“It’s pay or die” – More Thai-Swedes joins battle for health care

Sven Arne Hedell, initator behind Svenskar i Udon (Photo: Frederik Sonne)

Sven Arne Hedell, initator behind Svenskar i Udon (Photo: Frederik Sonne)

More Swedes unite in Thailand battling for national health insurance rights. Swedish expat organizations in Hua Hin and Phuket earlier this year send a letter to Swedish Minister for Health Care, Gabriel Wikström, pledging their discontent about the national health insurance not covering health services in Thailand. Now the newly founded association “Svenskar in Udon” has followed suit.

And It was only a question of time before the Udon Thani-Swedes took action. Sven Arne Hedell, initiator behind the group, told ScandAsia already in April, that the trigger to found the association as such was the health insurance issue. So why does the Swedes in Udon want to engage in this conflict. ScandAsia met with four members in Udon Thani to discuss this.

ScandAsia meets the four members at the Kavinburi Hotel café in the center of Udon Thani. Bo Melander (72), Kjell Nyström (69), Kent Svensson (73) and Sven Arne Hedell (65). They are more or less in the same situation. They are all retired, they all live in the Northeast of Thailand and they are all entitled to pay the Swedish SINK-Skatt, a fixed tax deal that Swedes can apply for when they decide to live abroad. If you’re approved for it, you’ll pay 20 percent flat but lose you right to vote to an extend and own land in Sweden among many other things. You’re still entitled to Swedish health care, but only in Sweden and only in urgent situations.

“Pay or die”

“It’s pay or die”, they say unanimously. That’s the bottom line in their critique. The logic is so to them: they feel entitled to health insurance because they pay their taxes, but according to them they can’t avoid a huge amount of extra expenses if they would get sick.

“You either need to have a private insurances, which is difficult and expensive to get when you’re a senior, or you need to pay for service here in Thailand or you’ll have to buy plane tickets back and forth to Sweden, so there’s no way of avoiding to pay and if you don’t pay you’ll die”, says Kjell Nyström, who recently paid 35.000 Baht for a skin cancer treatment, as he’s not insured privately.  

“But there’s a very easy way of avoiding this, if the Swedish health care would pay for treatment in Thailand”, he says.

(Photo: Frederik Sonne)

Bo Melander has a tumor in his ear that was operated in Sweden (Photo: Frederik Sonne)

Bo Melander, expat since 2007, gives an example of this. He has had a tumor in his ear since the beginning of the 90’s. This means he has to send a DVD with his MRI-scan to Swedes doctors every year. In 2012 the tumor grew and became an urgent matter. Bo was flown back to Umeå in Sweden to get it checked in January 2013. He then waited 3 months, staying at his ex-wife in Sweden, before he finally got an appointment for an operation in May 2013. He went back to Thailand for a while before he turned up at the hospital in May where he got the operation. The operation lasted 57 minutes.

“It’s absurd”, he says “that I had to fly all the way to Sweden and stay for at least 3 days to get an operation that lasted under an hour. I could get the same operation in Thailand and it would have been cheaper for me and the state”.

And as they points out that this is unfair, that you’ll have to deal with expenses as a Sweden living in Thailand, when you can live abroad inside the European Union, in Spain for instance, and get fully covered. 

The Norwegian scheme

As Swedes in Phuket and Hua Hin, Sven Arne Hedell and the Udon Thani Swedes, wants the Swedish officials to look at their neighbors in the North for a proper solution.

In Norway they have an international state insurance, where one pay “a little extra” on the tax bill for administration and then get covered for health treatment in Thailand. However in the Norwegian scheme, one has to have spend 3 of the last 5 years in Norway. The Swedes in Thailand wants to avoid this.

Bo Jonsson (82) from Skandinaver på Phuket (SpP) has made the math behind:

“I’ve done a comparison with the Norwegian scheme. If Sweden adopt this model, it would only cost the retired taxpayer in Thailand 375 SEK for a Swede with a state pension on 17.500 SEK a month and 187 SEK for a state pension on 10.000 SEK a month. And we’re more than eager to pay that in extra taxes”, he explained to ScandAsia in February.

Why can’t you stay?

A lot of work and concern is being put into the health insurance battle for Swedes in Thailand, the obvious question most be, why can’t you just stay in Sweden or inside the EU and avoid this?

(Photo: Frederik Sonne)

Kjell Nyström is the administrator of Svenskar in Udon (Photo: Frederik Sonne)

“When you decide to move to another country within or outside EU when you retire of course you consider what you get for your tax money in your old home country. But I would say all people moving abroad would never consider staying in the old home country just because of the health system. The reasons for moving can be many, health, love, politics and also what kind of life from a financial point of view can you live as a retired person.” Kjell Nyström explains and adds:

According to Thai legislation you’ll need to have a fortune on 800.000 baht or 400.000 baht, if married with a Thai in order to live in Thailand, so doesn’t it make sense, that the there’s a perception that you could take care for yourself?

“The 400k or 800k baht you talking about is not a huge sum if you sell off all your stuff; car, furniture, apartment or house in your old home country before moving. This can be used as a buffer if something happens.” Kjell Nyström tells.

And you couldn’t live in the EU?

“My view is that it is a question of equal treatment and democracy that if you pay tax in Sweden your health should be covered. Other countries like Norway has that implemented.” he says and adds:

“Another aspect is that health treatment has a lower cost in Thailand than in Sweden so, if implemented, it would be a cost reduction for Sweden as a country  to pay for health in Thailand instead of us, living here, fly back to Sweden to get a treatment to a much higher cost for Sweden and for us as individuals.”

It’s believed that approximately 360 Swedes live in the Udon area Thai immigration says, according to a report done by the Swedish Church.

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