30-baht scheme in hot water: is Thailand’s gold card running out of cash?

[webfact]

Thailand’s universal healthcare policy, known as the 30-baht gold card scheme, faces scrutiny over its financial sustainability and adequacy in providing security to all citizens. Health experts call for a reform to ensure the scheme’s long-term viability.

 

This populist policy, launched by the Pheu Thai Party more than two decades ago, strives to offer equitable medical treatment for Thai citizens, particularly the economically disadvantaged, without the burden of financial stress. Introduced in 2002, the programme initially required a co-payment of 30 baht per visit, a fee that was later abolished, granting cardholders free access to medical services.

However, a network of hospitals and medical staff has raised concerns about the scheme’s impact on state-owned hospitals. Increased patient visits, staff shortages, and financial deficits have become significant issues. The group urged the Ministry of Public Health to intervene, warning that the universal healthcare scheme is at risk of collapsing.

 

The group highlighted several contributing factors, including rising medical treatment costs, an increasing number of patients with complex illnesses, a growing elderly population, and a shrinking taxpayer base.

Academics and medical experts have echoed the need for reform to secure the scheme’s financial future. Dr Somsak Tiankao from Khon Kaen University’s Srinagarind Hospital reported annual losses of approximately 100 million baht due to an overwhelming patient load. Since the implementation of the cancer everywhere policy, patient numbers have surged by 400%, making it challenging for medical staff to provide adequate care, said Dr Somsak.

“The number of cancer patients annually increased from 6,000 to 25,000, leading to long queues and delayed treatments.”

 

Ageing society

 

To offset financial losses, many state-owned hospitals have resorted to establishing special clinics for out-patients and seeking public donations.

 

Dr Somsak warned that without remedies, his hospital might have to lower its standards, potentially limiting laboratory use and daily patient visits.

 

“We might face a situation in the next five years where an ageing society exacerbates medical costs due to more complex diseases. Worse, we might see strikes from overworked medical staff.”

He suggested that the new government consider allowing patients under the universal healthcare scheme to pay additional fees beyond the 30-baht co-pay ceiling to alleviate the state’s financial burden.

 

“Medical treatment should not be free for all; those who can afford better services should be allowed to pay extra.”

Dr Supat Hasuwannakit, president of the Rural Doctor Society, pointed out that the budget allocation for the universal healthcare scheme is about 7% of the 3-trillion-baht fiscal budget, roughly 200 billion baht. Despite an annual increase of 3%, this amount remains insufficient to sustain the scheme.

Emergency funds

Dr Supat proposed that the government provide emergency funds to support state-owned hospitals in the short term and invest more in community and medium-sized hospitals for long-term sustainability.

 

“The prime minister should upgrade the universal healthcare scheme, a hallmark policy of the party, and design a master plan for healthcare security to ensure sustainable healthcare in the country.”

 

Nuttanan Wichitaksorn from the Thailand Development Research Institute noted that many hospitals under the Universal Health Scheme and the Social Security Fund have reported significant losses due to inadequate government funding. Nuttanan suggested that the National Health Security Office (NHSO) manage the healthcare budgets for better efficiency.

“There should be some reform to the nation’s healthcare scheme to avoid future financial instability. The scheme is crucial for providing Thai people with access to proper medical treatment.

 

“We should wait and see what the next steps for the scheme will be.”

 

The Thailand Development Research Institute recently projected that without promoting healthy lifestyles among the population, the country’s healthcare expenditure could reach 2.2 trillion baht by 2032, reported Bangkok Post.

 

by Bob Scott

Picture courtesy of Healthcare Asia

 

Source: The Thaiger 2024-08-19

 

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[Pouatchee]

another puke thai populist vote buying scheme about to collapse?

[Dcheech]

Good to see a Bob Scott byline. A premier albino primate, churning out content about Thailand topics.

Bravo 

[Sydebolle]

30 Baht health scheme uncertain? 
10,000 Baht digital cash - a post-election vote-buying? 
20 Baht Red Line fares and the trains still empty?
3 submarines from China without engines for the navy?

F35 air fighters on the wishlist of the Air Force?
A prime minister evicted for appointing a (former) criminal into his cabinet? 
The same government tolerates a convicted smuggler of 4 kgs of heroin as a minister? 
A rich kid killed a police officer on duty on 12 September 2012 and has been on the run without any chance of "getting apprehended"; if luck has him, the statutory limitations will expire in less than three weeks. 

All this in the same country where millions of people cannot make ends meet as the oligarch elite keeps moving the ends? 

[Captain Flack]

A reported off topic post, again trying to push their US political views has been removed. If you can not stop trying to hijack topics I will have no alternative but give you a time out.

[roo860]

7 minutes ago, Sydebolle said:

30 Baht health scheme uncertain? 
10,000 Baht digital cash - a post-election vote-buying? 
20 Baht Red Line fares and the trains still empty?
3 submarines from China without engines for the navy?

