Junta reform ‘may kill off universal healthcare’

By Pratch Rujivanarom 
The Nation

 

 

Thai Experts warn of impending threat

 

THE MILITARY-LED government of Prime Minister Prayut Chan-o-cha is hostile towards universal health coverage and is planning reform that could weaken the health security of citizens, health experts warn. 

 

Though there has been no drastic change to the health system under four years of National Council for Peace and Order (NCPO) rule, experts worry that universal coverage is set to be degraded to cover the poorest members of society only.

 

The junta’s hostile attitude was only part of the problem, academics and activists said. The health security of Thais was also threatened by the huge disparity between the three main health security schemes, while urgent action was needed to secure the sustainability of the current system.

 

Nimit Tien-udom, a rights defender from the People’s Health System Movement, said Thailand’s globally renowned public health system is under major threat from the NCPO’s reform plans. It was the public’s duty to protect this fine policy, he added.

 

“Our health security, especially the Universal Health Coverage (UC) scheme, is a highly beneficial system that stops people from going bankrupt through health expenses while allowing all citizens access to adequate and affordable healthcare,” Nimit said.

 

“However, as this regime has a military-bureaucratic background, they hold a hostile view of the system, especially the UC scheme which they see as a drain on the national budget. So they seek to weaken it.”

 

He revealed that the government was trying to amend the National Health Security Office (NHSO) Act and draft a bill to establish a National Health Policy Board. These reforms to healthcare would lead to more centralisation that would reduce public sector participation in health policy planning.

 

 

Premier Prayut has repeatedly said his government has no intention of revoking universal healthcare, but added that reform was needed to curb the increasing expense of the system.

 

Budget reform plans include restricting universal healthcare to the 14 million citizens registered as poor, and enforcing co-payment by patients.

 

Nimit cautioned that these changes would destroy the original intention to provide access to proper healthcare for all citizens and turn the system into humanitarian health assistance for the poorest 14 million, while in reality more than 48 million people currently depend on the UC scheme.

 

While co-payment was not an entirely bad idea, he added, patients should not be made to pay for care after getting sick, since this could cause them sudden financial crisis.

 

This year, the NHSO has received a Bt111.179-billion budget for the UC scheme, or Bt3,197 for each beneficiary. The Cabinet has approved next year’s budget of Bt166.445 billion, or Bt3,426 per head.

 

Ammar Siamwalla, senior health security researcher at the Thailand Development Research Institute, said reform was necessary to ensure the sustainability of the system.

 

However, Ammar said reform needed to prioritise lowering the disparity between our three main health schemes and ensure that all citizens, especially the middle class, benefit from the system.

 

If the government restricts health security only to the poor, the expense and quality of healthcare would be kept to the minimum, he said. But if all citizens, including the politically active middle class, were covered, they could play a powerful role in campaigning for the system’s improvement and ensuring good and affordable healthcare for all.

 

Source: http://www.nationmultimedia.com/detail/national/30346131

 

-- © Copyright The Nation 2018-05-24

Interesting.  My wife is in Loei and over 60, so she's been getting some freebies at the local hospital.  This week she volunteered to work check-in for free two days a week at a government hospital. Apparently, doctors don't like Mondays and Fridays, so Tuesday and Thursdays are it.  555

Money should be enough if they don't spend it on useless submarines.

Too many cosseted bloody "Civil Servants" is what the figures shout out to me !

Healthcare is one of the trickiest issues for a government to deal with, but it really shouldn't be. Study after study, example after example, test case after test case have shown that Universal Healthcare is the most effective way to go. It is hard to justify the spending of 3,197 Baht per person on a general health care scheme and 16,740 per person for a Civil Servant, especially considering all the other perks that civil servants receive.

 

Is the health of a Civil Servant more important than a non Civil Servant? That is a hard argument to make. Further, when you remove the administrators of the health system (the civil servants), you remove their impetus to maintain and improve the system; if it doesn't affect you, you don't care as much.

 

The simplest, most cost-effective, fairest system is the Universal Health Care system. Only when all citizens receive equal care will there be equality among citizens; deeming some citizens "more worthy" of government-funded health care is saying that they are more valuable as people; after dealing with many Civil Servants over the years, I can tell you from personal experience that they are not.

 

And for those who feel that their health care isn't 'good enough', then they can supplement their coverage themselves.

 

I can't help but think that there is a political motivation behind this; it is well-known that the health care system is credited to Thaksin and that is the reason that the Junta wants to weaken/damage/destroy it. That and the arrogant belief that all citizens aren't equal...

 

Edited May 23, 20188 yr by Samui Bodoh
Lack of coffee

This has been on the agenda for sometime.

