to stop relying on donations to cover migrant healthcare costs, warning that free treatment without a proper system is unsustainable and risks placing a growing burden on the country’s public health budget.
On April 19, Dr. Nattakan Chuenchom, better known as “Doctor Beer,” reflected on her experience working in Thailand’s border healthcare system, saying that emergency care for migrants with no money is still necessary under medical ethics, but the country cannot continue to depend on charity alone.
She argued that trying to solve migrant healthcare problems with donations is like “watering a desert” or “dumping soil into the ocean” because the issue never truly disappears.
According to Dr. Nattakan, Thailand urgently needs a stronger migrant registration process and a proper health insurance system for foreign workers to ensure they can seek treatment early, before illnesses become more severe and more expensive to treat.
She stressed that charging migrants for health insurance should not be viewed as immoral, while treating them for free should not automatically be considered an act of charity.
Dr. Nattakan warned that many migrant workers avoid hospitals because they lack insurance or legal status, especially those in sectors such as fishing and construction. As a result, people with chronic coughs or infectious diseases such as tuberculosis may continue working and spreading illness instead of seeking timely treatment.
She said patients who delay treatment often require more medical resources and higher costs once they finally arrive at hospital.
The former doctor also suggested using migrant health insurance funds to hire more medical staff, including foreign doctors and nurses who can help bridge language barriers and improve disease control in border communities.
She concluded that while donations can still play a role in emergencies, Thailand needs a stable and sustainable healthcare system that protects both migrants and Thai citizens without overwhelming hospitals and frontline medical workers.
