Fears Over Aged-Care Costs In Thailand

[webfact]

Fears over aged-care costs

The Nation

Wannapa Khaopa

With people living longer and Thailand moving towards an ageing society, the country is facing a rising cost burden for treating chronic diseases, which will keep rising unless agencies reform the financing of national healthcare, a summit was told yesterday.

The country's healthcare expenses are 4.5 per cent of gross domestic product, or about Bt257 billion this year, said Kulit Sombatsiri, inspector-general of the Ministry of Finance.

The cost is forecast to reach Bt590 billion or 6.25 per cent of GDP by 2028, said Jiraphan Kalaprawit, of the Social Development Strategy and Planning Office.

It is expected that the number of senior citizens aged over 60 will increase by 20 per cent in the next 15 years.

Kulit said: "The National Healthcare Financing Development Office [NHFDO] has provided a mechanism whereby the three healthcare schemes would work together, which would benefit overall healthcare management - helping increase their bargaining power and even sharing a diagnosis-related group.

"The NHFDO is preparing to propose the mechanism's model to the government for consideration."

The scheme is funded jointly by the Social Security Office, covering 9.4 million people working in the private sector; the Comptroller-General's Department covering 4.96 million workers in the government sector; and the National Health Security Office (NHSO) covering 48.1 million people.

Different proposals were presented yesterday at the Thailand Healthcare Summit under the concept of sustainable national healthcare financing. The meeting at the Pullman Bangkok King Power Hotel sought proposals from agencies and stakeholders on how to deal with financing problems and other challenges the country is facing.

Shared payment between people and the government in different forms was proposed, including medical saving, deductible medical expenses and having local administrative organisations partially pay for people's medical expenses.

The NHSO, the organisation that finances regional and general hospitals nationwide, has not paid the hospitals adequately - causing most, some 585 hospitals, to suffer losses, said Dr Prachumphorn Booncharoen, president of the Federation of Thailand Regional and General Hospital.

"We have evidence that the NHSO accumulated Bt54 billion over the past nine years, although it denied having that amount. Why has it not paid the hospitals more?" she asked.

Prachumphorn said that as a result, the federation demanded that the NHSO change its role - stop allocating money to the hospitals and buying medical items and medicine, and allow provinces to manage and allocate the money to their own hospitals.

Representatives from many agencies agreed that the Public Health Ministry should initiate a national campaign to promote disease prevention rather than curing them. More budget should be allocated to the Department of Health to run a health-promotion and disease-prevention campaign seriously. Doing so would help reduce treatment expenses.

Jiraphan said: "About 50 per cent of the elderly suffer from preventable diseases, including high blood pressure, diabetes and heart disease."

Ramathibodi Hospital director Dr Than Supatarapun said physicians treating patients should be allowed to participate in budget management. As a result, they would understand their hospital's financial situation and help manage limited budgets and resources.

-- The Nation 2011-12-27

[waza]

Hmmm take from the poor to give to the rich

[pomchop]

In the USA health care cost is 17.6% of GDP....in Thailand 4.5%.....WoW.

[geriatrickid]

In the USA health care cost is 17.6% of GDP....in Thailand 4.5%.....WoW.

One of the reasons health care costs are bloated in the USA is that there are few controls in place. Drug costs are some of the highest in the world and the costs of procedures are far more expensive than elsewhere. There are no public not for profit large buying groups as occurs in canada, Australia, France etc. Part of Thailand's low % is attributable to the failure to have a fair and efficient tax collection structure. Without funds, one cannot provide services.

Thailand has an aging population. It also now has labour shortages. Part of the problem is that the economy has not moved fast enough away from labour intensive approaches to one that emphasizes efficiency and productivity. This ties in to thailand's low quality educational and vocational skills system. The culture has also moved away from one of caring and respect for the elderly to that of benign neglect. it is not uncommon now for the elderly to be left to their own devices because the one or two kids just don't care or are too busy. walk into a public hospital and yo will see plenty of old folks dropped off at the hospital. It never happened a generation ago, but now I'd estimate that 1 to 3 elderly people I have seen in waiting rooms are unaccompanied or if accompanied its by a kindly neighbour and not family.

[Reasonableman]

In the USA health care cost is 17.6% of GDP....in Thailand 4.5%.....WoW.

One of the reasons health care costs are bloated in the USA is that there are few controls in place. Drug costs are some of the highest in the world and the costs of procedures are far more expensive than elsewhere. There are no public not for profit large buying groups as occurs in canada, Australia, France etc. Part of Thailand's low % is attributable to the failure to have a fair and efficient tax collection structure. Without funds, one cannot provide services.

Thailand has an aging population. It also now has labour shortages. Part of the problem is that the economy has not moved fast enough away from labour intensive approaches to one that emphasizes efficiency and productivity. This ties in to thailand's low quality educational and vocational skills system. The culture has also moved away from one of caring and respect for the elderly to that of benign neglect. it is not uncommon now for the elderly to be left to their own devices because the one or two kids just don't care or are too busy. walk into a public hospital and yo will see plenty of old folks dropped off at the hospital. It never happened a generation ago, but now I'd estimate that 1 to 3 elderly people I have seen in waiting rooms are unaccompanied or if accompanied its by a kindly neighbour and not family.

Agreed it seems to be common these days, with the "me first" predominant culture. However, I cannot tell how much it has changed over time.There seems to be surprisingly little political commitment by any government to a "welfare state", in which the elderly receive adequate support for housing, food, healthcare, and travel, and the ability to live their latter years in relative security, comfort and dignity. Lots of talk, but little progress.

[ludditeman]

All the girls I know look after their parents, but those girls are largely reviled on this forum as uneducated farm girls.

I guess the new worthy educated, middle classes, half-Chinese, hi-so ladies don't bother with their parents any more.

Maybe modern education and ways of living aren't that special after all.

Edited December 27, 2011 by ludditeman

[geriatrickid]

All the girls I know look after their parents, but those girls are largely reviled on this forum as uneducated farm girls.

I guess the new worthy educated, middle classes, half-Chinese, hi-so ladies don't bother with their parents any more.

Maybe modern education and ways of living aren't that special after all.

One of the reasons why the wealthier families may not be as supportive is that there are fewer children. As these kids attempt to cope with their own families and careers they just don't have time for the parents anymore. It is really difficult for some of these people. Those that can still try, but its not like it used to be where the woman was a stay at home person, or there were alot of kids to share the burden.

[exeter]

Its a world wide problem now it will get more so as time goes on, Thais tend to look after the elderley better than the visitors homelands I think they have been brought up to know that it is expected of them, the state is not set up to do that. In the parts of the world which are more familiar with the state does get involved and now probably wishes it had not as the costs are multyplying and there never seems enough younger people to help pay for what is required, immigrataion is a 2 edged sword. Too many arriving to sponge and not put any input in. The future looks bleak for the ageing generations and solutions that look like they might work are not easyly visible, something has to give. of course if money is no problem personally then the situation is no problem, its always the less well off who end up suffering.

[VoterPower]

Its a frightening thought and I don't see it being taken seriously enough.

Where has all the money gone?

Who has ended up with it all

[waza]

Dont worry the PTP has promised all Thais will be rich in 6 months, has it been 6 months yet?