My Afternoon as a Social Welfare Case: Treating my Eye Infection in a Thai Hospital

After three months working in Thailand and paying the premium of about $20 per month, I was given my “social insurance card” which entitles me to treatment at one of the local public hospitals.   I did not have a chance to do any participant-observer until yesterday though when for the second day I woke up with an eye infection. With diagnoses of Zika Virus dancing my head (put there by my daughter, I might add), I had to make a decision. Do I go to the hospital with my new card and endure the lines of the unwashed that some expatriates warned me about, or do I go to a private clinic where the wait lines are shorter, and come up with the ten or fifteen dollars or so such a visit usually entails?

By way of explanation, Thailand for the last ten years or so has a system of national health care such as the type I am now enrolled in. This was implemented by a former government, and is none as the “30 Baht Plan.” Every Thai is enrolled in the program (as well some of the foreigners who work here), and the guarantee is that if you show up at a public clinic, your cost will be no more than 30 Baht, i.e. a little less than $1. The succeeding governments have kept this program through elections, and coups. It is very popular with the rural and urban poor who otherwise cannot afford medical care. This was the program I was enrolled in.

So I decided to do the participant-observer thing, and go down to the public Lanna Hospital to get my eye checked. I went without an appointment because that is how medical care is dispensed in Thailand, whether you go to a general care office, or to a hospital. It is all kind of like the Emergency Room in the United States. No appointments necessary, as long as you arrive during business hours.

Anyway, I arrived at Lanna Hospital at about 11:30 on a Saturday morning, and after some searching, was sent to the line which in English is called the “Social Welfare.”. I will admit to feeling strange about this label—in English such labels are stigmatizing to someone of the middle class status to which I claim fealty. Social welfare, not me! Anyway, I reasoned to myself, this is just a bad translation of the Thai which is social insurance, not social welfare. In American English it is the difference between MediCare which is the system for all elderly and not stigmatized, and Medicaid which his for the poor, and is stigmatized.

So I swallowed my pride, and accepted the ticket marked “Social Welfare,” and was sent to the fifth floor, and told to wait in a big waiting room with roughly another hundred people, none of whom looked like a white foreigner. Walking into the room, I tried to figure out where to sit, when I was approached by a nurse’s aide within about 30 seconds:

     Are you Anthony Waters?


     Yes, how did you guess?

Come over here. I was weighed, my blood pressure taken, and asked about my symptoms in Thai. And then I was told to wait between door 1 and door 2—my name would be called, eventually.

And I was finally called. I went into an office where a doctor was sitting behind a desk. She smiled, and asked in English about my problem. I showed her my eye, and she examined it with a light. “Virus,” she said. No bacterial infection yet, though. I will prescribe an anti-bacterial agent as a prophylaxis, and some eyedrops to keep your eye moist. “If you still have a problem with your eye in 3-4 days, please come back to see me. In the meantime, you can pick up your prescription at the pharmacy next door.” She was nice, but efficient. I think I was in and out under five minutes.

More waiting. Then the pharmacist in called me. “Here are your prescriptions,” and he read off the English instructions about when and how to take the eyedrops. Medicine in hand, I left the hospital.

Now you are probably wondering what time this was. Well, I arrived confused at the hospital at 11:30, and I was driving out of the parking lot at 1:00 pm with my medicine, all of which was covered by my Social Welfare insurance. No co-pays, and even the parking lot charge was waived!

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