Mae Sot, Thailand – When the brother of Aung Hein Thant went to the hospital in Thailand following a serious head trauma of a motorcycle accident, he faced an unexpected and disturbing situation: the hospital forced him to show his passport and pay a deposit of US $ 5,800 before taking a treatment. Faced with a series of delays, he finally died of his injuries.
“I thought that at the beginning, everyone should have equal rights,” Aung Hein Thant told RFA Burmese, describing the actions of the “discriminatory” hospital.
The constitution of Thailand guarantees the fundamental rights of patients to medical care without discrimination for reasons such as nationality, status, social position or the nature of their disease.
However, in a study in 2024 of the International Organization for Migration, or OIM, 22% of respondents said that discrimination was an obstacle to access to health care, while 45% replied that the cost was an obstacle.
The situation of Myanmar nationals has not become more precarious since a military coup in 2021 which prompted an exodus in Thailand. Many came to rely on Thai hospitals for medical support. The UN estimates that more than 4 million Myanmar nationals are now living in Thailand, but labor activists have put the number up to 7 million.
Many remain undocumented. Those who choose to register via the Myanmar Embassy controlled by the Junta in Bangkok are likely to be identified as participants in anti-Junta demonstrations, to refuse documentation or to face conscription in the army in Myanmar.
Consequently, they are left without access to universal health insurance in Thailand – and hospitals are left without any insurance that they can afford care.
As a result, Myanmar patients are often required to provide a deposit before receiving medical treatment if they are unable to show documentation – even in an emergency, said a researcher.
“In the event of an emergency, if you do not have your passport, it is certain by 90% certain that you will not receive the support of the health care you may need,” said Htet Khaing Min, a doctor who researching health care for migrants for the reflection group and the consulting firm Shetangthagathu Reform Initiative Center. The fees can range from a few thousand baht for ambulatory services to 300,000 Thai baht (US $ 8,700) for emergency treatment in private hospitals, he said.
“For a situation where a patient may need emergency treatment or [intensive] Patient care, you must certainly be able to give a deposit. Without deposit, you will not get it – it’s final, “said Htet Khaig Min to FRI.
The influx of migrants has also fueled the increase in the discrimination of certain Thai, online and offline. Support groups say that Myanmar nationals are increasingly considered competitors for jobs and essential resources such as health care.
Patients who cannot pay their bills
The IOM survey has also revealed that around a third of migrant households in Myanmar in Thailand have no form of health insurance. This leaves hospitals to assume the financial burden when undocumented patients cannot pay for treatment – sometimes inciting institutions to ignore legal guarantees and refuse care.
A head of a private hospital in Bangkok, speaking on condition of anonymity due to the fear of the repercussions, confirmed that undocumented patients are often refused unless they have appropriate documentation and health insurance.
“The hospital accepts patients under universal coverage for emergency patients [UCEP] Program, but only if they have identity documents and are not completely illegal, “the manager told RFA.
Presented in 2017, the UCEP policy guarantees emergency care at the nearest public or private hospital during the first 72 hours, without required deposit.
However, hospitals dealing with a large number of uninsured or undocumented patients often operate at a loss. Some border hospitals report that up to 25% of hospitalized patients and 50% of external patients are unable to pay their bills, forcing facilities to postpone payments for medicine and other essential supplies while hoping for government assistance.
Some hospitals ask patients with expensive and intensive diseases to treat, such as HIV, tuberculosis or hepatitis, to go elsewhere if they are undocumented and without insurance, said Nang Ei Lawnt Ying, project manager for a popular insurance scheme, M-Fund.
The program, which works with 251 hospitals and clinics in Thailand, offers low -cost monthly insurance for which approximately 90,000 migrants have recorded, attenuating friction between Thai hospitals and Myanmar patients.
While many hospitals have undertaken to provide care for Myanmar nationals, regardless of their ability to pay the bill, discrimination and increased pressure on the health system in Thailand still contribute to problems between patients and hospitals, said Htet Khaing Min.
The RFA journalist, Pimuk Rakkanam, in Bangkok contributed to this report. Published by Tajun Kang, Mike Firn and Mat Pennington.