Thai Govt Renews Bt30 Health Scheme

[samran]

People are missing the point here.

30 baht health care is catchy, easy to remember (even more so in Thai).

It is brilliant marketing, something that Brother number one is good at.

That is all that counts.

[Siripon]

PR. Reintroducing the 30 baht health care plan. ie implication it was scrapped and there was nothing that replaced it, which is actually what a fair few think thanks to the inept PR of the last regime.

Another subtle psychological aim is that people even poor people can be proud they can pay for their health care and dont have to take free handouts from the establishment they dislike.

TRT/PPP/PTP are excellent at PR. What is surprising is that their opponents either havent learned these lessons or are incapable of adjustng to them

You are more than likely correct,in the minds of the people,who are not used to anything for free,when the 30 baht card was scrapped by the last Government,and given for free.

It may have been interpreted as no longer in existance,because they do not have to pay at all. Poor PR by the Democrats most certainly. TIT!

Surayud's government cancelled the 30 baht fee, reasoning it wasn't worth collecting, the Democrats then abolished the gold card required and let the public use their ID cards instead, again saving more money.

These changes were announced clearly on all Thai media at the time.

What is not clear are the services available as each hospital obviously has budget constraints, thus for serious illnesses, ie liver cancer, a patient will be sent home to die with little more than paracatomal as comfort.

[samran]

PR. Reintroducing the 30 baht health care plan. ie implication it was scrapped and there was nothing that replaced it, which is actually what a fair few think thanks to the inept PR of the last regime.

Another subtle psychological aim is that people even poor people can be proud they can pay for their health care and dont have to take free handouts from the establishment they dislike.

TRT/PPP/PTP are excellent at PR. What is surprising is that their opponents either havent learned these lessons or are incapable of adjustng to them

You are more than likely correct,in the minds of the people,who are not used to anything for free,when the 30 baht card was scrapped by the last Government,and given for free.

It may have been interpreted as no longer in existance,because they do not have to pay at all. Poor PR by the Democrats most certainly. TIT!

Surayud's government cancelled the 30 baht fee, reasoning it wasn't worth collecting, the Democrats then abolished the gold card required and let the public use their ID cards instead, again saving more money.

These changes were announced clearly on all Thai media at the time.

What is not clear are the services available as each hospital obviously has budget constraints, thus for serious illnesses, ie liver cancer, a patient will be sent home to die with little more than paracatomal as comfort.

which was basically my uncle's experience (a different form of cancer), despite the best efforts of his son to get him into a good place - something he was apparently eligible for, but never got.

[sbk]

PR. Reintroducing the 30 baht health care plan. ie implication it was scrapped and there was nothing that replaced it, which is actually what a fair few think thanks to the inept PR of the last regime.

Another subtle psychological aim is that people even poor people can be proud they can pay for their health care and dont have to take free handouts from the establishment they dislike.

TRT/PPP/PTP are excellent at PR. What is surprising is that their opponents either havent learned these lessons or are incapable of adjustng to them

You are more than likely correct,in the minds of the people,who are not used to anything for free,when the 30 baht card was scrapped by the last Government,and given for free.

It may have been interpreted as no longer in existance,because they do not have to pay at all. Poor PR by the Democrats most certainly. TIT!

No idea, all the Thai people I know knew it was free.

[MAJIC]

PR. Reintroducing the 30 baht health care plan. ie implication it was scrapped and there was nothing that replaced it, which is actually what a fair few think thanks to the inept PR of the last regime.

Another subtle psychological aim is that people even poor people can be proud they can pay for their health care and dont have to take free handouts from the establishment they dislike.

TRT/PPP/PTP are excellent at PR. What is surprising is that their opponents either havent learned these lessons or are incapable of adjustng to them

You are more than likely correct,in the minds of the people,who are not used to anything for free,when the 30 baht card was scrapped by the last Government,and given for free.

It may have been interpreted as no longer in existance,because they do not have to pay at all. Poor PR by the Democrats most certainly. TIT!

No idea, all the Thai people I know knew it was free.

But exactly what is free on the 30 Baht card,is not very clear?

I'm not even sure if Thais have to pay for prescribed medication,or not ?

[ginjag]

I would be interested to know exactly what is free/or 30 baht, I would suggest there may be some cost waved, but a stay in hospital will still cost and would not come free......I am ok with being corrected if this is not the case

Issan province..........I have been talking to a health official and asked him "what do you get for 30 bht or / free"........answer was this, 1 -- all Thai persons with a valid I.D. card and are within the county of issue-the hospital VISIT is free, inclusive of doctor, x -ray, pharmacy. 2 --if in the case you are admitted over 1 day+further days MOST Thai persons will pay a subsidised rate. the old -pregnant-kids I could not get a straight answer -for some reason ??? 3 -- example a lady is admitted to hospital to give birth has just paid an inclusive price of 7,000 bht. 4 -- if you have a serious problem aids (ex) you will be

entitled to treatment to stablise you only, any extra treatment pay....this is also the case for motor accidents..... quick fix free but attending only . This was from an Health and environmental heath officer.

