Warning On Thai Healthcare System

[webfact]

Warning on healthcare system

By PONGPHON SARNSAMAK

THE NATION

Urgent action needs to be taken to overcome a financial crisis affecting hospitals across the country, according to the Senate Standing Committee on Public Health.

A study conducted by a subpanel of the committee has found that since the start of the universal healthcare scheme, 48 million people have made 140 million medical visits to hospital outpatient's departments and 5 million medical visits as inpatients.

However, insufficient budget provision by the National Health Social Office (NHSO) has left hospitals across the country in a state of crisis.

"The country's healthcare system will collapse, due to increasing provision of medical services and a decrease in service providers," said an advisor to the standing committee, Dr Ittaporn Kanachareon.

"The government needs to set up an ad hoc panel to resolve the shortage of medical personnel and the insufficiency of medical services," he said.

The committee's study of universal-healthcare coverage and urgent problems related to public-health issues found that the financial crisis at state hospitals was caused by the budget-allocation methods of the National Health Security Office. The NHSO makes budgetary provision for state hospitals and healthcare providers across the country.

The NHSO's budget provisions include the monthly salaries of healthcare workers plus 60 per cent of the per-head budget for providing medical services to patients.

Hospitals with large numbers of medical workers have been facing a financial crisis for several years. They have been forced to take from the 60-per-cent-per-head budget to pay the monthly salaries of medical workers and have been left with insufficient money to run the hospitals and provide medical services.

Moreover, hospitals in parts of the country with small populations have faced a liquidity problem because their budget allocations have been reduced according to their smaller population base.

"Efficient budgetary allocation to hospitals across country is a duty of the National Health Security Office, to help them to survive. But now, they are unable to survive," Ittaporn said.

The study also found that while the per-head budget for providing universal healthcare coverage has increased substantially over the past eight years, the monthly salaries for medical workers at state hospital have increased only slightly.

A prominent economist and member of the National Health Security Board, Ammar Siamwala, said the financial crisis at state hospitals was caused by the use of hospital budgets to pay increased special allowances to medical workers. Most hospitals whose budgets had run out were now blaming the NHSO for the financial crisis.

He said that increasing the monthly salaries of medical workers at state hospitals was essential if the government was to take care of the situation.

In a bid to improve the financial plight of state hospitals, the Senate standing committee has urged the National Health Security Office to make budgetary allocations to help hospitals with debt crises and has also asked the government to increase payments to hospitals.

It said the government should separate monthly salaries for state-hospital medical workers from the per-head budget provided by the NHSO to run the hospitals. In this way, the government would discover the real cost of running the hospitals and providing medical services.

To resolve the long-standing problem, the government should also set up a national unit to oversee the finances of the country's healthcare-insurance system.

The NHSO has spent more than Bt160 billion on healthcare services provided to 48 million people over the past 10 years. It recently asked the government to increase the per-head subsidy for the universal healthcare scheme from this year's Bt2,546 to Bt3,249 in the 2012 fiscal year.

Monthly salaries for medical workers at state hospitals are only 27 per cent of the size of the per-head budget.

-- The Nation 2011-03-01

[Colabamumbai]

This is Thailand. Health care system,? where does the money go, in corrupt politicians pockets? Take a look at the Canadian health care system, doctors visits and all hospital care free...Not good but free.

[tomyummer]

I wonder where they thought this '30 baht' health care scheme was going? Endless funds from where?

Why would doctors and nurses want to work in overcrowded government hospitals with crap pay when they can earn 20 times more at the private hospitals?

Must be the same guy who came up with the Thailand Elite Card. Oh right, it was.

[brahmburgers]

I wonder where they thought this '30 baht' health care scheme was going? Endless funds from where?

Why would doctors and nurses want to work in overcrowded government hospitals with crap pay when they can earn 20 times more at the private hospitals?

Must be the same guy who came up with the Thailand Elite Card. Oh right, it was.

