Doubts rise over new law covering healthcare

By The Nation

 

 

The government is obviously overburdened with medical schemes, but is reform proceeding as it should?

 

Critics of the Cabinet-approved bill to set up the country’s first “super-board” to govern all healthcare schemes have expressed doubt about its genuine objective, especially with regard to the future of the current universal healthcare scheme covering 48 million citizens.

 

The universal healthcare system is the largest of the three systems currently on offer, with a budget this year of Bt140 billion. The others are the social security system covering about 13 million employees, with an annual budget of about Bt50 billion, and the state healthcare system serving five million civil servants and their families, with an annual budget of Bt70 billion.

 

Under the proposed legislation, legal authority over all three healthcare plans will be consolidated to allow the government to restructure them. The so-called super-board will consist of 45 directors who mainly represent the government, state agencies and healthcare professionals, with just three or four seats reserved for representatives of non-governmental organisations, and they are supposed to protect the interests of universal-healthcare beneficiaries.

 

For years, the universal healthcare system has been a major welfare benefit for the majority of low-income people. Their dependence on and access to reasonably priced public health services are essentially guaranteed. However, such a system is costly to the state, with budget reimbursements constantly on the rise and this year reaching Bt140 billion. The increases are likely to continue in coming years and as such pose a serious fiscal issue for the government.

 

Efforts have been under way to reform the universal system to ensure that only citizens in genuine need qualify for free-of-charge healthcare services.

 

The aim is to ease the burden on the state budget, especially with regard to ever-rising future budget requirements, given the challenges that must be met as the population becomes predominantly elderly. Thailand is now an ageing society, entering an advanced stage of it, and the cost of welfare will reach new peaks.

 

One of the reform goals is to require middle- and upper-middle-income earners to pay a share of their own expenses for healthcare provided under the universal system. So far, the government has built a national database covering 11 million or so low-income earners – people earning less than Bt100,000 per year – who would be eligible for free healthcare.

 

Regarding the social security system’s healthcare benefits, there are now about 13 million members who co-pay based on their salaried income. Civil servants and their families use the state healthcare system, which provides the most generous benefits, resulting in the highest cost per head.

 

There are about five million beneficiaries in this system whose expenses are as much as Bt70 billion – an average cost of Bt14,000 per person per year compared to an average of Bt2,916 under the universal healthcare system covering 48 million people and Bt3,846 for about 13 million people under the social security system.

 

As the bill on consolidation of power governing all three healthcare systems goes before the National Legislative Assembly prior to its enactment, critics are concerned that the interests of those served by the universal healthcare and social security systems are unlikely to be adequately defended.

 

Source: http://www.nationmultimedia.com/detail/opinion/30356745

 

-- © Copyright The Nation 2018-10-19

Health Care is a complex, emotive and difficult issue to manage, and the process will only get more difficult in the future as societies age.

 

However, Thailand has one HUGE flaw in its system which needs to be corrected immediately; the people who manage the health care scheme (the Bureaucrats) have their own, special scheme to cover themselves and their families. Why is this a flaw? It is human nature, compounded by bureaucratic training and thinking, to ensure that the benefits received by the Bureaucrats and their families will always take priority over the benefits provided to the general public. The solution? Immediately disband the special provisions for the Health Care of Bureaucrats and force them to use the same, universal system as everyone else.

 

There are those who feel that it is legitimate to offer special health benefits to Bureaucrats as part of their salary and benefit structure. If a person does believe that (it is incomprehensible to me; I think Thai Bureaucrats are already wildly over-paid and over-benefited), then perhaps increase their salaries to cover the lost health benefit.

 

Simply put, if the people who manage the Health Care scheme, the Bureaucrats, have proverbial 'skin in the game', they will ensure the best possible system allowed under their budget(s). If the Bureaucrats have their own, special, independent system, they will ensure that their special, independent system works best and neglect the general public's Health Care scheme.

 

This is an easy reform to enact and one that will provide for immediate, positive benefit to "Somchai on the street'.

 

 

Edited October 18, 20187 yr by Samui Bodoh

3 hours ago, Samui Bodoh said:

However, Thailand has one HUGE flaw in its system which needs to be corrected immediately; the people who manage the health care scheme (the Bureaucrats) have their own, special scheme to cover themselves and their families.

Would have thought nobody paying into or collecting taxes for it would be a bigger flaw.

If there's an unpopular law mooted like pet control or pick-up passengers, the vocal opposition causes it (the offending law) to be shelved.  Where is the clamour over this important issue?

On 10/19/2018 at 4:16 AM, webfact said:

The universal healthcare system is the largest of the three systems currently on offer, with a budget this year of Bt140 billion. The others are the social security system covering about 13 million employees, with an annual budget of about Bt50 billion, and the state healthcare system serving five million civil servants and their families, with an annual budget of Bt70 billion.

What I find amazing is that 18 million 'upper-crust' people are entitled to ฿130 billion of the healthcare budget, and that the other 58 million Thais are entitled to ฿140 billion of the healthcare budget.  And the government is seeking ways to decease that ฿140 billion for the majority of Thais because it's draining the system?  Really?  ????

The system isn't perfect but it works. I pay social security every month and get free treatment as result of my contributions. Those that don't pay tax shouldn't get help, unless it's a really big emergency or choose to go down the private path. Citizens of Thailand should all pay tax regardless of what they do as a job. If they make an income then they should be subject to tax, it's only fair.

 

Foreigners who don't contribute to the system (if not working or tourists) should have mandatory private insurance as part of their conditions to apply for a visa or extension of stay in the Kingdom. Naturally Non-B/O visa holders should have 800,000/400,000 THB in the Thai account to not only provide proof that they have sufficient funds, but to provide a guarantee if in the event they become ill and require medical treatment, that they do not become a burden to the state.