Four Bangkok Hospitals Abandon Universal Health Care

[webfact]

Four hospitals abandon universal health care

By Puangchumpoo Prasert

The nation

BANGKOK: -- Four private hospitals in Bangkok have withdrawn from the government's universal health care program, blaming heavy workloads and financial burden.

The withdrawal has affected 199,269 people, who were entitled to receive free treatment but will now

be transferred to other healthcare service providers.

"We are solving the problem. Everything should run smoothly by April," Dr Suradej Walee-ittikul said yesterday in his capacity as director of National Health Security Office's Area 13 Bangkok.

Under the universal healthcare programme, healthcare-service providers received an annual flat subsidy of Bt2,202 from the government per patient assigned to their care.

This year, the subsidy will be increased up to Bt2,400 per head. However, to many healthcare-service providers, the subsidy is still too little.

Suradej said the Kasemrad Prachachuen, Kasemrad Bang Khae, Kasemrad Sukhaphiban 3, and Srivichai 2 hospitals had suggested since late last year they would withdraw from the universal healthcare programme.

The Kasemrad hospitals, so far, have agreed to continue treating patients referred to them under the programme. In cases of referrals, the hospitals can seek payment from the referring healthcare-service providers.

Suradej said although these four hospitals had withdrawn from the programme, the Mongkutwattana Hospital had already jumped in to fill the gap.

"It's going to be a new choice for people," he said.

Suradej said his office had asked the four withdrawing hospitals to provide patient files to the new healthcare-service providers to which the patients would be transferred.

-- The Nation 2010-02-17

[newsfooter][/newsfooter]

[SomTumTiger]

One of the missing elements in the whole "Thaksin is great because he brought us university health care" is that none of the governments, starting with Thaksin's own, funded the program to the level it needed to be. Many of these programs are saying - to hel_l with this, and rightly so. Save the money the navy wants for submarines, and fund this program better.

[geriatrickid]

One of the missing elements in the whole "Thaksin is great because he brought us university health care" is that none of the governments, starting with Thaksin's own, funded the program to the level it needed to be. Many of these programs are saying - to hel_l with this, and rightly so. Save the money the navy wants for submarines, and fund this program better.

Forget about Thaksin. The national health scheme wasn't even his idea. He took it from the social activists and rural doctors association proposal. He gets credit for listening to the "experts" and that's about it. Alot of the scheme was the product of faceless civil servants that were there before Thaksin and that were there after him. The bureaucracy guesstimated the national health status.

The governments that followed Thaksin, could have dealt with the situation and could have proceeded with the planned funding increases but they didn't . The mess was dumped on Finance Minister Korn's plate some time ago. He was the one setting the funding priorities and he didn't deal with the situation.

Now to understand what the problem is and why finance ministers are ducking the problem. Let's go back to 2008;

Dr Pongthep, Nanoi Hospital director (Nan Province) and rural physician ;

While the universal health care concept was noble in principle, it was put to work in the wrong direction from the start. The scheme was aimed at providing medical services for the young, the elderly and the unemployed. With only a limited budget of about 2,300 baht per head per patient, up from an earlier 2,100 baht, it was impossible for the state to provide medical treatment for chronic and costly illnesses such as cancer, heart disease and kidney dialysis, especially for poor villagers in remote areas.

Quoted by Apiradee Treerutkuarkul, Bangkok Post 8 April, 2008.

It's like the nation is in a state of denial. What this story does is to peel back the curtain on a secret no one wants the people to know: There are an awfully lot of physically ill people in this country and they are poor. The current format won't work. Healthcare is already being rationed. Some people (one "male" in particular) pissed all over me when I pointed out almost a year ago, that HIV+ patients in rural areas did not have access to care. Well, now the cat's out of the bag aint it.

Think about the social and economic ramifications of the present situation. The current political mess is not just about Thaksin, but is about the direction a nation will take. Will the money be invested in moving the nation forward, in social programs as promised by PM Abhisit or will it continue to be sucked off by the priviliged few, corrupt officials and the military's bloated budget?

[TAWP]

geriatrickid>> We are many that has always said that the lines 'he gave them universal healthcare' was incorrect, thanks for agreeing. Now if only the 'Taksin' magazine would write a retraction too...

[hammered]

Nobody ever thought how the funding for the scheme would be raised. A national health scheme needs to be funded by taxation or some soical insurance shceme. The social security scheme actually does have funding worked out to some degree altrhough I was perosnally advised by a private hospital doctor not to nomiante a private hospital for the social security scheme as money only went so far.

