One of the fast-growing sectors that have been identified in Thailand is healthcare and it is expected to be a key driver of the country’s economy. Deloitte estimates that the health care spending in Thailand would have reached $18.7bn last year, growing by 8% between 2014 and 2018. The consultancy added that total spending was $12.8bn in 2013. The medical equipment market is growing quickly as well, having risen in value from BT25.92bn ($780.2m) in 2010 to BT38bn ($1.1bn) in 2015. Nearly 80% of this medical equipment is imported.

The government’s share of sector spending is the second highest in the region, at 77%, yet private sector spending is on the rise. In 2008, the Thai government spent BT8.2bn ($246.8m) on health care while the private sector spent BT2.6bn ($78.3m). By 2015, the government was spending BT12.5bn ($376.3m) for health care, while the private sector spent BT4bn ($120.4m). Private hospitals have benefited from government efforts to provide universal health care. Local hospitals report having experienced sharp increases in patient numbers, and this has led patients with the financial means to seek treatment at privately run establishments.

Private sector growth

According to the data from the Health Service Support Department at the Ministry of Public Health in 2015, there were 343 private hospitals operating in Thailand, up from 321 in 2011. Around 40% of these were in the Bangkok Metropolitan Area. The private hospital sector has been undergoing structural change and the effects of this are becoming increasingly clear. Large hospitals which are able to expand rapidly are doing so through mergers and acquisitions and by expanding their commercial networks both in the Bangkok Metropolitan Area and in important regional centers, especially those in border regions.

Thailand’s Medical tourism industry is largely driven by private hospitals. Some of the well-known private hospital groups in the country include:
(i) Bangkok Dusit Medical Services, the largest private hospital group in Thailand which consists of six major hospital groups – Bangkok Hospital, Samitivej Hospital, BNH Hospital, Phyathai Hospital, Paolo Hospital and The Royal Hospital and
(ii) Bumrungrad International Hospital, one of the largest private hospitals in Southeast Asia and the first hospital in Asia to receive Joint Commission International (JCI) accreditation in 2002.

The above-mentioned private hospitals are also continually looking to expand their international reach through Memorandum of Understanding (MoUs) with foreign online health platforms or companies. For instance, Bangkok Dusit Medical Services signed an MoU with China’s Ping An Good Doctor in November 2018 and Bumrungrad International Hospital signed an MoU with Malaysia’s BookDoc in June 2018.

New players such as huge conglomerate companies in Thailand are also increasingly interested in investing in healthcare. These investments are huge and tend to be concentrated in the Bangkok Metropolitan Region. Examples of investors include Pruksa Holdings (Vimutti Hospital, scheduled for opening in 2020), RSU Group (RSU International Hospital, also scheduled for opening in 2020), CP Group, and TCC Group.

Convergence of public initiatives and private sector developments

Through a number of incentives, the Thai government wants to capitalise on the market development of medical tourism. Thailand is shifting public policy towards creating an environment wherein medical tourists can access the country’s services with ease. Part of the government’s strategic plan to become a global medical hub involves the loosening of visa restrictions and the creation of smart visas. Extending visas from 30 days to 90 days for citizens of China along with those of Cambodia, Laos, Myanmar and Vietnam (CLMV) will increase treatment options and draw customers with the promise of quality facilities.

The private healthcare sector will be expected to grow and become more competitive due to the entry of non-traditional players such as huge conglomerate companies. Additionally, some public hospitals have also noticed the potential opportunities and have developed services (e.g. specialist treatments or providing services outside regular working hours) that match the standards of the private hospitals.

Piyamaharajkarun Hospital, part of the Siriraj Hospital network and the Somdech Phra Debaratana Medical Centre at Ramathibodi Hospital are examples of public hospitals which have followed this path.

Challenges and conclusion

Thailand provides universal health coverage to its citizens, which is great but comes with several challenges. Some of these big challenges include fiscal sustainability in the long term, maintaining healthcare service quality and the shortage of healthcare professionals to meet the demands of universal health coverage. There is also the existing urban-rural divide in terms of the provision and quality of healthcare. The clever and practical use of technologies could address some of these issues, but this also requires significant buy-in and commitment from the policy makers and public sector.