On 24 May 1987, readers were astounded by a Bangkok newspaper's front headline “Hospitals refuse to care for patients”. While the public might not have been surprised by something like this some twenty years ago, today when the number of doctors and medical facilities have increased considerably, this withholding of medical care by the medical professional seems inexcusable. The story indicated that five rural workers were seriously injured in an explosion at a work site 130 km. north of Bangkok, but the victims could not be admitted at the rural hospitals near the place of the accident because of lack of adequate medical facilities. Relatives of the victims then hired a car and headed for Bangkok where, to their shock, five large government hospitals turned them down with the reply that not enough beds were available. In their desperate search for a hospital, one of the five victims died, another was finally admitted to a government hospital, and the other three could find treatment only at a small private hospital, eight hours after the accident occurred. The father of one of the victims told reporters: “The doctors didn't even try to help. No one treated my son kindly. What is the use of building all these modern hospitals?”

The case of modern health care utilization just cited reflects the plight of poor patients, who generally receive inferior health care or no care at all. The excuse that “hospital beds are full” is often heard by all patients but particularly those of lower social status and those with no connections with a hospital. Although such an excuse is commonly given, an admission can be arranged when the patient shows an indication of high social status or a link with the hospital. It has been observed that refusing admission to poor patients has long existed, and this may be explained by the fact that modern health personnel, whose backgrounds represent the most affluent sectors of society, generally prefer treating patients with a similar social standing.