 

The unelected gov't should be very careful if it is perceived that the increased cost/fees of the health service does not effect the vast hordes of 'Civil Servants' or those who can afford private medical services and who are gorging mightily at the trough.

2 hours ago, webfact said:

Junta reform ‘may kill off universal healthcare’

If a political party democratically voted in came up with such an idea, they would, pretty soon, be democratically voted out again, However, with this illegal junta, this is not possible.

I understand that there may be a need for some tweaking, but to me, the answer is obvious! Clearly the civil servants scheme is the biggest drain per capita. I believe that this scheme not only benefits civil servants, but also members of their families. If these people are truly servants to society, then they should be happy to relinquish some of their benefits for the good of society as a whole. After all they only require the same treatment as the rest of us to remain healthy!

Sent from my X98 Plus II (C2D6) using Thailand Forum - Thaivisa mobile app

That simple graphic showing the huge difference in per head spending for the civil service scheme needs to be shown all across the country on huge billboards. Its the finest example of just how 'special' these bureaucrats think they are and the entitlement they allow themselves despite having decent working conditions. They get 5 times as much as ordinary citizens, something that needs serious attention. I feel sure the average citizen is unaware of this disgusting unbalance which is just why we need a free and uncensored news coverage. 

Even many years after his departure, people are still benefiting from Thaksin's policy, and that's what hurts Prayut

 

The poor only care that Thaksin allowed them to live longer healthier lives. Not something that, in Thai politics, is as common as respiration.

 

No doubt the Prayutistas will refer back to Thaksin's war on drugs, but compared to deaths that abolishing the healthcare will cause, that was an act of sheer benevolence

‘may kill off universal healthcare’  I even didn't know that is exist in Thailand

3 hours ago, Samui Bodoh said:

Healthcare is one of the trickiest issues for a government to deal with, but it really shouldn't be. Study after study, example after example, test case after test case have shown that Universal Healthcare is the most effective way to go. It is hard to justify the spending of 3,197 Baht per person on a general health care scheme and 16,740 per person for a Civil Servant, especially considering all the other perks that civil servants receive.

 

Is the health of a Civil Servant more important than a non Civil Servant? That is a hard argument to make. Further, when you remove the administrators of the health system (the civil servants), you remove their impetus to maintain and improve the system; if it doesn't affect you, you don't care as much.

 

The simplest, most cost-effective, fairest system is the Universal Health Care system. Only when all citizens receive equal care will there be equality among citizens; deeming some citizens "more worthy" of government-funded health care is saying that they are more valuable as people; after dealing with many Civil Servants over the years, I can tell you from personal experience that they are not.

 

And for those who feel that their health care isn't 'good enough', then they can supplement their coverage themselves.

 

I can't help but think that there is a political motivation behind this; it is well-known that the health care system is credited to Thaksin and that is the reason that the Junta wants to weaken/damage/destroy it. That and the arrogant belief that all citizens aren't equal...

 

You forget one thing, the civil servants and the people in SSS pay into the system at a rate of 442 bt per month while the uninsured don't pay a dime. So in a way the people in SSS are subsidizing those that don't pay a dime. The civil servants take lower pay and by doing so get other perks. 

 

A social health program will only work when every one pays into it, too many "free loaders" will make a system too expensive. With ever new developments that make healthcare more expensive some limits have to be set. I feel that people who pay into a system should receive better care then those who don't.

 

So in a way already those paying into the system receive better care, the civil servants and the SSS people pay monthly contributions while those others don't. 

 

As for the junta wanting to kill it because its a Thaksin idea, not so sure Thaksin invented it but neither Thaksin or any of his later governments funded the program enough, hence the run of Toon. Fact remains the funds are just not enough and no government want to add funds because that means they have to cut somewhere else hence the pitiful state of some hospitals, add to that the fraud in hospitals and you get what we have now.

 

I do however think that lower military spending would be a good idea and add that to the health program. 

 

I am all for universal healthcare, but only if everyone has to pay for it (based on income with a certain cap) But even then you can't just do everything even in my country with universal healthcare there is always a shortage of money. Would you rather give a new hip to a 70 year old or help a young child for the money. Money is not unlimited and nobody wants higher taxes.

Junta just mean.

Poor people merit health care too.

This would be very typical of Little P. and his merry band of greedy nitwits. Universal health care was one of the few things that any Thai administration had done, to benefit the average Thai, and now they want to take that away. One can only wish them complete failure, with this bone headed move. Also, this could be the last straw, for the people. It is a move that could betray their true intentions, which is to protect the wealthy and elite. And the people could rise up, once and for all.

