Thai Govt's Emergency Health Care Scheme Excludes 1 Million People

[webfact]

Emergency care excludes 1 million

PONGPHON SARNSAMAK

THE NATION

Premier oversees signing of MoU for commencement of scheme on April 1

BANGKOK: -- More than 1 million people will not be able to access the government's new healthcare scheme that provides unlimited emergency medical treatment, health experts said.

"They cannot avail of the emergency healthcare scheme with unlimited access at any hospital as they are not members of the three national healthcare schemes," health economist Dr Pongsathon Pokpermdee said.

The large number of people comprises 450,000 stateless people, 270,000 state-enterprise employees, 300,000 employees of local authority organisations, and 100,000 private school teachers.

The government earlier claimed that its new emergency treatment plan covered all Thais but in fact, there are millions of people who will not be able to access this healthcare scheme, he added.

Thailand has three national healthcare schemes:

lThe National Health Security Office (NHSO) provides universal healthcare to 48 million people;

lSocial Security Scheme (SSS) provides health benefits to 10 million employees;

lComptroller-General's Department provides medical benefits to 5 million civil servants.

These three national healthcare schemes yesterday signed a memorandum of understanding to start the government's new healthcare plan and provide emergency treatment to all patients regardless of which scheme they belong to by April 1.The signing ceremony was chaired by Prime Minister Yingluck Shinawatra. Pongsathorn also expressed his concern over the readiness of medical infrastructure and human resources to provide unlimited emergency treatment under the new scheme.

"Many hospitals still do not have enough medical workers and beds to provide emergency medical treatment to patients," he said.

To date, about 150,000 patient beds are available at hospitals across the country. Some hospitals could refuse or transfer patients to receive emergency treatment at other hospitals as they do not have enough beds. Dr Methee Wongsirisuwan, a neurosurgeon at Rajvithi Hospital, said many patients were transferred from other hospitals to receive medical treatment at Rajvithi. "We have to receive patients and provide emergency treatment to them even though we do not have enough beds. We have no choice," he said.

Dr Chalerm Hanpanich, a president of the Private Hospitals Association, said some private hospitals could transfer patients with emergency condition to other hospitals as they do not have enough beds.

Moreover, instead of taking care of patients until they fully recovered, some hospitals might provide basic treatment and transfer them to the patients' original hospitals.

Chalerm also asked the Emergency Medical Institute to be a major agency to send patients back to their original hospitals after they recover. "The government must prepare its system with good management to receive patients for emergency medical services," he said.

NHSO secretary-general Dr Winai Sawasdivorn said non-eligible members of the three national healthcare schemes would also be able to receive emergency medical treatment at any hospital. They do not have to worry about the payment as NHSO, which is in charge as a clearing house, will foot their bill. We will negotiate with their healthcare insurers about reimbursement for their bill," he said. So far, NHSO has only signed an agreement with SSS and the Comptroller's Department for reimbursement with the same rate and procedures.

-- The Nation 2012-03-29

[BookMan]

Is there a plan to cover these millions that have slipped through the net? Universal emergency health care treatment would imply that all Thai people are covered. Surely it is an easy fix to cover the remainder?

[endure]

Thai Govt's Emergency Health Care Scheme Includes 59 Million People

[slapout]

With a population of 68+ million it would seem there are still a substantial group excluded from this new vote getter proposal. Read the fine print on the deals which are being put in the publics eyem as things may not be what they are proclaimed to be.

Another phot shoot/publicity stunt to bring more into the fold????

[moe666]

They didn't budget enough money for the original 30baht plan and hospitals are now in debt up to there eyebrows. Have the government budgeted enough for this plan, more than likely not. PTP in action.

[CalgaryII]

"Pongsathorn also expressed his concern over the readiness of medical infrastructure and human resources to provide unlimited emergency treatment under the new scheme.

"Many hospitals still do not have enough medical workers and beds to provide emergency medical treatment to patients," he said."

On the one hand trying to create the impression how many people are excluded, and in the next breath complaining about pending overuse. The medical profession, along with Government officials, the underground lottery people, teachers and some other groups have reasons to be anti-Ms. Y, considering their treatment at the hands of Mr. T.

To be specific, the 30 baht scheme was not kind to the financial well-being of above noted health professionals, Government officials considered themselves above being civil SERVANTS, the underground lottery people didn't appreciate losing their 'golden goose', and teachers didn't enjoy being faced with Performance Standards.

So it is not surprising to see conflict between health professionals and the Ms. Y. people.

