‘Medical hub’ ambition requires thorough thinking

State-supported healthcare is always controversial, as it can never be universally agreed on how much or to what extent the poor should be assisted. The government’s plan to turn the country into a medical hub for foreign tourists will not make things any easier. While there is a clear line between how much the poor and the rich can afford when they seek medical treatment, thus making “medical tourism” something that seemingly doesn’t affect the former, the government's ambition requires thorough thinking.
The very first thing that can happen if Thailand becomes a full-blown medical hub is further migration of health personnel to the private sector. Professionals follow the money and doctors, nurses and physicians are no exceptions. The situation is already worrying; only the best-known state hospitals are able to afford to keep qualified human resources, and it could get really bad when the private sector starts headhunting.
Medical tourism is not new. In fact, a lot of foreigners come to Thailand with a priority of, say, seeking dental services while doing some sightseeing or enjoying a break as a secondary factor. Thailand, Singapore and India account for some 90 per cent of Asia’s medical tourism market. The current government must have seen the trend, and thus an opportunity to make more money. Immigration rules can also be relaxed for potential “patients” from overseas while medical services that are in demand stand to get more or less state support.
On the one hand, Thailand’s ability to attract “medical tourists” is something the country can be proud of, and its “Land of Smiles” reputation will undoubtedly help the ambitious plan when it is carried out. On the other hand, that Thailand can provide cheap but quality healthcare adds insult to injury, as it mocks the fact that a lot of Thai nationals still get substandard medical care, and state-supported healthcare still has significant room for improvement. Many state employees, meanwhile, are reluctant to quit their low-paying jobs because one of the major fringe benefits is that they can get medical fees reimbursed for immediate 
family members. That can only mean one thing: the healthcare sector in this country is far from perfect.
The government needs to think it through, and a lot of safeguards must be put in place to make sure that the “medical hub” ambition does not succeed at the expense of the poor or Thai people in general. The best brains can be easily sucked to where big money is. It has happened to all professions, but we must be extra careful when it comes to key social services like healthcare. We don’t need to look further than the Thai education system, whose dismal state is a direct result of the fact that fewer and fewer good teachers have wanted to work in the public sector, with more and more having sought employment in 
private institutions that pay better salaries.
Medical investment is increasingly geared toward the rich. Many 
private hospitals already look 
intimidating for poor people to walk into, although the facilities cater mainly to Thais. Imagine what could happen when the healthcare sector gets a bigger licence to cash in on 
foreign patients. However, squeaky clean lobbies or hotel-like waiting rooms are not what we should be worried about. What the government should focus on is the question how many qualified health personnel will be left to serve the Thai public, if the balance is upset and medics begin to think that serving rich foreign patients is the way to go.