Thai Hospitals Facing Serious Cash Crises

[george]

Thai hospitals facing serious cash crises

No funds to buy medicines or supplies

http://www.thaivisa.com/index.php?514&backPID=10&tt_news=607

BANGKOK: Thailand's hospitals are facing a financial crisis caused by the government's cut-price healthcare scheme which has left them without enough funds to buy medicines or supplies, officials said today.

Kriengsak Vacharanukulkieti of the Rural Doctors Society said that of some 700 community hospitals, one in three was facing serious problems due to the "30 baht" healthcare initiative.

"The loss of funds has caused these hospitals to go into debt, and pharmaceutical companies are now refusing to give them any more medicines," he told AFP.

The controversial healthcare scheme, which allows Thais to see a doctor for just 30 baht (75 cents) was one of Prime Minister Thaksin Shinawatra's headline policies when he swept to power in January 2001 elections.

But the populist initiative which is credited with helping him win the ballot has faced repeated criticism from political observers and healthcare experts, who say that it is not financially viable.

Kriengsak said smaller hospitals were being bankrupted because the government funded them according to how many patients they treated, while bigger hospitals raised revenue by offering additional fee-paying services.

"Most of the affected hospitals are in the northeast, and their income is less than their expenses," he said, referring to the country's impoverished rural region.

The worst-affected hospital, in Amnat Charoen province, has run up a huge debt and has been forced to put up a sign apologising to patients for the shortage of medication and poor service levels.

Hospital staff told The Nation newspaper in a front-page report that they had been trying to inform the government about the problem for a year but had not received a response.

Source: Agents

[chaamjamal]

hello

i am a calpers retiree in thailand worried about health insurance

i would be interested to know if there are other calpers membes here

and to find out which calpers healthcare option works in thailand

i am thinking blueshield since bupa bluecross is active here

any help greatly appreciated

cheers

chaam jamal

[Guest IT Manager]

Many hospitals have a person responsible for advising about hospital cover. If you have a favourite hospital go and ask them about it. They will also let you know who they have direct relationships with so the paperwork for you is easier.

[DaveYo]

Hi all, this news being given about the hospitals was forthright and coming. I sort of expected this more or less. How much is worth believing is measurable. I do know if you buy the prescriptions at the hospital it is about three times that out in the street pharmacy.

Secondly the real deal here is that I know of in Bangkok you cannot leave the hospital without paying your bill because they technically escort you to the bill and payment department and the hospital staff hands over the paperwork to such person. The patient never gets the bill itself until such is paid.

Now if they are facing a crisis, I wonder. It is possible when out of the main city going north and west or east or South for the matter like 250KM out or more this might be the case due to the limited facilities and ability to render complete medical care. I don't think it has anything to do with the management or what the hospital can provide. I do believe the hospital receives a certain quota from the government as of funds and now that particular funds are well depleted thus creating a cash shortfall.

This may be the beginning of the financial crisis that I have predicted will be coming in the future days ahead. They also have committed themselves to so many projects that is making huge expenses, besides hosting a summit there etc., something has to give.

My guess is the Thai government now is going to do "the shuffle" meaning moving any funds around to cover debts. Once they start doing this after a time it is going to become like a virus and many more projects or funds will soon be facing a financial crisis when due.

Recovery of this money is mainly relied upon tourism. If for some reason this drops so does the revenue. A very bad situation indeed to be forced relying on tourism. The taxes that they receive is of such amount but not enough to buffer the cash shortfall so it is not worth mentioning except coming from major corporations.

Since Thailand came out of the IMF itself, they have been on a huge spending spree the last couple months. Of course USA may have given them a pledge of 10M dollars, but it might be in installments rather than one lump sum.

These problems begin to surface towards the end of the terms of individuals who are in office. I am surprised that the PM got elected because of his campaign saying 75 cents to people for hospital care gets him elected. Whew.

Therefore I would like to suggest to all the Expats out there to be watchful of the Government in the future days ahead concerning the FINANCIAL REPORTS, because this indicator does tell you its stability and future events.

I am not a financial analyst but remember 'THE ALAMO" of the past collapse. Once the fracture begins and such not repaired quickly, it will get bigger till it gets out of hand. So I say this is the beginning of the fracture.

Daveyo

[MekhongKurt]

I have to agree that the fracturing has begun. And it's really stupid; all anyone has to do is consider the fate of the Soviet Union, with it's socialized medical scheme. The Chinese got it better, in that the government used to employ everyone, and paid less money in salaries to be able to cover medical [and other] expenses, but even they are having trouble now that they've shifted to a capitalist economy [loathe though they are to *admit* they've gone capotalist].

[george]

The Nation reports further today:

Ministry admits to healthcare fund crisis

Published on Nov 11, 2003

The Public Health Ministry yesterday admitted the Bt30-per-hospital-visit healthcare scheme was facing a financial crisis and placed the blame on the National Health Security Office (NHSO), saying it had delayed distributing the funds budgeted for the scheme.

