Health Ministry backs THB450 tourist fee as hospitals face billions in unpaid bills

Thailand’s Ministry of Public Health has backed a proposed THB450 fee for foreign tourists, calling for part of the revenue to fund insurance or health cover that could reduce hospitals’ exposure to unpaid medical bills.

Public Health Minister Pattana Promphat said a preliminary survey of more than 30 regional hospitals found that they incur several billion baht in unrecovered treatment costs involving foreign patients each year.

“We previously conducted a preliminary survey of more than 30 regional hospitals and found that we have several billion baht in bad debt each year,” Pattana said.

He said the ministry supported the Tourism and Sports Ministry’s proposal if part of the fee collected through a tourism fund was used to provide insurance for foreign visitors.

Such a system would shift the risk of hospitals being unable to collect treatment costs to insurers, he said.

“If revenue goes into a fund that can support the purchase of insurance or health insurance, we would like this cover to be provided to tourists who are not coming here to work,” Pattana said. “That would shift the risk of receiving payment away from hospitals and onto insurance companies.”

Hospitals collected THB9.9bn of THB17bn billed

At an October 6 meeting on the proposed foreign tourist fee, chaired by Tourism and Sports Minister Surasak Phancharoenworakul, Pattana presented 2024 data from 32 hospitals.

The hospitals billed foreign patients a combined THB16.957 billion for medical treatment but actually collected THB9.935 billion, leaving a difference of THB7.022 billion.

In proportional terms, hospitals received about THB59 for every THB100 billed.

However, the figures cover several categories of foreign patients and do not represent tourists alone.

Any insurance arrangement linked to the proposed THB450 fee would cover only eligible tourists who pay the charge. Authorities would therefore need to verify the underlying data and determine the scope of the scheme, while developing a system that allows hospitals to confirm eligibility and make insurance claims effectively.

Ministry supports insurance element of tourist fee

The Tourism and Sports Ministry is pushing ahead with a proposal to charge eligible foreign tourists THB450 per person, initially applying the fee to those arriving by air.

Under the proposal, implementation for land and sea arrivals would be delayed by one year, while part of the revenue would be used to provide visitor insurance.

The October 6 consultation brought together representatives of the government, private sector and civil society to consider the proposed fee and insurance arrangements. The plan remains under consideration and has not yet taken effect.

Pattana said the Public Health Ministry supported the principle of the proposal despite raising concerns about some details of the draft arrangements.

“I joined yesterday’s hearing with the relevant agencies and raised some concerns about parts of the draft announcement,” he said. “But we support the proposal.”

The ministry’s position is that properly designed insurance could provide protection for tourists while reducing the financial risk currently borne by hospitals when treatment bills cannot be recovered.