Thailand is pushing for regulations that would require international tourists to obtain accident insurance before entering the country, as rising unpaid medical bills and accident risks place a mounting strain on public healthcare.

"Each year, we absorb about 10 million baht in treatment costs for foreign patients without insurance," the director of Vachira Phuket Hospital said.

He pointed to inexperienced motorcycle use and consumption of alcohol and drugs. "Many visitors come to Phuket and try riding motorcycles for the first time, which increases accident risks."

The Ministry of Public Health estimates unpaid medical bills from foreign patients amount to at least 100 million baht annually, with major tourism hubs such as Phuket and Chiang Mai most affected.

Emergency care cannot ethically be delayed, meaning hospitals often treat patients regardless of their ability to pay, leaving health facilities to absorb the financial costs.

Industry data shows that travel insurance for a two-week stay costs about 1,100 baht and typically provides medical coverage of 3.6 million–9 million baht. Despite the relatively low cost, many travellers arrive without it.

A proposed 300 baht entry fee for air arrivals remains under cabinet review, but attention is shifting towards compulsory insurance.

Mandatory travel insurance is already required in several regions, including the Schengen Area, the United Arab Emirates, Russia and Cuba. In many cases, insurance is integrated into visa applications or bundled with travel costs.