There is also a public healcare system here which is quite terrible.
Interestingly, some public hospitals offer "special clinic" hours where you can get treatment on a cash basis instead of using the public healthcare system. Since the "special clinics" are not so heavily oversubscribed the wait times are shorter and service is better. Not luxurious like the private hospitals (which are indeed luxurious) but solid care by excellent doctors. I had foot surgery at Siriraj Hospital (oldest and largest public hospital [0]) by an excellent specialist [1] who also practicies at Bumrungrad (pricey private hospital). Total cost of everything, including two nights in hospital, was USD700.
I guess that's a sort of hybrid of public and private and is an excellent value. But the private healthcare is outstanding and (again) luxurious, and while more expensive still only a fraction of western pricing. The thing is, the prices are known and even advertised in advance and you can just pay out of pocket. Wife had surgery at Bumrungrad to remove an ovarian cyst, three nights in hospital with pampered treatment, total cost a little over USD2,000.
[0] https://en.wikipedia.org/wiki/Siriraj_Hospital [1] https://www.bumrungrad.com/doctors/Bavornrit-Chuckpaiwong
I'm pretty sure the private healthcare in Thailand is very good, but the only reason it's affordable for us is the difference of the cost of life, I doubt a farmer there can afford those services.
And those fundamentals are why the private system is so much better. It's not free and consumers are spending their own money on themselves so seek out the best value they can. And the competition between private hospitals is pretty fierce so they are contantly upgrading, innovating, and advertising (including their prices) to attract customers.
It is common here for many of the best doctors to practice in both private and public sectors. My anecdote mentioned the fact that the doctor who did my foot surgery does that.
As for cost, those private hospitals, and there are lots of them, cater primarily to Thais. So plenty of Thais can afford private care. It's not a huge unknown cost going in that is potentially ruinous like in the U.S.
Like you said, in order to exist the private system must be better than the public system. That is the wonderful effect of markets when they are allowed to operate.
