HIV Patient Quits Job As Thai Social Security Won't Pay For Drug

[webfact]

HIV patient quits job as social security won't pay for drug

By Pongphon Sarnsamak

The Nation

To save his life after living with the Aids virus for more than 20 years, Boriphat Donmoon, 47, decided to quit his job and terminate his healthcare coverage under the socialsecurity scheme because he could not access the antiretroviral drug atazanavir.

"I've been living without atazanavir for six months, as the hospital told me that patients under the Social Security Scheme are not eligible for the drug," he said.

Previously, Boriphat received a combination of two antiviral medications, lopinavir and ritonavir, under the SSS but since these drugs increased the levels of fat and sugar in blood vessels, doctors recommended that he take the secondline drug atazanavir, which has fewer side effects.

But when he went to hospital to receive atazanavir, staff would not dispense the drug to him, saying the SSS would not cover it.

Boriphat wrote to the Social Security Office (SSO) asking for an explanation. SSO staff told him he could access this drug but needed a recommendation from a doctor to explain his condition.

"I'd already handed a doctor's recommendation to the hospital, but a hospital staffer told me that I had to use my own money to buy this medicine," he said. "How could I find Bt13,000 a month to buy this lifesaving drug?"

Boriphat earned only Bt12,000 a month from working with a nonprofit organisation to help people living with HIV, which can cause Aids. Under the Labour Bill, he has to pay 5 per cent of his monthly salary to the Social Security Fund so he can receive healthcare coverage under the scheme.

But after he learned that he could not access lifesaving drugs such as atazanavir under this fund, even though he had paid a contribution every month, he decided to quit his job and terminate his SSS healthcare coverage.

"I was surprised when I learned that the hospital kept this drug in storage but only for patients who were registered with the National Health Security Office, which provides universal healthcare coverage, but not for an SSS subscriber like me," he said.

"So I would rather quit my job and be unemployed, as I could register to receive better medication under the universal healthcare scheme without paying any contribution."

Boriphat and a group of 40 people living with HIV yesterday organised a demonstration against the SSO asking it to add atazanavir to the SSF's medical benefits.

SSF medical committee member Dr Wichai Hokewiwat said the fund's medical benefits did not cover atazanavir, as it was an expensive drug. Moreover, patients could access other antiviral drugs for HIV/Aids treatment.

However, he said the SSF's subpanel on HIV/Aids would consider adding the drug to its medical benefits, but so far, there had been no meeting of the subpanel to discuss this issue.

-- The Nation 2011-03-03

[asiawatcher]

Another example of bureaucracy out of control...

[iono]

First off WoW! he has survived a long time, that's great! Can this really be corruption or is it just the norm for insurance programs all over the world to withhold from the poor, or is the price so high because the drug company is attempting to recoup its research monies, then eventually the drug will be sold at a cheaper price, however now we have program administrators in between the care of a patient and the doctor/care giver.

[jonclark]

The odd thing here is that the drug is free under the universal healthcare scheme, but not availble under the social security scheme which you pay into. How odd!! Surely what is freely available, should also be available under the more expensive scheme as the government subsidies both, don't they???

[sirchai]

The odd thing here is that the drug is free under the universal healthcare scheme, but not availble under the social security scheme which you pay into. How odd!! Surely what is freely available, should also be available under the more expensive scheme as the government subsidies both, don't they???

Boriphat earned only Bt12,000 a month from working with a nonprofit organisation to help people living with HIV, which can cause Aids. Under the Labour Bill, he has to pay 5 per cent of his monthly salary to the Social Security Fund so he can receive healthcare coverage under the scheme.

Hope he'll get his medicine soon. Well a good topic the Thai Social Security. For all people paying in:

After one year paying in you've got the right to receive money for your kids, 350 baht for one. Until the age of nine, or ten.

When you lose your job, for example working at a school, the SSF has to pay you a monthly income of about 12,000 baht.

Well, if you need to jump in a box, they'll pay your wife some money too. Sorry. But it's an intereting topic. :jap:

[Jingthing]

It sounds like he is making a totally rational economic decision and doing all he can to stay alive. Best wishes to him.

[jfchandler]

It makes absolutely no rational sense that a Thai medical coverage scheme for the poor/unemployed would cover this particular HIV/AIDs drug, but the companion government medical scheme that covers those with jobs who help pay to support the system won't cover it.

But then again, I think that's pretty much the point of the guy's complaint.

[Ijustwannateach]

Reminds me of cases where disabled people get disproportionately punished (all benefits cancelled) for trying to work part-time and receiving any income at all...

[Jingthing]

It's an insurance scheme dude. People pay in, not everyone is sick, sick people get taken care of. That is normal. Also consider he may be paid only 12K but if he is doing good work, the work he is doing is worth a lot more than that.

Next ...

[manarak]

It makes absolutely no rational sense that a Thai medical coverage scheme for the poor/unemployed would cover this particular HIV/AIDs drug, but the companion government medical scheme that covers those with jobs who help pay to support the system won't cover it.

But then again, I think that's pretty much the point of the guy's complaint.

Yep, they should remove the coverage for that drug from the free scheme.

[Bagwan]

I wonder if he contacted the Anonymous clinic run by Thai Red Cross. 13K sounds like a private hospital price to me. I understand that the TRC will provide any medicines at a cheap price against prescriptions from registered medical practitioners. I know from experience that they provided 3 months supply of antiviral medication for about the same amount of money charged by what likes to be known as BKK's preeminent hospital. But then they don't have expensive state of the art TV's wherever they can fit one in.

[jayjay0]

I wonder if he contacted the Anonymous clinic run by Thai Red Cross. 13K sounds like a private hospital price to me. I understand that the TRC will provide any medicines at a cheap price against prescriptions from registered medical practitioners. I know from experience that they provided 3 months supply of antiviral medication for about the same amount of money charged by what likes to be known as BKK's preeminent hospital. But then they don't have expensive state of the art TV's wherever they can fit one in.

Now why would he want to contact the anonymous clinic if they charge the same as a five star hospital?

[jayjay0]

I wonder if he contacted the Anonymous clinic run by Thai Red Cross. 13K sounds like a private hospital price to me. I understand that the TRC will provide any medicines at a cheap price against prescriptions from registered medical practitioners. I know from experience that they provided 3 months supply of antiviral medication for about the same amount of money charged by what likes to be known as BKK's preeminent hospital. But then they don't have expensive state of the art TV's wherever they can fit one in.

Now why would he want to contact the anonymous clinic if they charge the same as a five star hospital?