Thai people to pay more for medical care under healthcare reform

[webfact]

People to pay more for medical care under healthcare reform

By Chularat Saengpassa 
The Nation

 

 

AS A PART of the country’s upcoming national healthcare reform, Thais will definitely have to pay extra for any extra medical services or medicines they want.

 

“For example, if you want medicines that are not on the national drug list, you will be charged,” Dr Seree Tuchinda, who heads the national healthcare reform committee, explained. 

 

Seree said the reform will present three healthcare packages. The first one will offer basic healthcare for all Thais, regardless of what level of healthcare they are currently entitled to. Coverage under this package will be no less than that under the universal healthcare system now available for 48.8 million people.

 

The second package will present the additional medical services that each major state-supported healthcare scheme wishes to provide to its members. The third package will offer medical benefits that people will get only when they pay extra under a co-payment scheme. 

 

“The details of these three packages will become clear and definite within the next year,” Seree said. 

 

However, Kannikar Kijtiwatchakul, who sits on the National Health Security Board, attacked this plan. “It’s a reform planned by a certain group of people for their own group’s interests,” she said. 

 

Kannikar said she suspected the reforms would mean that there would no longer be any free medical services for Thais. 

 

At present, the country’s universal healthcare scheme offers most types of medical treatments for free. 

 

Seree, meanwhile, downplayed concerns that these new packages would hurt the benefits Thais now enjoy, saying that fairness and risks of medical bankruptcy would be taken into consideration. 

 

“In the event of co-payment, we will set the ceiling of what Thais will have to pay each year,” he said. “We will also ensure that local administrative bodies help the poor, at least partially, regarding the cost of treatments.” 

 

Seree said that some people might oppose the concept of national healthcare reform because they thought they would lose some benefits. “But it’s necessary that we go with the concept that will benefit the majority. We need to take into account the fact that the government cannot fully pay for everyone’s medical costs. We need to be realistic,” he said. 

 

Dr Churdchoo Ariyasriwatana, an adviser to the association protecting civil servants’ medical rights, agreed with the concept of making three packages available. “People must realise that there are no free things in this world. They can get basic healthcare for free, but if they want more than that, they have to accept co-payment,” she said. Churdchoo also believed that people would take better care of their health if they were aware they would have to pay a medical bill. 

 

 

Asst-Professor Dr Thira Woratanarat, who teaches at the Chulalongkorn University’s Department of Preventive and Social Medicine, said medical costs would continue to climb in the face of increasingly advanced medical technologies. He noted that even rich countries could not afford to provide completely free medical services to their people. “The government cannot pay for medical treatments of all its citizens. At one point, sooner or later, it will find that it doesn’t have enough money to do that,” he said. 

 

Thira recommended the government consider using the proceeds of “sin taxes” for public health and to promote healthy behaviour among people. 

 

He said the government should also provide Thai consumers with healthy alternatives. For example, the government may offer tax incentives to entrepreneurs who produce healthier choices such as food with less sodium, fat or sugar. 

 

Thira said the government should also provide counselling services to Thais to raise their awareness of medical costs and their choices so they can seek proper medical coverage. “Without counselling services, many people may fall prey to health-insurance firms.

 

The government should help people assess their health risks and advise them as to which health insurance policy is suitable for them,” he said. 

 

Thira also recommended the use of family medical services, which would ease overcrowding at big hospitals and reduce the use of unnecessary healthcare. 

 

There are now three major healthcare systems in Thailand: the universal healthcare scheme, the social security scheme, and the medical benefit scheme for civil servants and their family members. In the current fiscal year, the annual per-capita budget is Bt2,592.89 for the first scheme, Bt3,354.80 for the second, and Bt12,676.06 for the third. 

 

The upcoming national healthcare reform will set up a new National Health Policy Board to align healthcare policies and goals, and establish a National Health Data Clearing House to facilitate the delivery of medical services. 

 

“We will also go toward decentralisation,” Seree explained. 

 

Source: http://www.nationmultimedia.com/detail/national/30343719

 

-- © Copyright The Nation 2018-04-23

[YetAnother]

1 hour ago, webfact said:

Churdchoo also believed that people would take better care of their health if they were aware they would have to pay a medical bill. 

thais don't think like that ; look at driving, do they drive better because they think they Might be involved in an accident ?

[new2here]

thais don't think like that ; look at driving, do they drive better because they think they Might be involved in an accident ?

I agree. I also think that there has to be a fair balance between providing some list of services and the costs to the hospitals (state or private) to provide them.

It’s just not sustainable to have a system that covers near everything, but does so at costs that are unrecoverable - be the from government program subsidy, patient-copays or otherwise.