5 -- If you go to an hospital OUTSIDE your county you have to pay--it is not Nationwide.

[h90]

The reason they took away the 30 baht fee was because it costs 50 baht in administration to collect 30 baht.

Lots of bureaucrats lost their jobs.

Revenge of the bureaucrats.

that alone is bizarre. If you have a collection only lady who earns 300 Baht per day, it is 10 collections.

But I would say like in the bus or train, kind of ticket pay 30 Baht get the ticket. That can never ever cost 50 Baht in administration. Let it be 5 Baht.

[h90]

I would be interested to know exactly what is free/or 30 baht, I would suggest there may be some cost waved, but a stay in hospital will still cost and would not come free......I am ok with being corrected if this is not the case

Issan province..........I have been talking to a health official and asked him "what do you get for 30 bht or / free"........answer was this, 1 -- all Thai persons with a valid I.D. card and are within the county of issue-the hospital VISIT is free, inclusive of doctor, x -ray, pharmacy. 2 --if in the case you are admitted over 1 day+further days MOST Thai persons will pay a subsidised rate. the old -pregnant-kids I could not get a straight answer -for some reason ??? 3 -- example a lady is admitted to hospital to give birth has just paid an inclusive price of 7,000 bht. 4 -- if you have a serious problem aids (ex) you will be

entitled to treatment to stablise you only, any extra treatment pay....this is also the case for motor accidents..... quick fix free but attending only . This was from an Health and environmental heath officer.

5 -- If you go to an hospital OUTSIDE your county you have to pay--it is not Nationwide.

my wife sister got every treatment for free. Just it was so substandard that it was unbelievable. A skin infection. Going to clean it every second day...did not get much better. No antibiotics. Till I feed her some and it was good, because I could not watch it anymore after 2 weeks.

[MAJIC]

I would be interested to know exactly what is free/or 30 baht, I would suggest there may be some cost waved, but a stay in hospital will still cost and would not come free......I am ok with being corrected if this is not the case

Issan province..........I have been talking to a health official and asked him "what do you get for 30 bht or / free"........answer was this, 1 -- all Thai persons with a valid I.D. card and are within the county of issue-the hospital VISIT is free, inclusive of doctor, x -ray, pharmacy. 2 --if in the case you are admitted over 1 day+further days MOST Thai persons will pay a subsidised rate. the old -pregnant-kids I could not get a straight answer -for some reason ??? 3 -- example a lady is admitted to hospital to give birth has just paid an inclusive price of 7,000 bht. 4 -- if you have a serious problem aids (ex) you will be

entitled to treatment to stablise you only, any extra treatment pay....this is also the case for motor accidents..... quick fix free but attending only . This was from an Health and environmental heath officer.

5 -- If you go to an hospital OUTSIDE your county you have to pay--it is not Nationwide.

Thanks ginjag

That makes the free/costs somewhat clearer!

Edited September 27, 2011 by MAJIC

[473geo]

I would be interested to know exactly what is free/or 30 baht, I would suggest there may be some cost waved, but a stay in hospital will still cost and would not come free......I am ok with being corrected if this is not the case

Issan province..........I have been talking to a health official and asked him "what do you get for 30 bht or / free"........answer was this, 1 -- all Thai persons with a valid I.D. card and are within the county of issue-the hospital VISIT is free, inclusive of doctor, x -ray, pharmacy. 2 --if in the case you are admitted over 1 day+further days MOST Thai persons will pay a subsidised rate. the old -pregnant-kids I could not get a straight answer -for some reason ??? 3 -- example a lady is admitted to hospital to give birth has just paid an inclusive price of 7,000 bht. 4 -- if you have a serious problem aids (ex) you will be

entitled to treatment to stablise you only, any extra treatment pay....this is also the case for motor accidents..... quick fix free but attending only . This was from an Health and environmental heath officer.

5 -- If you go to an hospital OUTSIDE your county you have to pay--it is not Nationwide.

Thanks ginjag

That makes the free/costs somewhat clearer!

Agreed good post thanks ginjag

[animatic]

PR. Reintroducing the 30 baht health care plan. ie implication it was scrapped and there was nothing that replaced it, which is actually what a fair few think thanks to the inept PR of the last regime.

Another subtle psychological aim is that people even poor people can be proud they can pay for their health care and dont have to take free handouts from the establishment they dislike.

TRT/PPP/PTP are excellent at PR. What is surprising is that their opponents either havent learned these lessons or are incapable of adjustng to them

You are more than likely correct,in the minds of the people,who are not used to anything for free,when the 30 baht card was scrapped by the last Government,and given for free.

It may have been interpreted as no longer in existance,because they do not have to pay at all. Poor PR by the Democrats most certainly. TIT!

Surayud's government cancelled the 30 baht fee, reasoning it wasn't worth collecting, the Democrats then abolished the gold card required and let the public use their ID cards instead, again saving more money.

These changes were announced clearly on all Thai media at the time.