[RussellBellagrego]

Total fiscal insanity. A bankrupt nation will be the result. This little country just cannot generate enough cash flow to provide even the basics of life, You know, like Clean WATER. This is an overreach by standing government to insure their popularity without regard to the future ,Same for the unrealistic and debilitating minimum wage hike to 300 baht.f

[Cheops]

"Emergency care excludes 1 million"

Yes, farangs of course!

It can't be that any farang should possibly helped with free emergency health care, can it! That would be too tourist-friendly

[hansnl]

Total fiscal insanity. A bankrupt nation will be the result. This little country just cannot generate enough cash flow to provide even the basics of life, You know, like Clean WATER. This is an overreach by standing government to insure their popularity without regard to the future ,Same for the unrealistic and debilitating minimum wage hike to 300 baht.f

The biggest problem in Thailand is the fact that the tax office does not have enough "contributors"

So, not enough money comes in, and too much goes out.

[hansnl]

"Emergency care excludes 1 million"

Yes, farangs of course!

It can't be that any farang should possibly helped with free emergency health care, can it! That would be too tourist-friendly

Tourist should have a travel & medical insurance before coming to Thailand.

Expats living in Thailand can have some kind of cover, or have to pay by themselves.

In that case, go to a state hospital, definitely payable.

[hellodolly]

They didn't budget enough money for the original 30baht plan and hospitals are now in debt up to there eyebrows. Have the government budgeted enough for this plan, more than likely not. PTP in action.

The charge of 30 baht cost a hospital 50 baht to administer free service would be cheaper there by allowing the hospitals more money to provide beds.

The bill said nothing about funding hospitals in out lying areas. It is easy to have a Photo op and say thing that sound good but are based on unavailable principals.

[MILT]

What is so typical is the fast tract to make their scam promises when so far not one of their election promises have really worked. Nothing really thought out. This just another failure

[bangon04]

"Emergency care excludes 1 million"

Yes, farangs of course!

It can't be that any farang should possibly helped with free emergency health care, can it! That would be too tourist-friendly

Tourist should have a travel & medical insurance before coming to Thailand.

Expats living in Thailand can have some kind of cover, or have to pay by themselves.

In that case, go to a state hospital, definitely payable.

Maybe he means the Farang who work and pay their taxes.......in Thailand

[timewilltell]

Chalerm also asked the Emergency Medical Institute to be a major agency to send patients back to their original hospitals after they recover. "The government must prepare its system with good management to receive patients for emergency medical services," he said.

Shouldn't they go home after they recover? Or does he mean transfer them when still very sick but no longer an emergency?

Bizzarre!

[Teddy3943]

Emergency? What is emergency here?

When some officials travel through the country the police blocks all the other traffic, sometimes for 20 to 30 minutes, to clear the road for these over-rated creatures. On the other hand, when an ambulance with emergency signals tries to get as quick as possible to a hospital, almost no one will give way. So if you in an emergency situation be prepared to die. This kind of discrimination between "higher class" and ordinary people is one of the disgusting attitudes of many Thais. Sorry to say, but true.

[BigJohnnyBKK]

Is there a plan to cover these millions that have slipped through the net? Universal emergency health care treatment would imply that all Thai people are covered. Surely it is an easy fix to cover the remainder?

Only a million? That's not bad!

Perhaps true for "Thai people", but the hilltribes that are denied citizenship despite having lived here for generations will have to wait for pigs to freeze over, they don't even get to go to school.

And people thinking true foreigners should be covered by the health scheme - what are **you** smoking?

Note that private school teachers are also not covered by the severance pay requirements of the Labor Law, the owners in that industry are pretty well-connected. . .

These two are the only groups that seem like they need fixing to be included IMO.

State-enterprise and local authority organisations presumably have their own insurance schemes in place, and this is likely the justification for the school teachers as well, but as there's no effective labor representation I bet they'll just continue to be shafted. . .

[slapout]

Have no fear, the defination of emergency has been inscribed on the tablets of Thailand. A unnamed newspaper did publish them today.

God help those seeking emergency treatment in the present system, as the enforcement of this proposal may follow the understanding/enforcement of real law here.

[cheeryble]

"Emergency care excludes 1 million"

Yes, farangs of course!

It can't be that any farang should possibly helped with free emergency health care, can it! That would be too tourist-friendly

Not so fast to condemn!

I actually believe universal healthcare here means just that, and farang are covered.

My GF works in a private hospital and says farang can go to the public hospital if they really must.

Not 100% sure would like confirmation.