I also am a fan of a risk-based pricing that, like some countries do for auto insurance rates - that peg rates, in part, on a persons health and other factors.

While I cede that this means issues like controversial pricing variables like pre-existing conditions, age and gender may come into the conversation, I think that it’s a fair way to better associate premium costs to those who statically are more likely to use more and higher priced services.

I have SSO coverage through work - but am also eligible for a wide range of heavily discounted or nearly free services at the universities on-campus hospital as well... but still think that nationally something is going to have to be done to bridge the gap between costs incurred to provide care and the size and sources of revenue received.


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[JayBangkok]

Why do civil servants and their families have far better benefits than social security members?

 

Civil servants do less stressful, less active jobs, worker shorter hours and retire earlier.

 

Bt12,676.06 compared to Bt12,676.06 is a lot of difference

[new2here]

Why do civil servants and their families have far better benefits than social security members?

 

Civil servants do less stressful, less active jobs, worker shorter hours and retire earlier.

 

Bt12,676.06 compared to Bt12,676.06 is a lot of difference

 

With all sincerity, I *think* the logic was that by going to civil service work, one would be accepting a lower cash pay rate and potentially higher salary scale as opposed to the private sector... therefore, one of the ways the public sector could compete to draw in top talent against the private sectors ability to pay higher cash wages, would be to add overall value to the cash-salary part — and that classically would be via benefits and retirement (like retirement age and non-contributory pensions)

 

Now, whether or not that works or has produced the quality of civil servants one wants or expected is debatable.. but I think this was the concept at the get go.

 

 

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[JAG]

1 hour ago, new2here said:

I have SSO coverage through work - but am also eligible for a wide range of heavily discounted or nearly free services at the universities on-campus hospital as well... but still think that nationally something is going to have to be done to bridge the gap between costs incurred to provide care and the size and sources of revenue received

You are a fortunate chap. That provision is simply not available or attainable for the vast majority of people in this country, who will likely lose the basic health care provision they have under these proposed "reforms".

Edited April 23, 2018 by JAG

[JAG]

I've several times said that the acid test of whether this regime feels secure enough to weather any storm will be when they decide they can go ahead with withdrawing the universal healthcare provision introduced by the Thaksin government.

 

Details will become clear in the next year - so they're not sure (about weathering the storm) yet?

Edited April 23, 2018 by JAG

[new2here]

Provision which is simply not available or attainable for the vast majority of people in this country, who will likely lose the basic health care provision they have under these proposed "reforms".

 

Yes, that’s possible.. and one of the reasons why I personally support keeping a low/no-cost (depending on income) basic health care coverage plan.. in the end, I do think that the public (by way of the national government) will end up with a net savings by investing in a basic level of proactive care which, in theory, would reduce the number or costs of future health care costs (which assumably be more expensive) ... but even with the basic plan- I think that plan coverage/costs and the amount that patients should contribute, needs to be a discussion point as well... and even at the basic coverage level, I do think that personal lifestyle choices (ie do you use tobacco) need to be factors when assessing premium prices or even excluded/limiting some services.

 

 

 

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[nausea]

A bit vague, what does "basic healthcare" mean - an aspirin and a jar of ointment. And talking of vague:

 

3 hours ago, webfact said:

However, Kannikar Kijtiwatchakul, who sits on the National Health Security Board, attacked this plan. “It’s a reform planned by a certain group of people for their own group’s interests,” she said. 

I suppose those in the know understand what she's talking about.

[baboon]

4 hours ago, webfact said:

Asst-Professor Dr Thira Woratanarat, who teaches at the Chulalongkorn University’s Department of Preventive and Social Medicine, said medical costs would continue to climb in the face of increasingly advanced medical technologies. He noted that even rich countries could not afford to provide completely free medical services to their people. “The government cannot pay for medical treatments of all its citizens. At one point, sooner or later, it will find that it doesn’t have enough money to do that,” he said. 

Have one system for all, from the Prime Minister down to the binman. They'll find the money pretty sharpish then...

[hansnl]

3 hours ago, YetAnother said:

thais don't think like that ; look at driving, do they drive better because they think they Might be involved in an accident ?

If people have to pay for healthcare they will not take better care of their health but will not go to the doctor.

Most of the time resulting in higher costs for the system.

This is just a scam for those wanting to earn from healthcare.

Be certain the insurance companies are not content with the existing universal health care system.

 

[TallGuyJohninBKK]

5 hours ago, webfact said:

“The government cannot pay for medical treatments of all its citizens. At one point, sooner or later, it will find that it doesn’t have enough money to do that,” he said. 

 

Yes, but there's a seemingly unlimited budget for new jets, tanks, ships, etc etc. and a variety of other multi billion baht boondoggles. And no one's calling for co-payments from the users of those goodies.

