Thai Health Officials Unsure About Reviving Bt30 Scheme

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YINGLUCK GOVERNMENT

Officials unsure about reviving Bt30 scheme

By Phongphon Sarnsamak

Duangkamon Sajirawattanakul

The Nation

The newly-elected government's public health policy to bring back the Bt30 copayment has left health officials and economists sceptical about whether it will work.

"It is just a return of a populist policy after it was totally eliminated by the military-appointed government in 2007," said Viroj na Ranong, a senior official at the Thailand Development Research Institute (TDRI), who conducted a study on the impact of the Bt30 health care scheme after its introduction in 2001.

"The new government should focus more on improving the quality of medical services rather than thinking about collecting Bt30 for medical care," he said.

The Bt30 health care scheme was implemented by the dissolved Thai Rak Thai party led by ex-premier Thaksin Shinawatra to provide universal health care coverage for all people not eligible for medical services under the Social Security Scheme and the Civil Servant Medical Benefit Scheme.

The breakthrough policy allowed nearly 48 million, especially in remote areas, access to medical services and to remove financial burdens.

However, the government has to allocate over Bt100 billion as the total annual budget for the National Health Security Office to run the universal health care scheme. Even though the government charged Bt30 for medical services, it could collect only Bt 1 billion, which was not enough to improve their quality.

The scheme was later abolished by the military junta-appointed government which made the universal health care scheme free.

During the general election campaign, the Pheu Thai Party announced it would bring the Bt30 copayment back, saying it would ensure good quality health care services.

"This money will be collected to buy medical devices and other products to treat patients," deputy leader Vichan Meenchaiyanant said.

Instead of collecting Bt30 for medical service charges, Viroj said the government should increase the amount of per head budget to provide medical services of a high quality.

Former Public Health Minister Dr Mongkol Na Songkla, who was appointed by the military junta, said bringing the Bt30 scheme back would not reduce the large number of patients at hospital.

If the new government wanted to go ahead with its plan, it should collect only money for outpatient services and provide free treatment for inpatient services.

"Some people could not afford to pay money for medical treatment for inpatient services," he said.

However, he asked the new government to focus on health promotion and prevention to improve the quality of people's health.

"This approach would reduce the financial burden," he said.

Meanwhile, Thailand Medical Council's deputy secretary-general Dr Itthaporn Kanachareon said the Bt30 co-payment health care scheme would help hospitals to screen patients who really needed treatment and to reduce t patient numbers.

In order to help people receive quality health care services, the government should divide people into two groups according to their tax payments. This would create a balance for the health care system.

Itthaporn said the amount of money collected from the Bt30 scheme would be only a small portion but it would be enough to improve the quality of drugs and develop medical services such as kidney dialysis centres. Moreover, the government could allocate this budget to help hospitals now facing financial crisis.

-- The Nation 2011-07-11

[jaltsc]

"Some people could not afford to pay money for medical treatment for inpatient services," he said.

It's a tough choice...a pack of cigarettes and a bottle of beer vs. paying for needed medical services.

[manutoo]

However, the government has to allocate over Bt100 billion as the total annual budget for the National Health Security Office to run the universal health care scheme. Even though the government charged Bt30 for medical services, it could collect only Bt 1 billion, which was not enough to improve their quality.

Does it mean that to not lose money, the patients should pay 3'000b / visit instead of 30b ..?

I wonder if there's 0 too much somewhere, or if there are a large part of patients needing long & intensive care...

[pastitche]

"Some people could not afford to pay money for medical treatment for inpatient services," he said.

It's a tough choice...a pack of cigarettes and a bottle of beer vs. paying for needed medical services.

I wonder what it would cost to treat such a bad case of rampant bigotry

[slapout]

Of all the acknowledged problems within the Thai medical system, to be pondering a reinstatement of the 30 baht charge, the collection, paperwork involved, accounting, and proper management of the system would appear to be a further waste of time.

[tragickingdom]

Didn't the amount per head eroded heavily in the last 5 years and with it the quality? The problem is that the military thinks it needs the budget much harder than the people.

[citizen33]

Didn't the amount per head eroded heavily in the last 5 years and with it the quality? The problem is that the military thinks it needs the budget much harder than the people.

All through the history of the UC scheme successive governments have generally failed to fund the capitation payment (the figure the local health network gets per patient per year) at the level estimated to be necessary. Dr Na Ranong is quite right to say that the co-payment is a distraction and it is the capitation payment that needs to be boosted a little bit. Abolishing the 30 baht co-payment, which never brought in much money, was one of the few sensible things the ruling military council did.

After getting early credit from people working in the health care sector, TRT lost a good deal of support because it was perceived to be more interested in 'marketing' than building on its excellent start. What a pity if Yingluck falls into that same trap of favouring image over substance.

[lannarebirth]

Didn't the amount per head eroded heavily in the last 5 years and with it the quality? The problem is that the military thinks it needs the budget much harder than the people.

All through the history of the UC scheme successive governments have generally failed to fund the capitation payment (the figure the local health network gets per patient per year) at the level estimated to be necessary. Dr Na Ranong is quite right to say that the co-payment is a distraction and it is the capitation payment that needs to be boosted a little bit. Abolishing the 30 baht co-payment, which never brought in much money, was one of the few sensible things the ruling military council did.

After getting early credit from people working in the health care sector, TRT lost a good deal of support because it was perceived to be more interested in 'marketing' than building on its excellent start. What a pity if Yingluck falls into that same trap of favouring image over substance.

"Fool me once, shame on you.

Fool me twice, shame on me."

[DP25]

Of all the acknowledged problems within the Thai medical system, to be pondering a reinstatement of the 30 baht charge, the collection, paperwork involved, accounting, and proper management of the system would appear to be a further waste of time.

It may be a waste, but it's being done for propaganda reasons. 30 baht health care is associated with the Thaksin regime in many people's minds. In their rhetoric they will claim that bringing back the 30 baht fee will offer a huge increase in services, and that the free health care given by their opponents doesn't work. Health care will naturally improve with time anyway, so they will claim that it is all because they brought back the 30 baht plan and not their opponents. It's all marketing

[rubl]

As usual just wondering. What else will change with the re-introduction of the 30 baht scheme? Only the 30 baht payment for every visit, or are there real tangible improvements for the patients ?

[johncat1]

"Some people could not afford to pay money for medical treatment for inpatient services," he said.

It's a tough choice...a pack of cigarettes and a bottle of beer vs. paying for needed medical services.

Don't forget the gold they must show to impress their friends

[khaowong1]

"Some people could not afford to pay money for medical treatment for inpatient services," he said.

It's a tough choice...a pack of cigarettes and a bottle of beer vs. paying for needed medical services.

I was just taking a sip of Dr. Pepper and spit it out my nose.