F35 air fighters on the wishlist of the Air Force?
A prime minister evicted for appointing a (former) criminal into his cabinet? 
The same government tolerates a convicted smuggler of 4 kgs of heroin as a minister? 
A rich kid killed a police officer on duty on 12 September 2012 and has been on the run without any chance of "getting apprehended"; if luck has him, the statutory limitations will expire in less than three weeks. 

All this in the same country where millions of people cannot make ends meet as the oligarch elite keeps moving the ends? 

Absolutely, well said!!!!

[hotchilli]

3 hours ago, webfact said:

This populist policy, launched by the Pheu Thai Party more than two decades ago, strives to offer equitable medical treatment for Thai citizens, particularly the economically disadvantaged, without the burden of financial stress. Introduced in 2002, the programme initially required a co-payment of 30 baht per visit, a fee that was later abolished, granting cardholders free access to medical services.

Another populist policy.

[2baht]

4 minutes ago, hotchilli said:

Another populist policy.

Yeah............but where's the money???

[hotchilli]

Just now, 2baht said:

Yeah............but where's the money???

Patient originally paid 30 baht, hospital claims the full cost from the government?

[worgeordie]

The majority of the population will be very angry if they

cancel the 30 Baht ,so they need to stop buying Military

crap ,the Sub can go first ,and put money into peoples

health ,what's more important ?

 

regards worgeordie

[Tropicalevo]

3 hours ago, Pouatchee said:

another puke thai populist vote buying scheme about to collapse?

Sorry, but I cannot really see how giving people affordable medical care is deemed to be vote buying.

The UK did it years ago.

It is a genuine benefit to all citizens regardless of wealth.

Giving cash handouts to some is definitely vote buying.

[Lacessit]

IMO the Thai government should tread very carefully.

 

While Thais are reasonably apathetic about most government follies, this is the kind of issue that can topple governments, and start revolutions.

 

Almost invariably, revolutions are seeded by economic hardship of one kind or another. It's a common feature of the French, American and Russian revolutions.

[MikeandDow]

49 minutes ago, 2baht said:

Yeah............but where's the money???

In submarines ,Planes and other military gear that Thailand does not need

[Khyron]

It has been a great scheme so far, my SIL has had radiation treatment for the last few years for a brain tumor, almost gone. They have had to pay maybe 9000 Baht in those two years, otherwise they would never been able to afford it.

 

The hospitals do ask for donations though, rightfully so.

 

8 years ago maybe, my wife got a migraine one night. The ambulance from the amphur was called, decided the best course of action was to take her to Chumpae, about 45 minutes away. Got to the gov't hospital in Chumpae, they gave her a shot of Toradol, cleared it up in 30 minutes. 

 

When she was getting back into the ambulance for a ride home (included), she asked how they could afford it, this whole thing cost her 30 baht, they said donations helped.

Luckily, she had her purse and gave them B10k, they were properly shocked as most donations were in the 100's.

The people in the Gov't hospitals do a great job from what we see, no problem whatsoever for them to ask for some gratuity.

[MikeandDow]

4 minutes ago, Khyron said:

It has been a great scheme so far, my SIL has had radiation treatment for the last few years for a brain tumor, almost gone. They have had to pay maybe 9000 Baht in those two years, otherwise they would never been able to afford it.

 

The hospitals do ask for donations though, rightfully so.

 

8 years ago maybe, my wife got a migraine one night. The ambulance from the amphur was called, decided the best course of action was to take her to Chumpae, about 45 minutes away. Got to the gov't hospital in Chumpae, they gave her a shot of Toradol, cleared it up in 30 minutes. 

 

When she was getting back into the ambulance for a ride home (included), she asked how they could afford it, this whole thing cost her 30 baht, they said donations helped.

Luckily, she had her purse and gave them B10k, they were properly shocked as most donations were in the 100's.

The people in the Gov't hospitals do a great job from what we see, no problem whatsoever for them to ask for some gratuity.

Totally agree first class service

[PETERTHEEATER]

2 hours ago, hotchilli said:

Another populist policy.

And one of Thaksin's whhen he eas PM.

[khunPer]

Probably more both wise and important to distribute some money to here than in a digital wallet...

[LukKrueng]

4 hours ago, hotchilli said:

Patient originally paid 30 baht, hospital claims the full cost from the government?

Patients still have to pay the 30 THB per visit. It was stopped for a short time and later reintroduced. 

And seems more the government freed about m450 THB so it gives them at least 4 more years to operate the 30thb scheme....

[Emdog]

"Another populist policy"... really? There is a wing of the political beast that believes nothing of benefit should be done for the people, as it is "populist". Maybe I am old school, but government is there to implement what individuals cannot do on their own. The 30 baht plan is popular beyond words. You dinos would prefer people to die in poverty, unable to afford medical care? And meanwhile support porkbarrel projects like submarines, fighter planes, high speed rail when normal rail doesn't work.... that is all good, but something that can directly impact people in a positive is a no no.

"Give the people something that greatly improves their lives and they'll want more. Next thing you know they will want good schools. Nip this in the bud"