 

[TallGuyJohninBKK]

5 hours ago, webfact said:

There are now three major healthcare systems in Thailand: the universal healthcare scheme, the social security scheme, and the medical benefit scheme for civil servants and their family members. In the current fiscal year, the annual per-capita budget is Bt2,592.89 for the first scheme, Bt3,354.80 for the second, and Bt12,676.06 for the third. 

 

My my, those government funded ED prescriptions for the civil servant class are getting to be pretty pricey!

 

But hey, there's only a 5-fold difference in the health care budget allocated to civil servants vs. the health care budget allocated to UC recipients (low income Thais).

 

[robblok]

22 minutes ago, baboon said:

Have one system for all, from the Prime Minister down to the binman. They'll find the money pretty sharpish then...

Not even my country works like that... if your rich you can always buy more services. I am like the people in this article in agreement that something has to be done. Health cost keep rising with new technologies.. you see it in all countries. You can't just do nothing.

 

Thaksin did a good thing, but he forgot to fund it and so did all other governments. The proof of this is Toon's run.  So something had to be done and its not like there is unlimited money.

The way i read it the (in the picture at least) people will still keep the same service.. if that is true remains to be seen.

I find it brave that the junta dares to do something about this failing system. It would have exploded for sure if no reforms are done.  

 

I would like it if they checked government hospitals more on corruption.. i bet some money can be found there too. 

 

 

As for the civil servants, was said before you become one and get less paid as in the private sector but there are other benefits like the healthcare. It was no different in my country people became civil servants as a job for life accepting lower salaries but better general terms of employment (that is now mostly gone)

[frodo77]

I wonder what will happen with the medication for hiv positive people?

 

[shaurene]

Government workers get the top medical cover available,  my friend Australian, has had quite a few opperations for free. Because his wife is a school teacher and he is covered by this. This is for life even after she retires.

[TallGuyJohninBKK]

27 minutes ago, robblok said:

As for the civil servants, was said before you become one and get less paid as in the private sector but there are other benefits like the healthcare.

 

Tell that to all the civil servants who have been getting accused of embezzling millions of baht from projects/funds supposedly intended for poor Thais, those who are building and living in mansions in resort areas, driving around in Mercedes or BMWs, those who get free homes built for them by the government, those who somehow manage to become "unusually wealthy" while in government service and end up with suitcases of stuffed with cash in their homes and rooms filled with gold and artifacts, etc etc.  Yes, they're really suffering....

 

[robblok]

3 minutes ago, TallGuyJohninBKK said:

 

Tell that to all the civil servants who have been getting accused of embezzling millions of baht from projects/funds supposedly intended for poor Thais, those who are building and living in mansions in resort areas, driving around in Mercedes or BMWs, those who get free homes built for them by the government, those who somehow manage to become "unusually wealthy" while in government service and end up with suitcases of stuffed with cash in their homes and rooms filled with gold and artifacts, etc etc.  Yes, they're really suffering....

 

Who said they were suffering or that i condone corruption. You are stating all civil servants are crooked.. that is a huge blanket statement. 

Edited April 23, 2018 by robblok

[TallGuyJohninBKK]

4 minutes ago, robblok said:

Who said they were suffering or that i condone corruption. You are stating all civil servants are crooked.. that is a huge blanket statement. 

 

This is Thailand. If the shoe fits, wear it.

 

I never said all, but certainly in reality, there are plenty... Especially among the management class. It comes with the territory and is well and long engrained here.  A nice healthy skim off pretty much any business being transacted.

 

Edited April 23, 2018 by TallGuyJohninBKK

[mrmicbkktxl]

50 minutes ago, TallGuyJohninBKK said:

 

My my, those government funded ED prescriptions for the civil servant class are getting to be pretty pricey!

 

But hey, there's only a 5-fold difference in the health care budget allocated to civil servants vs. the health care budget allocated to UC recipients (low income Thais).

 

I think what you wanted to say was “Submarines and luxury watches are very expensive “!

Didn’t they just raise alcohol tax and sugar tax  to finance the health care system?

[robblok]

13 minutes ago, TallGuyJohninBKK said:

 

This is Thailand. If the shoe fits, wear it.

 

I never said all, but certainly in reality, there are plenty... Especially among the management class. It comes with the territory and is well and long engrained here.  A nice healthy skim off pretty much any business being transacted.

 

Yes but what about street sweepers, teachers, bus drivers (on government buses) 

[new2here]

 
This is Thailand. If the shoe fits, wear it.
 
I never said all, but certainly in reality, there are plenty... Especially among the management class. It comes with the territory and is well and long engrained here.  A nice healthy skim off pretty much any business being transacted.
 

