Thailand is considering introducing mandatory travel insurance for foreign visitors in response to a shocking rise in unpaid medical bills, which is putting serious pressure on the local healthcare system.
Backed by the country’s health and tourism authorities, the proposal aims to ensure that visitors, who are drawn to Thailand’s nightlife, beaches and hospitality, cover the cost of care in the event of an accident.
This comes at a time when Thailand continues to attract millions of tourists while grappling with the hidden costs of mass tourism. According to officials, this issue has become increasingly visible in major tourist destinations such as Phuket and Chiang Mai, where hospitals regularly treat foreign patients without guaranteed reimbursement.
At Vachira Phuket Hospital, one of the main hospitals in the popular province of Phuket, unpaid bills amount to around 10 million baht (€265,000) each year. According to its director, Weerasak Lorthongkham, the hospital is forced to absorb these costs for tourists who arrive without adequate insurance.
Most cases involving substance abuse or motorcycle accidents drain hospital resources. In early 2023, over 500 scooter accidents involving tourists were reported in Phuket in just the first two months.
Dr Lorthongkham cited the case of a Russian tourist who suffered a serious spinal injury in a motorcycle accident and required long-term care. Unable to contact the patient’s family, the hospital ended up covering the cost of treatment and repatriation, which exceeded one million baht.
Embassies and consulates generally treat such cases as personal expenses and refuse to cover the bills.
According to the Bangkok Post, the authorities are now assessing the full scale of the issue. Somruk Jungsaman, the permanent secretary at the Ministry of Public Health, said that clear data is needed to design appropriate measures. He added that “both the level of insurance and payment mechanisms will be discussed with relevant agencies”.
Sisdivachr Cheewarattanaporn, chairman of the Association of Thai Travel Agents, told the Bangkok Post that Thailand had long prioritised attracting tourists while leaving related pressures unaddressed.
The issue is gaining urgency amid broader concerns about the sustainability of tourism. Although Thailand remains one of the world’s most popular tourist destinations, arrivals fell last year for the first time in a decade outside of the pandemic, dropping from around 35 million in 2024 to 32.9 million in 2025 amid security concerns and regional instability.
Thailand has already attempted to address the issue in the past. In 2019, it introduced insurance requirements for long-stay visitors over 50 after unpaid foreign medical bills totalled around 500 million baht (€13 million). The authorities are also revisiting an earlier proposal for a 300 baht (€8) fee on air arrivals, which would partly fund basic medical coverage and tourism infrastructure. The idea is still under cabinet review.
Thailand would not be the first country to take this step: Argentina, Qatar, Saudi Arabia and Schengen Area countries already have similar rules. Japan is also considering such measures after reporting unpaid medical bills totalling more than 61 million yen (€320,000) in 2024.
For now, however, no law has been passed, and no final timeline or system has been confirmed.