What is not clear are the services available as each hospital obviously has budget constraints, thus for serious illnesses, ie liver cancer, a patient will be sent home to die with little more than paracatomal as comfort.

Same as under 30 baht health care.

It is tax supported health care,

and removing the 30 baht technicality of payment,

also removed the cost of accounting for that 30 baht,

which cost MORE than the 30 baht.

[samran]

PR. Reintroducing the 30 baht health care plan. ie implication it was scrapped and there was nothing that replaced it, which is actually what a fair few think thanks to the inept PR of the last regime.

Another subtle psychological aim is that people even poor people can be proud they can pay for their health care and dont have to take free handouts from the establishment they dislike.

TRT/PPP/PTP are excellent at PR. What is surprising is that their opponents either havent learned these lessons or are incapable of adjustng to them

You are more than likely correct,in the minds of the people,who are not used to anything for free,when the 30 baht card was scrapped by the last Government,and given for free.

It may have been interpreted as no longer in existance,because they do not have to pay at all. Poor PR by the Democrats most certainly. TIT!

Surayud's government cancelled the 30 baht fee, reasoning it wasn't worth collecting, the Democrats then abolished the gold card required and let the public use their ID cards instead, again saving more money.

These changes were announced clearly on all Thai media at the time.

What is not clear are the services available as each hospital obviously has budget constraints, thus for serious illnesses, ie liver cancer, a patient will be sent home to die with little more than paracatomal as comfort.

Same as under 30 baht health care.

It is tax supported health care,

and removing the 30 baht technicality of payment,

also removed the cost of accounting for that 30 baht,

which cost MORE than the 30 baht.

yeah, but the PR is priceless...

[scorecard]

The reason they took away the 30 baht fee was because it costs 50 baht in administration to collect 30 baht.

Lots of bureaucrats lost their jobs.

Revenge of the bureaucrats.

that alone is bizarre. If you have a collection only lady who earns 300 Baht per day, it is 10 collections.

But I would say like in the bus or train, kind of ticket pay 30 Baht get the ticket. That can never ever cost 50 Baht in administration. Let it be 5 Baht.

There are many other costs involved in the collection process additional to the 'cashier lady'.

I'm sure your aware that there will be numerous 'summaries' and other on-going documents which are prepared by other staff then all of this documentation and data goes to the supervisor for sign off, then the accounting manager of the hospital for more sign off, then maybe the manager of the hospital for more sign off, and then it all hits the provincial centre, then it goes to the Bkk ministerial office etc etc for more processing, then there's the auditor general staff who must audit the payments: was everything (every visit) recorded?, does it all balance - is there proof that equal funds were banked?, etc, then the auditors report must be added to the national total audit report of everything, then this is looked at by the cabinet etc. It all adds up to a lot more than the 30Baht revenue.

[samran]

The reason they took away the 30 baht fee was because it costs 50 baht in administration to collect 30 baht.

Lots of bureaucrats lost their jobs.

Revenge of the bureaucrats.

that alone is bizarre. If you have a collection only lady who earns 300 Baht per day, it is 10 collections.

But I would say like in the bus or train, kind of ticket pay 30 Baht get the ticket. That can never ever cost 50 Baht in administration. Let it be 5 Baht.

There are many other costs involved in the collection process additional to the 'cashier lady'.

I'm sure your aware that there will be numerous 'summaries' and other on-going documents which are prepared by other staff then all of this documentation and data goes to the supervisor for sign off, then the accounting manager of the hospital for more sign off, then maybe the manager of the hospital for more sign off, and then it all hits the provincial centre, then it goes to the Bkk ministerial office etc etc for more processing, then there's the auditor general staff who must audit the payments: was everything (every visit) recorded?, does it all balance - is there proof that equal funds were banked?, etc, then the auditors report must be added to the national total audit report of everything, then this is looked at by the cabinet etc. It all adds up to a lot more than the 30Baht revenue.

There are two valid arguments here:

1) the 30 baht is purely a PR exercise. As others have said, it implies that the government has bought something back that the democrats 'took away' (even though they replaced it with free health care at point of delivery). Also, '30 baht health care' is darn catchy in Thai. It is a vote winner.

2) Then there is the opportunity cost argument. The other side of it is that the 30 baht payment, though token and more costly to administer than the 30 baht collected, actually can reduce pressures on the health system. The logic here is that if you make health care 'free' (at point of delivery) then you get doctors rooms filled with bored little old ladies turning up wanting to have a chat with the doc as they've got nothing better to do.

This logic is certainly used in places like Australia where while they have universal health care along similar lines to the UK, a visit to the GP generally requires some token payment of $30 or $40.

The payment ensures two things: It is not too expensive to act as a disincentive to visit the doctor if you are sick, but it still is something that you'll only go if you really need to use the system, therefore weeding out serial hypochondriacs etc.

In the case of Thailand, I'm leaning towards option 1, but option 2 also has merit in discussions such as this. Unfortunately '200 baht health care' isn't anywhere near as catchy.

Edited September 28, 2011 by samran