I don’t disagree that TiT, but again, I think it’s fair to say that one cheating is unacceptable and the fault/failing to properly police, enforce and prosecute violators falls to the state as a governmental body. In the same way, I think that as a percentage of the whole, it this misconduct really is done by the vast minority. Again, not saying it’s zero... but it’s far from the majority as well.


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[TallGuyJohninBKK]

6 minutes ago, new2here said:

 In the same way, I think that as a percentage of the whole, it this misconduct really is done by the vast minority. Again, not saying it’s zero... but it’s far from the majority as well.

 

I think you'd find, it's pretty much standard practice whenever government agencies are awarding contracts, building things, ordering supplies, engaging in financial business, regulating anything where there's a profit to be made.

 

Even aid to the poor gets skimmed. And lately, even some of the nation's top monks being accused of skimming government funds.  Payoffs to illegally enter the country. Payoffs to illegally stay in the country. Payoffs to run unlicensed businesses. Etc etc.

 

It's commonplace.

Edited April 23, 2018 by TallGuyJohninBKK

[JAG]

1 hour ago, TallGuyJohninBKK said:

 

My my, those government funded ED prescriptions for the civil servant class are getting to be pretty pricey!

 

But hey, there's only a 5-fold difference in the health care budget allocated to civil servants vs. the health care budget allocated to UC recipients (low income Thais).

 

Civil servants are one of the groups in Thailand from which the Junta seeks to draw it's support...

[saminoz]

4 hours ago, JayBangkok said:

Why do civil servants and their families have far better benefits than social security members?

 

Civil servants do less stressful, less active jobs, worker shorter hours and retire earlier.

 

Bt12,676.06 compared to Bt12,676.06 is a lot of difference

"Bt12,676.06 compared to Bt12,676.06 is a lot of difference"

Acually, it is zero difference!  I'll be generous and assume that you went to a Thai school!

Edited April 23, 2018 by saminoz

[new2here]

 

I think you'd find, it's pretty much standard practice whenever government agencies are awarding contracts, building things, ordering supplies, engaging in financial business. Even aid to the poor gets skimmed. And lately, even some of the nation's top monks being accused of skimming goverment funds.  It's commonplace.

 

Again, perhaps it is... but I’ll restate what is my opinion (because there is no independent and objective data that addresses the issue - one way or the other) that when one looks at ALL civil servants and compares that to the percentage that have or continue to commit dishonest acts (be that embezzlement, unjust enrichment, fraud or the like) that these people do in fact represent the minority and not the majority of servants — but due to the public’s (rightful) distain, frustration and perception of lack of accountability to enforce law and to take meaningful acts to stop it, it tends to color the whole — which again, in my opinion, wouldn’t be supported by objective data.

 

In a very rough analogy, to me, it’s kind of like the taxi cab driver behavior issue... there is no doubt that misconduct to flat out criminal acts are committed by drivers... but.. I think at times what perhaps gets lost is that while it’s not to condone bad acts, but it is fair to say that those who commit said acts really are the minority... but again, due to issues like publicity, shock value, lack of enforcement/follow through by officials etc, the public perception drifts towards a view that it’s the majority, commonplace or how “most” operate.

 

 

 

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[yosuik]

Why even raise the price when you can just

 

1. Tax the Rich

2. Change Drug Laws for Cannabis and Medical Marijuana from Ilegal and Death Penalty Law to Decriminalize but with a Fine for Possession depending on amount, Tax on all Cannabis and Case-by-Case Rehabilitation Program aimed towards finding Individual Talents and Strengths along with Government funded Manufacturing and Study, Support Programs, New laws for Drug Free Zones or Areas, New Industries with use of Hemp.

3. Create a Penalty System based on the persons Wealth or Inheritance and Social Status.

4. Create a Government run Pharma company that will manufacture and provide the most basic medical necessities for cheap. and also CBD oils, edibles and sales of Space Cakes.

5. Create schools to learn work for jobs at Nursing and Care facilities

6. Run a government sponsored Cannabis Cup

 

[Sonhia]

The writing is on the wall.

 

That financial slippery slope could be looming nearer.

 

Time to buy expensive watches and rings.

 

What next?

[seajae]

health services should be free to all the poor and low income earners, tax should pay for it but tax is not paid by many thais so it does run into trouble, unless the govt can find a way to pay/cover for the costs involved they are between a rock and a hard place. Taxing the rich would be a great start but as many things are done by cash that would be hard to do too, the only real tax collected from any wages is the tax for govt workers and company workers as it is taken out automatically, really need to sort the tax system out so they can cover all the costs and keep free health care

[pornprong]

Edited April 23, 2018 by pornprong