My thoughts also. It was clear when Thaksin declared the 30-baht scheme that it was simply one of several stunts to get elected. Same for 1 million baht per village, forgiving farmers' debts, his messy war on drugs, or his solutions for Bkk's gridlock and/or the trouble in the south. Indeed, any one of T's grand plans, if looked at closely, was a failure. Who remembers he wanted to use Thai taxpayer money to purchase Liverpool football team?

[ginjag]

I wonder where they thought this '30 baht' health care scheme was going? Endless funds from where?

Why would doctors and nurses want to work in overcrowded government hospitals with crap pay when they can earn 20 times more at the private hospitals?

Must be the same guy who came up with the Thailand Elite Card. Oh right, it was.

I just want to tell posters about a situation regarding where some money will go... This IS fact. The town hospital Pharmacy department have just paid out for some Government dept., employees ...wait for it------------------A FREE HOLIDAY TRIP TO BALI...................Shame about the monies being short in the report. This is not Thai bashing by Farrang--its Thai bashing Thai !!!!!...................I should ..according to some readers defend this action. If I dont like it --I should get out of Thai.

[pedro01]

Wihlst Thaksin did bring in the 30 Baht healthcare scheme. The current government have been in long enough to fix the situation.

You can't just keep blaming Thaksin for every problem in the country. The current government can reverse bad policies.

[geriatrickid]

30 baht healthcare wasn't such a bad idea as it allowed the poor to access rudimentary healthcare, What people forget is that having a large segment of the population serving as a reservoir for communicable diseases put everyone's health at risk. Yes, the system is underfunded and yes there are some serious administration shortcomings. However, if the finance ministry actually made an effort to collect basic taxes due to government, there would be no shortfall and no one would be arguing over whether or not some poor woman can have access to chemotherapy for her breast cancer or some kid with TB will receive treatment.

[harrisonkrs1]

Do they not make a killing of farang coming over for operations and tourism?

[TerryLH]

“This is Thailand. Health care system,? where does the money go, in corrupt politicians pockets? Take a look at the Canadian health care system, doctors visits and all hospital care free...Not good but free.”

It doesn’t sound like you know very much about the Thai system.

What’s the difference between the two systems you mention?

“Why would doctors and nurses want to work in overcrowded government hospitals with crap pay when they can earn 20 times more at the private hospitals?”

If a government nurse gets 8000Baht a month, you’re saying a nurse at a private hospital gets 160,000baht? Can you give just one example of that?

[mca]

If a government nurse gets 8000Baht a month, you’re saying a nurse at a private hospital gets 160,000baht? Can you give just one example of that?

Yeah I was just doing the maths on that.

[uncola]

i can never get the sums to add up when i read a somewhat complex article like this one where you need to understand the charts and somehow correlate that to the article itself. but it would appear to me that the money that is needed it not really all that much when you see the much larger picture. the shortfall in revenue also may or may not be due to the taksin medical scheme. this article never mentions that this is wholly the as a result of the 30 baht scheme or has anything to do with it.

i am a foreigner working here etc. as part of my work permit obligations i also have to have social insurance [no choice] and the government medical insurance. it costs squat and it is pretty good i think. could this be the same program that this article says is in trouble? it is efficient and i reckon the medical care is equal to that of any country that has socialized medicine.

but again i think the money to square up the system is not all that much and possibly the cost of one or two of the new jets thailand is buying from sweden [sweden makes jets?] would be enough so that this writer of this article above would not have had to write it and therefore confuse anyone reading it.

also another comment about the military. my wife's son is about to be drafted 'thai style'. he is in the army for 6 months and will serve on an air force base. his job will be to wash airplanes. that is beyond ridiculous.

[PaulDee]

Do they not make a killing of farang coming over for operations and tourism?

No.

Farang coming to Thailand for medical treatment use private hospitals.

The topic herein is limited to government hospitals and health system.

[Arkady]

The NHSO is in great shape compared to the SSO. People in the social security scheme get worse medical care than under the gold card system which they are not allowed to use. Worst of all the social security fund is not going to be able to meet its pension obligations when a critical mass of pensioners start to claim. Then, as Warren Buffet likes to say, we will see who has been swimming naked when the tide goes out. Like the government rice warehouse, it will be revealed that the money on the fund's balance sheet is not actually there.