 

Kick them out. Get rid of them. They are not wanted. They are not popular. They are not needed. They are sucking the blood of their country.

Happiness to the (rich, well-to-do, elite, hi-so) people! 
Everyone else?  "Toe the line and don't complain - it's the Law."

6 hours ago, webfact said:

This year, the NHSO has received a Bt111.179-billion budget for the UC scheme,

Anyone notice that this amount is close to the new funding for Prayut's "Thai Niyom" scheme with a price tag of Bt100 billion, of which Bt2 billion will be paid to the officials charged with implementing it? "It is, in essence, an attempt to buy loyalty and will do nothing to improve livelihoods or productivity."

http://www.nationmultimedia.com/detail/opinion/30338781

So it's essentially buying votes at the expense of Thai people's healthcare.

The Thai people need to start connecting the "dots" behind the junta's generosities.

I would imagine this could hit a very raw nerve for those in need of heath care, and would suggest they don't even try to take it away.  It's not like they're taking away a tax break or something, it will be someones wife, son, grandmother.  The coaches would be loading up to visit BKK before they can blink.

Next time a monied government decision maker needs medical assistance I suggest they show willing and get in the queues at a Northern Gov't hospital and get a feel for their responsibilities.

 

If there is some rice worker living on subsistence they *have* paid their dues to the betterment of the country.  To deny that would be asking for trouble and it could easily spiral out of control.

6 hours ago, webfact said:

This year, the NHSO has received a Bt111.179-billion budget for the UC scheme, or Bt3,197 for each beneficiary. The Cabinet has approved next year’s budget of Bt166.445 billion, or Bt3,426 per head.

Healthcare budget this year is actually 164 B which was lower than what the NHSO asked. Meanwhile the defense budget roses by 5-7% since junta seized power to 214 B this year. In their Modernisation Plan, the army will increase existing budget spending of about 1.4% of GDP to 2%. More or less tell you that the priority is more for the military than for the health of the country. The 357,000 active military personnel must be taken good care while the 48 m peasants who depend on the UHC will have to fend for themselves. 

 

they are digging their own grave, prepare for another uprising if this does happen. Many folks wills suffer. Stupidity of the junta is speechless. Civil workers in Thailand are one of the most inefficient and paid too much for playing on social media whole day while leaving work early on almost daily basis.

This would be very typical of Little P. and his merry band of greedy nitwits. Universal health care was one of the few things that any Thai administration had done, to benefit the average Thai, and now they want to take that away. One can only wish them complete failure, with this bone headed move. Also, this could be the last straw, for the people. It is a move that could betray their true intentions, which is to protect the wealthy and elite. And the people could rise up, once and for all.

 

Kick them out. Get rid of them. They are not wanted. They are not popular. They are not needed. They are sucking the blood of their country.

Were you at Thammasat university yesterday spidermike007? If not then why not? They could use a man like you.

 

Civil service gets the perks because they bought their positions and are part of the corrupted buddy system. Sod peasants.

2 minutes ago, DrTuner said:

Civil service gets the perks because they bought their positions and are part of the corrupted buddy system. Sod peasants.

Indeed.

..and the peasants are being sodded..

If the people don't wake up to this nonsense and revolt, then an Ostridge with it's head in the hole is smarter. A higher deductible per income should be implemented. Even if it is 80baht.

 

They don't care about the people, they care about the elite.

11 minutes ago, Wilsonandson said:

Were you at Thammasat university yesterday spidermike007? If not then why not? They could use a man like you.

 

Unfortunately we are for the most biggest majority never will be able to become citizens as the bar is set to awkward and high, so spiderlike cannot band in with them.  

Universal Health care and Education are two things that should

be a priority for any civilised Government,both benefit all of the 

the population,a healthy,educated workforce is what any country 

needs.

What the country does not need,is buying of war weapons,that may

not be fit for purpose,that after a few years will be scrap,or not used,

few examples ,the Blimp,the Aircraft Carrier,Bomb detectors,expect

the Chinese Subs will be added after they arrive.

regards worgeordie

Just to add to the story, this is news brought out by governmental critics, nothing has been engraved in stone yet as no proposals have been processed by the parlement. If you read carefully, it only says that it might happen. as for civil servants, most salaries are capped and are low for the work done, so in exchange they receive some perks, but in the matter of healthcare, the civil servants do pay quite a lot to the system.

Hi speed trains , subs, armoured vehicles come to mind

It will never happen, the army wouldn't be able to hold back 48 million Thai's. Thats why the government will never break up the NHS, even if they are trying to, Brits won't allow that too!

37 minutes ago, natway09 said:

Hi speed trains , subs, armoured vehicles come to mind

yep!