The funding for the universal health shceme was never there from the start and when the scheme was introduced a lot of doctors at rural based hospitals left for the sunnier climes of urban based private hospitals. It wasnt necessarily that they wanted to but that they faced a choice of either bankrupting the local hospital by proper treatment or passing out the paracetemol and saying dont worry. Not much of a choice. The people in areas I know about always joked it was 30 baht paracetemol for everything although to be fair a few basic operations did get done for 30-baht although complications after seemed a tad high and people quickly learned to ask doctors the code "is there any special treatment I can get if I pay a bit more".

It is a hard life in rural areas especially if you are sick.

There were salso connections between powerful polticians who were involved in intorducing the scheme and private hospitals although not Thaksin himself. The introduction gainmed the private hopsitals good doctors and the crammign of usually state hospitals by the poor encouraged those who could afford it to move to private health. A nice little earner all round.

Quite a few private hospitals registered under the scheme but in paractical terms didnt really get that involved. Even in

urban areras most of the really poor have house papers for another province and iirc you got your gold card from the province you were house papered in and could only use it once per year outside that province (if you were lucky)

The implementation of the whole thing has been terrible/. Remeber when it came out that it cost more by charging 30 baht than being free as an adminstration had to be set up to administer the money that cost more than the all 30 bahts received?

I have talked to loads of doctors about this scheme and the nicest thing I have ever heard was "its just politics".

Then again governments the woprld over like to give things but tax is a word they dont like to mention and even in the US they are struggling to ensure health coverage will be provided for all and that is hundreds of years after democracy and constitutions were introduced

[Scott]

I think it was P.J. O'Rorke who said "If you think health care is expensive now, just wait and see how much it costs when it's free."

[Jingthing]

I think it was P.J. O'Rorke who said "If you think health care is expensive now, just wait and see how much it costs when it's free."

He was wrong. The US system proves it. The only industrialized country without universal health care, the most expensive system in the world, leaving a out a huge chunk of the population from access to care, with poor results in disease rates and life expectancy.

[TAWP]

I think it was P.J. O'Rorke who said "If you think health care is expensive now, just wait and see how much it costs when it's free."

He was wrong. The US system proves it. The only industrialized country without universal health care, the most expensive system in the world, leaving a out a huge chunk of the population from access to care, with poor results in disease rates and life expectancy.

The most expensive system in the world? That sounds like hyperbole.

But the current US model is a clear side-effect of corporatism, when corporations and politicians try to pervert the open marketplace. And now they want to replace it with an equally flawed solution. But I digress...

[Alwaysright]

I think it was P.J. O'Rorke who said "If you think health care is expensive now, just wait and see how much it costs when it's free."

He was wrong. The US system proves it. The only industrialized country without universal health care, the most expensive system in the world, leaving a out a huge chunk of the population from access to care, with poor results in disease rates and life expectancy.

The people of the US do not take care of themselves,this is the major reason for the costs.Get your facts straight before making comments.You can get the best medical care in the world in the states,but you have to plan for it,and it has to be paid for,the people that don't have health insurance,should not get proper care.

[Jingthing]

The most expensive system in the world? That sounds like hyperbole.

It is fact. Private (non-employment based) health insurance in the US is not available at any price to people with preexisting conditions and the insurance is tied to employment, so those who lose employment, lose their coverage.

http://www.commonwealthfund.org/Content/Pu...ance--2008.aspx

The U.S. spends twice per capita what other major industrialized countries spend on health care, and costs continue to rise faster than income. We are headed toward $1 of every $5 of national income going toward health care. We should expect a better return on this investment.

Across 37 indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States.

Edited February 17, 2010 by Jingthing

[Credo]

Jingthing you are wrong on the insurance issue. If you are insured and you lose your employment you can continue in the health care plan. There will be no partial payment by an employer, so you get to shoulder the entire cost.

Many of the group plans are not through a single employer. Small companies usually join with other groups to form one larger group plan.

[Jingthing]

Jingthing you are wrong on the insurance issue. If you are insured and you lose your employment you can continue in the health care plan. There will be no partial payment by an employer, so you get to shoulder the entire cost.

Many of the group plans are not through a single employer. Small companies usually join with other groups to form one larger group plan.

There is a short term continuation available for private purchase. It is Cobra, a government mandated option. If the insurance companies had their way, they wouldn't offer it. After the time period ends, the availability to purchase it ends. Most laid off people cannot afford the payment anyway. Also now there are many millions of Americans who have been unemployed for years now who have given up, and with good reason. Not to mention the huge percentage of employment situations that do not offer coverage, less than full time hours, small employers that simply don't offer anything, and contract work, etc.

