More private hospitals opt out of system

By Duangkamon Sajirawattanakul

The Nation

Not happy with govt subsidy for service, group says

More private hospitals are abandoning contracts with both the Social Security Office and the universal health scheme, due to higher costs and no increase in the government's subsidy per person, according to the Private Hospital Association of Thailand.

The association's chairman Dr Ua-chart Kanjanaphithak called on SSO beneficiaries, who pay monthly contributions, to demand more benefits, because people who did not pay under the National Health Security Office (NHSO) scheme, formerly the Bt30 health scheme, would soon earn equal right of treatment for illnesses.

He said most large private hospitals, with a minimum of 200,000 SSO and NHSO beneficiaries, would not renew their contracts with the SSO. That was because they serviced SSO beneficiaries at a loss. But small or medium-sized hospitals with around 20,000 beneficiaries were likely to join in the SSO scheme.

The doctor said Ramkhamhaeng Hospital chain, where he is part of the management, had no contract with either the SSO or NHSO.

"We don't accept patients under either scheme, because we give quality services that require high costs."

The per-head government subsidy for private hospitals had not increased for a third year, despite a contract condition it would rise every two years.

"Most private hospitals that have contracts are operating at loss, and some of them cannot abandon the contracts because the current ones have yet to end," he said.

Ua-chart said the SSO problem stemmed from the claim most beneficiaries were labourers who were in good health, but this was true only in the beginning when the SSO was newly founded in 1990.

"But after two decades, those people are now ageing, with a large number suffering from natural diabetes and high blood pressure, the two main diseases burdening treatment costs on the NHSO," he said.

Referring to the widespread call for the SSO and the NHSO to be merged and jointly managed, he said more than 9.4 million SSO beneficiaries needed to take the initiative on their own. They should make sure SSO benefits were better than those under the NHSO, as they paid monthly contributions while those under the NHSO paid nothing, as the Bt30 fee was only a token amount.

Ua-chart said he agreed with the proposed merger if the government kept on subsidising both schemes at a higher per-head amount.

SSO secretary-general Pan Wannaphinij said it was normal for private hospitals to enter or depart the SSO scheme each year.

"There are three to four hospitals leaving and another coming, on reasons those leaving don't state clearly."

The annual per-head subsidy paid to participating government or private hospitals is now Bt1,404. Those earning a Public Health Ministry certificate for giving good service are given another Bt77 in annual per-head subsidy. Hospitals treating 26 diseases on a special list would be given another Bt400 per head.

Pan said other factors should be considered if hospitals manage to cut the costs.

Labour Ministry permanent secretary Somkiat Chayasriwong said there were five private hospitals not renewing the contract at the end of this year, but dismissed the claim that the subsidy amount was not enough.

-- The Nation 2011-02-03

Maybe the govt doesn't pay the hositals enough...maybe hospitals will always push for higher payments saying the payments are too low....maybe it's a combination.

Hmm, new tanks for the army or the provision of essential medical care. Tough call.

Well judging by the increase in food costs over the last three years I would have to say they are not getting enough money today

But then again I am not a politician and have a different thought process..