PHUKET, THAILAND – Thailand was considering requiring international tourists to show accident or travel insurance before entry, amid mounting unpaid hospital bills in public facilities.
Hospitals raised alarm over unpaid treatment
At Vachira Phuket Hospital, the financial pressure was already clearly felt, according to director Dr. Weerasak Lorthongkham. The hospital served around 400,000 registered residents and more than 1 million visitors.
He reported that about 10 million Baht in treatment costs for uninsured foreign patients remained unpaid every year. The hospital currently had to absorb these sums itself.
Motorcycle crashes and risky behavior behind many cases
Dr. Weerasak described recurring patterns among tourists, including inexperienced motorcycle riding and the use of alcohol or other substances. In Phuket, many visitors rode a motorcycle for the first time, which increased the risk of accidents.
One particularly serious case involved a Russian tourist who suffered a spinal injury and required long-term care. The treatment cost the hospital more than 1 million Baht, but no payment was made and the family could not be reached.
Nationwide burden estimated at at least 100 million Baht
The Health Ministry estimated that unpaid medical bills from foreign patients nationwide reached at least 100 million Baht per year. Major tourism centers such as Phuket and Chiang Mai were said to be especially affected.
Permanent Secretary Dr. Somruk Jungsaman said officials were currently collecting more detailed data to determine the true scale of the problem. Based on this, they planned to coordinate the level of insurance coverage and payment mechanisms with relevant agencies.
Emergency care could not be delayed
In emergencies, hospitals could not postpone treatment for ethical reasons, even when it was unclear whether patients could pay. As a result, costs often remained with hospitals and ultimately with the public system.
Traffic accidents, particularly on Thai roads, were cited as one of the most common reasons for hospital stays among tourists. Motorcycles were a central risk factor, especially during peak travel seasons.
Insurance relatively cheap, but many still arrive without it
Reports indicated that average costs per emergency medical case in 2025 were around 60,000 Baht, reflecting rising healthcare spending. Nevertheless, many visitors continued to enter Thailand without adequate coverage.
Industry data suggested that travel insurance for a two‑week trip cost about 1,100 Baht. Such policies typically covered medical expenses from 3.6 to 9 million Baht, yet take‑up remained inconsistent.
Policy shift from sheer volume to better protection
For years, industry representatives said Thailand had prioritized visitor numbers and allowed many travelers to enter without insurance, for example under visa‑exempt schemes. This approach was now being reviewed in light of rising costs.
Sisdivachr Cheewarattanaporn, president of the Association of Thai Travel Agents, said mandatory fees and insurance had not previously been the main focus. Now, he noted, compulsory insurance was moving to the forefront as a more targeted solution.
Entry fee on hold as focus moves to insurance
A proposed 300‑Baht entry fee for air arrivals was still under Cabinet consideration. In parallel, the idea of mandatory insurance was gaining traction.
Sisdivachr stressed that travel insurance was now affordable, but that effective verification was crucial to ensure travelers were actually covered. Without proper checks, he warned, the measure risked becoming ineffective.
Diplomatic pressure yielded little on unpaid bills
Attempts to recover unpaid bills through diplomatic channels had so far brought limited results. Dr. Supakit Sirilak of the Health Systems Research Institute said embassies generally regarded medical costs as a personal responsibility.
“I support measures that limit the burden on the ministry, and tourism authorities could share losses if mandatory insurance cannot be enforced.”
said Dr. Supakit Sirilak, from the Health Systems Research Institute.
He added that hospitals could not detain patients over debts without damaging Thailand’s international reputation.
Mandatory cover already standard in many destinations
In several regions, compulsory travel insurance was already standard, including the Schengen area, the United Arab Emirates, Russia and Cuba. Proof of insurance was often integrated into visa procedures or bundled with travel costs.
Observers suggested that Thailand could adopt a similar model, for example by linking insurance requirements to entry processes or ticket purchases. This would protect public finances while improving safety for travelers, particularly those engaging in high‑risk activities.
Government pushed for swift action, details still open
Health Minister Pattana Promphat said the government was ready to push ahead with the plan and already had proposals in place. A central question, he noted, was what level of coverage would be appropriate and what the total burden from foreign patients actually was.
He added that any future framework would need to take into account different groups, including tourists and migrants, especially in border areas. Strengthening the mechanism should reduce the load on the system and improve its overall performance.