Many Swedes living in Thailand have a hard time getting a proper health insurance. Cases and stories a different, but common is that they either deselect insurance or face unmanageable insurance costs as they’re nearing retirement. Now they want the Swedish Government to look into their case.
Swedish laws demand that one needs to be a resident in Sweden and moreover stay in the country for more than 6 months a year in order to receive national health insurance. For some Swedes this is not suitable for their health, while others think this is unfair, as they pay Swedish pension taxes.
Meet Åke Andersson, 75-year old retiree living in Thailand since 2007. Åke Andersson suffers from rheumatism and has for 25 years. In Sweden he was taking medication to battle the illness but now living in Thailand the climate helps him. He doesn’t take medication anymore. This means he has to be in Thailand all year around, which prevents him getting support from the Swedish national health insurance, even though he pays a 20 % tax over his pension.
When Åke Andersson was diagnosed with his disease more than 20 years ago, the government allowed him to reside in Spain and still get covered by the state insurance – until the joint European Union’s health care agreement was adopted that is. But now when he’s retired and resides in Thailand the government won’t cover him.
Another case is Åke Viktorsson, a 72-year-old expat living in Thailand for 6 years, while also paying tax on his pension to Sweden. Åke Viktorsson is healthy and made the choice to live in Thailand for personal reasons.
“I’ve been working outside of Sweden most of my career and didn’t pay taxes. Back then it wasn’t a problem that I was not covered by the Swedish state. But now I pay my taxes and then it would only be fair if I was covered by the national health insurance”, he states.
Åke Viktorsson has the right to treatment when visiting Sweden, but he may have to pay himself. There are no guarantees as it depends on circumstances and the specific case. Emergencies are fully covered, but according to him, the problem is he doesn’t know if or when this could occur.
So when moving to Thailand with his wife and son, Åke Viktorsson was investigating for private insurances, but they were simply not worth it. It would cost 350.000 baht a year to cover his family. So he took the risk.
“Avoiding illness would save my family 350.000 baht each year. We have been lucky enough to avoid this and now have a couple of millions baht to get sick for”, he says, adding: “It’s a risky game, but it is more economical than to pay for a private insurance each year”.
Private insurances are pricey when nearing retirement age and they often don’t cover former illnesses.
“When you’re in your seventies your medical record is pretty long, so these private insurances covers almost nothing of importance”, Åke Viktorsson assess.
The Norwegian scheme
A group of Swedish expats resided in Phuket are now taking action. They are united in the community Skandinaver på Phuket (SpP) and want to be accepted on the national health insurance – as they pay taxes – without having to spend half the year in Sweden. Bo Jonsson, 81-year old Swedish living in Phuket because “it is cheaper and the climate is better”, leads this initiative.
The group doesn’t understand why Swedish pensioners can live outside of Sweden in the European Union and still get covered by the national health insurance , while the same Swede living in Thailand paying the same tax, cannot.
As an alternative they propose an international state insurance, where they could pay “a little extra” on the tax bill for administration and then get covered for health issues in Thailand. Norway has such a system.
“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”, Bo Jonsson, retired economist explains.
This is 2500 SEK a year on a state pension with 10.000 SEK and 4500 SEK a year, if your state pension is 17.500 a month. “So this is much cheaper, than a private insurance”, Bo Jonsson concludes. However in the Norwegian scheme, one has to have spend 3 of the last 5 years in Norway. SpP wants to avoid that limitation, since it could exclude those who e.g. may have worked many consecutive years abroad, like Åke Viktorsson and Bo Jonsson.
Sweden has special health care agreements with Australia, Israel and Algeria. Surprisingly to Bo Jonsson as he states “they have lesser Swedish expats, than in Thailand”.
Bo Jonsson propose that Sweden should expand these agreements to be global: “The matter is to adjust to the fact that people more and more live in other countries than their native one, also outside of EU”.
Couldn’t people take undue advantage of an international agreement as costs are different around the world?
“It depends on how the agreement is done. It should be negotiable, so Sweden supports a fixed amount for certain issues regardless of where you live. In Thailand this would be very cheap for Sweden but in New York of course it would be expensive, so there the care might not cover fully”, Åke Viktorsson suggests.
Why is it not just a possibility for you to stay in Sweden half the year?
”Me and my wife, in wheelchair, are here because of a better climate and I could not have the help in Europe I can have here and cover costs with our pensions, my wife’s pension is a minimum one from Italy. We are healthy, apart from that. In reality I could not afford travelling twice a year to Sweden and rent another apartment and pay for the service there, only to eventually get the health care we might need”, Bo Jonsson answers and adds: “I would still not be covered here in Thailand. That is what we are asking for; to be covered during the time here, i.e. if you live longer time and not as a tourist, but when having e.g. a visa for a whole year working or being a retiree”.
And what should be the Swedish state’s’ interests in such an agreement?
“Fair and equal treatment of citizens is a sine qua non [indispensable and essential action] for politicians, discrimination between people concerning matters of rights is not feasible. Even Swedes living abroad have the right to have health care in Sweden, to me it is a matter of practical implementation of such health care rights. Furthermore, it is more efficient to receive it where you actually live and in the case of Thailand, also far cheaper and available faster than in Sweden. If Sweden has an agreement with Australia, the state must already have identified the advantages for its citizens”, Bo Jonsson says.
Bo Jonsson has done a report on the insurance situation for 24 of SpP’s 240 members backing their proposal. The survey is not statistically validated, but Bo Jonsson states: “the cases are validated”.
At the Tsunami ceremony 27th December 2014 in Khao Lak Bo Jonsson and other representatives from SpP were asked to present a report to Åsa Regnér, Minister in Sweden for Children, the Elderly and Equality, and she told them that “we have started to think of the matter”. When getting the report she answered she would take the report with her to her colleagues in the Social department. Since then it has been waiting.
“Later correspondence has only concerned the general approach by the government to others who are not well off economically, and socially and concerning that people in general question all the generosity to refugees or so called refugees until they are refused asylum, while for certain others, such as citizens living abroad there is no such funding. We are glad to have learned in the answer from the minister: ‘I am reading what you are saying and thinking of how to handle it’”, Bo Jonsson reports.
Now Bo Jonsson and SpP has taken action in co-operation with Svenskföreningen i Hua Hin. They just posted a letter to the Government concerning their proposal. They got the advice to send it to Gabriel Wikström, the Minister for Health Care.
The letter asks for a government study, a so called elucidation for a purposeful action.
“We expect that the government now has enough control over the issue of caring for the real asylum seekers and can include our issue as one of its many other actions to reach people that need the support of the state”, Bo Jonsson ends.