[Robby nz]

Do they not make a killing of farang coming over for operations and tourism?

No.

Farang coming to Thailand for medical treatment use private hospitals.

The topic herein is limited to government hospitals and health system.

Farang can and do also use public hospitals, I know I do, however when they do they pay.

[ginjag]

Do they not make a killing of farang coming over for operations and tourism?

No.

Farang coming to Thailand for medical treatment use private hospitals.

The topic herein is limited to government hospitals and health system.

Farang can and do also use public hospitals, I know I do, however when they do they pay.

NO PROBLEM I am the same out in the sticks and use the town hospital...we don't drain the health service--I pay a doctors fee--and the pharmacy for the prescription. in fact the 30 bht scheme in our area is wavered---WHY ????30 baht to attend hospita is fair for Thais, so with NOT charging them anything, it's totally funded--thats an impossible situation, so in fact farrangs are helping not hindering-as we pay

Edited March 1, 2011 by ginjag

[Seanextra]

I live in government housing here in Thailand misses is a nurse and she gets the house behind the Primary Care Unit , it comes with her job . I see lots of Huge Wastes of money in the health system here lots of holidays and SEMINARS !!! but they one that blew me away was all the saunas now at all the PCUs . Thats right SAUNAS, and they were provided by the local government hospital !!! Only answer i can work out is someone must be related to the seller of Saunas as im not really sure the primary care unit could use one specilly not here in summer !

Edited March 1, 2011 by Seanextra

[rfukata]

there is nothing wrong with the 30 baht medical scheme. the under budget is directly linked to the over inflated military useless budget

to accomodate the useless generals and their cronies.

[TerryLH]

"i think at one time they amended that scheme anyway as 30 baht did not take care of the admin costs let alone treatment]"

They did away with the 30 baht charge.

"i am a foreigner working here etc. as part of my work permit obligations i also have to have social insurance [no choice] and the government medical insurance. it costs squat and it is pretty good i think. could this be the same program that this article says is in trouble?"

You should be in the Thai Social Security System, which is not what the article is talking about. I agree with you about it being a pretty good system.

[lungmi]

I wonder where they thought this '30 baht' health care scheme was going? Endless funds from where?

Why would doctors and nurses want to work in overcrowded government hospitals with crap pay when they can earn 20 times more at the private hospitals?

Must be the same guy who came up with the Thailand Elite Card. Oh right, it was.

Right, when you give free access to health treatment you most provide the funds for the hospilal to take care. In TAK province (all time Dems) Mr.T forgot this. People who don't vote for him can die.

Edited March 1, 2011 by lungmi

[alant]

I wonder where they thought this '30 baht' health care scheme was going? Endless funds from where?

Why would doctors and nurses want to work in overcrowded government hospitals with crap pay when they can earn 20 times more at the private hospitals?

Must be the same guy who came up with the Thailand Elite Card. Oh right, it was.

Right, when you give free access to health treatment you most provide the funds for the hospilal to take care. In TAK province (all time Dems) Mr.T forgot this. People who don't vote for him can die.

how do you blame the 30b service and its originator from this article?

what i see indicates need to update the financial planning and allocation to the current needs. it seems a reasonable objective to provide some affordable healthcare for your people.

as for the question about why would anyone work in the overcrowded government hospitals, i guess you could ask the same if you are a Brit, why work in the NHS and not private for much more? another financially challenged healthcare organisation undergoing management review god knows what number.

the good old USA doesn't seem to know how to offer healthcare at the moment as well if i understand that the Obama scheme is being given a rough time.

to me this article is simple one of "it is time to update the system".

[bitterbatter]

They should spend just a little money on educating people about nutrition, promote exercising, and support the availability of natural medicines and knowledge. A little prevention will go a long way towards lowering trips to the hospitals and costs. People get addicted to pain killers and antibiotics. This is old school medical practices that cause a downward spiral in health. I personally am working in a company to help change this.