"There are a number of hospitals that are facing financial crisis . . . but I'm not sure if the amount is as high as was reported by the Rural Doctors Society," said Dr Anan Ariyachaiphanitch, deputy permanent secretary for Public Health.

Anan said that in response to news reports that about a third of the hospitals participating in the scheme were in a state of financial crisis, he had asked the Rural Doctors Society to hand over financial reports from those hospitals, copies of which had already been given to the media.

However, he added that the ministry was set to distribute Bt800 million-Bt900 million to the 800 hospitals under the scheme as a final instalment of the funds budgeted for fiscal 2003, which ended last month. The NHSO only transferred the money to the ministry last week and the ministry is preparing to distribute it to the hospitals.

"We have enough money but it will be late because we received it late," he said. Under the Bt30 scheme budgetary funds are normally distributed through the NHSO every two months. The Public Health Ministry acts as a purchaser, receiving the funds to buy healthcare services.

In addition to the budgeted funds, about Bt5 billion has been set aside to help hospitals that require additional funding. The budget this year has been increased from last year's Bt1,202 per patient per year to Bt1,308 per patient.

Meanwhile, Dr Kiengsak Vacharanukulkieti, the head of the Rural Doctors Society team that announced the crisis, said there was no need to check the reports he released because the Public Health Ministry already had copies.

He said the director of Pathum Ratchawongsa Hospital in Amnat Charoen had come under pressure from his superiors after the media reported on a sign posted at his hospital apologising to patients for a shortage of medical supplies.

[DaveYo]

Oh Wow, far out! Check this I just read 800M baht to be distributed to 800 hospitals which mean each one gets 1M baht. ????????????

How long will that last???? They only receive funds every two months? I wonder if this means they distribute the allocated funds only 6 times a year to these hospitals which means they only get B166,667 every 2 months. Now what kind of program is that to the people. Now if it is 1M baht every two months that means only B500,000 each month so translate that to days is onlyB16,129 . Hmmm, 30 baht per visit. So I am thinking the first way instead of the second way. B166,667 every 2 months means only B83,334 which goes into days of 31 means B2,689 a day. This sounds more realistic. This means it takes care of only 90 visits a day by the public. If we go to the other one that is 538 visits a day.

So which one is common? In Bumrungrad, hundreds pour thru those doors daily. And many of them are not poor.

If anyone out there, check it please to see if my calculations are correct. This has to be a joke, or am I wrong.

Daveyo

[dr_Pat_Pong]

So which one is common? In Bumrungrad, hundreds pour thru those doors daily. And many of them are not poor.

Daveyo

Not too many poor one's go to the very private and exclusive Bumrungrad Hospital Dave.

[Guest IT Manager]

I wonder how much of this is reflected in the fact that a kid in our village with AIDS has been taken off the GPOvir?

Must needs go check it out I think. If that's the case there is a need to make a loud noise among the body politic to let them know that bad (no) planning is going to cost the lives of Thai people who cn't afford the meds for AIDS, or many others I suppose.

[DaveYo]

You know I just cannot see how this is possible for the hospital and Doctors to survive. I mean 30Baht is just the visit alone. That is precisely what it says. Now comes the Doctor and you can bet this visit must mean just 5 minutes only.

The hospital or clinic has to not only pay the Doctor but what about the other workers on the payroll?? Then if you need medications who has to pay for that?? Does the government foot the bill since on first hand your visit is paid by the Government to begin with. How many visits is one entitled to under this program? What medications are covered under such program???? What illnesses are covered under this program???

For them to apply this to all the hospitals, that does mean that Bumrungrad is included and any other private exclusive hospital too. They qualify so to speak, so the poor people can in fact get exclusive treatment as it stands at the moment.

Also they say here HOSPITALS does this include CLINICS?????? especially when out in the countryside boondocks.

This program should be directed to hospitals that are not that well off and struggling financially and in the poor areas, and out to clinics thruout Thailand. Not to exclusive private hospitals or hospitals that are on solid ground financially.

No wonder the Medical Directors are saying it is a disaster overall.

The way I see it here it is very vague. No guidelines or directions or prerequisites as given.

does anyone agree on this assessment??

Daveyo

[pnustedt]

does anyone agree on this assessment??

I think that you're looking at the problem from what you see first hand in Bkk. The problem is much bigger.

In the last year or two clinics have opened in most rural areas of Thailand and people who have lived their lives on poor diets and living conditions have just got access to free (or cheap) medical facilities.

I actually believe this "crisis" is good news. It is evidence that the Thai authorities have now got to focus their attention on the common people that they represent and find ways to provide the basic medical care that is taken for granted in the West.

Of course, it has got to be paid for, and ways to expand the Thai economy is central.