Life can be a sad thing. I was at the hospital, where i know many of the docs and staff, the other night and while looking for a farang with COPD who had, with difficulty, walked out in a huff to try and sort him out I found another alcoholic farang, white as a sheet, on the deck at the doorstep having a real bad time. After being told he suffered from delusions, I pushed that they need to do something, and we eventually sent him on a free ambulance trip to Maharat public hospital and for the first time I had to organize the belt and pull a man's pee soused trousers up. Too much indignity don't help. There's a thousand stories out there as we speak. Just wish the anti-universal-healthcare lot in the US could get a dose of reality if they were on the receiving end they might change their mind.Cheeryble

Edited March 29, 2012 by cheeryble

[TerryLH]

""Emergency care excludes 1 million"

Yes, farangs of course!"

I'm covered. You aren't?

"Maybe he means the Farang who work and pay their taxes.......in Thailand"

Some are covered, some are not. Paying taxes isn't one of the criteria for being in one of the schemes. Foreigners who quality for any of the schemes are eligible. If you don't, you aren't.

"And people thinking true foreigners should be covered by the health scheme - what are **you** smoking?"

Apparently not the same stuff you are. Many qualify in either the Social Security or the Civil Service schemes.

'I actually believe universal healthcare here means just that, and farang are covered.

My GF works in a private hospital and says farang can go to the public hospital if they really must.

Not 100% sure would like confirmation."

Although some claim to be in the '30 Baht' scheme, they probably got in by someones mistake. They are not really eligible for that scheme as they could be for one of the other two.

But yes, foreigners can use public hospitals. Anyone can. You have to pay, but they are usually inexpensive, comparetively speaking.

[jsflynn603]

"Emergency care excludes 1 million"

Yes, farangs of course!

It can't be that any farang should possibly helped with free emergency health care, can it! That would be too tourist-friendly

Tourist should have a travel & medical insurance before coming to Thailand.

Expats living in Thailand can have some kind of cover, or have to pay by themselves.

In that case, go to a state hospital, definitely payable.

There really is no available health insurance for an expat living in Thailand. One may argue the point but research it and it's true...as the years go by so much will become excluded that in reality you're lucky to be covered for one incident, or worse, find your policy that you thought would last you till death simply cancelled.

As a Registered Nurse (RN) as much as I enjoy Thailand, I will always keep a property in the US to return to if necessary. I don't mind a nice major MI (heart attack) that sweeps me away, but frankly I do fear having my life ending in Thailand with some form of painful illness such as certain types of cancers. Why? Because Thailand has no quality end-of-life care, and poor palliative (pain-relieving) protocols. Thais are fearful of opiates such as morphine and so the answer is, "life is suffering" so let the person suffer until death. I do hope that hospice/palliative care quality takes an exponential leap up over the next decade.

[TerryLH]

"There really is no available health insurance for an expat living in Thailand."

You're right, there isn't - if you mean health insurance just for being a foreigner.

Many foreigners are in either the social security scheme or the civil service scheme. Eligible through work or marriage.

I consider it pretty good coverage, but I haven't had a major event yet.

[frances]

One Million excluded? Is this somehow news? It seems a very tidily manufactured statistical joke given the current population. Based on the math, I must know an inordinate amount of unlucky Thai folks who have not been able to afford treatment for a whole spectrum of diseases while also not understanding the actual three-tier healthcare access schema outlined here... And regarding farangs, well, do the same sums on the US-UK-China-India-Europe etc etc. exclusion rate for medical treatment. Seems to me a million excluded was intended to be read as a triumph these days, which it would be, were it real...Don't forget also that the term 'medical treatment' is highly open to interpretation..when we throw the 'quality' factor into the equation, the term 'medical treatment' may be moot..

Statistics =/ >/< reality equations, plus definition of 'medical treatment' require either a little more thought or outright cynicism. A sincere reaction to same may find you kicking whatever wound acquired in the back of that ambulance in five lanes of traffic...

[BigJohnnyBKK]

There really is no available health insurance for an expat living in Thailand. One may argue the point but research it and it's true...as the years go by so much will become excluded that in reality you're lucky to be covered for one incident, or worse, find your policy that you thought would last you till death simply cancelled.

There is of course no guarantee for life anywhere in this world, but there are many private schemes available that are usually just fine - obviously the higher a premium you can afford and the younger you are when you start the better.

Those of us from more enlightened countries do at least have the option of returning home if necessary and being taken care of, but in the end we all must die. NBD IMO, as long as you've taken the opportunities you've been given to have a good life.

One Million excluded? Is this somehow news?

IMO Thailand has an excellent and relatively enlightened health care system appropriate to its level of development. Wish I could say the same for the US. They should enfranchise the hill tribe people that are now second-third generation, for education as well, and of course the quality and equality of coverage needs improving.

At some point they will also need to make sure staff are better compensated or ASEAN 2015 will see a massive braindrain of the best practictioners.