Edited February 17, 2010 by Jingthing

[Scott]

I am not commenting about the rightness or wrongness of health care. I am simply quoting someone on the cost. At this point in time, Thailand seems to be experiencing this.

[ding]

The most expensive system in the world? That sounds like hyperbole.

It is fact. Private (non-employment based) health insurance in the US is not available at any price to people with preexisting conditions and the insurance is tied to employment, so those who lose employment, lose their coverage.

http://www.commonwealthfund.org/Content/Pu...ance--2008.aspx

The U.S. spends twice per capita what other major industrialized countries spend on health care, and costs continue to rise faster than income. We are headed toward $1 of every $5 of national income going toward health care. We should expect a better return on this investment.

Across 37 indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States.

American Helthcare is so rotten and broken that it's really criminal. The rich get very good care, the rest get PIA garbage care. Many are going to emergency rooms for care, the MOST expensive. Young and healthy adults don't bother paying the abusive fees. So the cherry picking providers kick the old off, and then jack up rates 29% a year.

And fixing this is somehow socialist? No, when I read a Thai saying this privatizing is providing choice, I think of the mafia choice; Lead or Gold.

Those who blame Americans for not taking care- are blaming the victims. Victims of propaganda first, allowing the 'free market' lie to go into law. I hope Thais are relentless fighting this vampiric system of healthcare denial. That's how they make money, deny care to the sick. Don't get sick, old, or lose your job!

COBRA temporary extension lets you buy into a cheaper group plan for a bit. Last I checked mine was to be 25,600 Baht a month. Consolidated Omnibus Budget Reconciliation Act; to make it affordable when you have NO JOB!

Edited February 17, 2010 by ding

[YORKSHIREPUD]

Jingthing you are wrong on the insurance issue. If you are insured and you lose your employment you can continue in the health care plan. There will be no partial payment by an employer, so you get to shoulder the entire cost.

Many of the group plans are not through a single employer. Small companies usually join with other groups to form one larger group plan.

There is a short term continuation available for private purchase. It is Cobra, a government mandated option. If the insurance companies had their way, they wouldn't offer it. After the time period ends, the availability to purchase it ends. Most laid off people cannot afford the payment anyway. Also now there are many millions of Americans who have been unemployed for years now who have given up, and with good reason. Not to mention the huge percentage of employment situations that do not offer coverage, less than full time hours, small employers that simply don't offer anything, and contract work, etc.

Why are you and your rambling friends going on and on and on about the US system,this is about THAILAND, not THE usa ?

[Jingthing]

Why are you and your rambling friends going on and on and on about the US system,this is about THAILAND, not THE usa ?

As a rebuttal to the poster who asserted that government run health care is always the most expensive. Clearly, it is not the case.

[connel707]

Why are you and your rambling friends going on and on and on about the US system,this is about THAILAND, not THE usa ?

As a rebuttal to the poster who asserted that government run health care is always the most expensive. Clearly, it is not the case.

We are all grown-ups, and as such, should be 100% responsible for our own health or health care... we will all die one day ...suicide is painless and free...... if you need help... call me..!!

[katana]

I think it was P.J. O'Rorke who said "If you think health care is expensive now, just wait and see how much it costs when it's free."

He was wrong. The US system proves it. The only industrialized country without universal health care, the most expensive system in the world, leaving a out a huge chunk of the population from access to care, with poor results in disease rates and life expectancy.

The figures seem to back up Jingthing here:

http://knowledge.allianz.com/en/media/graphics/31/detail/

http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

Edited February 17, 2010 by katana

[peecee]

One of the missing elements in the whole "Thaksin is great because he brought us university health care" is that none of the governments, starting with Thaksin's own, funded the program to the level it needed to be. Many of these programs are saying - to hel_l with this, and rightly so. Save the money the navy wants for submarines, and fund this program better.

First post & it's already Mr T's fault!

[TAWP]

One of the missing elements in the whole "Thaksin is great because he brought us university health care" is that none of the governments, starting with Thaksin's own, funded the program to the level it needed to be. Many of these programs are saying - to hel_l with this, and rightly so. Save the money the navy wants for submarines, and fund this program better.

First post & it's already Mr T's fault!

If he and his Red Shirts is the first to try to take credit for it in every news article that is printed about him, then surely he must be the first one to accept the blame when it fails?