Edited fix; sorry.

if you are in any of the “Wealthy” categories is ฿40k a year (or less) for a LTR qualifying insurance policy really going to kill you or “alienate tens or hundreds of thousands of potential applicants” ? I doubt it. Are you going to have overlapping policies ? Perhaps. But many Thai policies have exemptions/limits for US coverage and so when in the US use your US group coverage and when in Thailand (and likely outside your US group policy “network”) have the peace of mind you will be covered. Just my two cents.