Bt30 Healthcare Scheme Is Back But Not Everybody Is Happy: Thailand

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Bt30 scheme is back but not everybody is happy

PUANGCHOMPOO PRASERT,

KANNIKAR WIJITSAKONKARN

THE NATION

BANGKOK: -- Despite the return of the Bt30 healthcare scheme, not all hospitals will be collecting the co-payment from patients seeking treatment under the government's universal health plan, which had previously been free.

According to the Public Health Ministry, the fee col?lection must take effect from September 1.

"Many hospitals look set not to collect the Bt30 fee from patients," said Dr Arak Wongworachart, director of Sichon Hospital in Nakhon Si Thammarat. "They will not directly argue with the ministry but they will simply ignore the new rule."

A former president of the Rural Doctors Society, Arak spoke yesterday after attending a meeting called by the ministry on implementation of the Bt30 scheme.

The administration of Prime Minister Yingluck Shinawatra has decided to relaunch the Bt30 co-payment instituted under Thaksin Shinawatra's govern?ment, scrapping a free universal healthcare plan that had been implemented after Thaksin's ousting.

"The fee collection will raise the public's expectations of what they will get from the services and increase work procedures and expenses because hospital staff will have to prepare the payment documents," Arak said.

The director of a hospital in the South complained that the government tried to explain to the public that the co-payment would come with better services, such as making services available during lunch breaks.

"But that's something some hospitals won't be able to provide in practice," the hospital director said on condition of anonymity.

Public Health Ministry permanent secretary Paijit Warachit said most medical facilities under his supervision were equipped to increase the services for the implementation of Bt30-per-visit fee collection. He said only six hospitals at the tambon or district levels were unable to do because they were operating with just one doctor.

"But we are going to reallocate resources," he said.

Paijit also said exemption from the Bt30 co-pay?ment was possible, but approval must be granted on a case-by-case basis.

Arak said: "Asking whether the patients will pay may cause conflicts. Many hospitals believe they had better put up donation boxes. Donation amounts can be much higher."

Meanwhile, about 100 Lamphun residents gathered in front of the provincial hall to protest against the Bt30 plan.

"It's the fundamental right of people to receive health services from the government," Pirun Jantham said yesterday as the coordinator of a network of Lamphun residents who have used the government's free universal healthcare scheme.

He said a large number of people in other Northern provinces, including Chiang Mai and Chiang Rai, were also unhappy about the Bt30 fee.

-- The Nation 2012-08-22

[Siripon]

An absolutely foolish idea from Pheua Thai-reintroduce the 30 baht fee after the Democrats made it free,reasoning collecting 30 baht was not worth the admin cost.

So how to sell to the public? Promise better services (for only 30 baht!). It's not going to happen and will simply cause resentment amongst the patients.

[somtumlion]

Nobody ever said that PTP was smart...

[slapout]

The present government seems to want to tweak/dictate every asspect of public service, with little input by those affected nor those providing the service.

Another example of 'busy work' which will accomplish nothing for anyone, other than possibly hiring/appointing a committee of friends to ensure they get a regular paycheck, at taxpayer expense.

[Greer]

Yes, I thought that one of the reasons for scrapping the 30 baht scheme, as stated in the article, was that it cost more than the incoming just to administer it...so no point.

They are upsetting their own voters through a lack of consideration and common sense...

[ramrod711]

"The fee collection will raise the public's expectations of what they will get from the services and increase work procedures and expenses because hospital staff will have to prepare the payment documents," Arak said.

If this statement makes any sense at all, it eludes me. The public will expect more.....because the staff will all be busy preparing useless paper work.....HUH?

[Moruya]

So, if you drink, smoke or are ill, if you eat chicken, pork or rice, if you have a vehicle, or have kids that need uniform then you will be spending much more per month.

On the other hand, if you are lucky enough to live in one of the 7 (out of 76) provinces that has the 300B minimum wage then you might, possibly, work for a company that was benevolent enough to award the salary increase without strings attached.

Your child may also be one of the 800,000 (out of around 10,000,000) lucky enough to have received a cheap Chinese tablet PC that is about as much use to your child as a chalk board.

Populism at work

[Moruya]

"The fee collection will raise the public's expectations of what they will get from the services and increase work procedures and expenses because hospital staff will have to prepare the payment documents," Arak said.

If this statement makes any sense at all, it eludes me. The public will expect more.....because the staff will all be busy preparing useless paper work.....HUH?

If the service is free and then costs a buck the expectation is that it will be better than it was.

The effort involved in having bits of paper signed by doctors and nurses sent to accounts and used to create a bill, receive a buck, provide a receipt etc. is not worth it.

[rkidlad]

If it ain't broke, don't fix it.

Or, if you're a Thai politician who wants to feel important and assert him/herself because you're a jobsworth - "If it ain't broke, break it"

If you work or have worked in Thailand, you'll know exactly these kind of people.

Edited August 22, 2012 by rkidlad

[joseph49]

So, if you drink, smoke or are ill, if you eat chicken, pork or rice, if you have a vehicle, or have kids that need uniform then you will be spending much more per month.

On the other hand, if you are lucky enough to live in one of the 7 (out of 76) provinces that has the 300B minimum wage then you might, possibly, work for a company that was benevolent enough to award the salary increase without strings attached.

Your child may also be one of the 800,000 (out of around 10,000,000) lucky enough to have received a cheap Chinese tablet PC that is about as much use to your child as a chalk board.

Populism at work

how does Thai med system work please?

[Moruya]

So, if you drink, smoke or are ill, if you eat chicken, pork or rice, if you have a vehicle, or have kids that need uniform then you will be spending much more per month.

On the other hand, if you are lucky enough to live in one of the 7 (out of 76) provinces that has the 300B minimum wage then you might, possibly, work for a company that was benevolent enough to award the salary increase without strings attached.

Your child may also be one of the 800,000 (out of around 10,000,000) lucky enough to have received a cheap Chinese tablet PC that is about as much use to your child as a chalk board.

Populism at work

how does Thai med system work please?

I believe that Thai people are able to apply for a gold health card free of charge. It used to entitle the holder to free health care in most things at government hospitals.

The shaggy dog story is how the hospital is reimbursed for the treatment and whether or not the patient will be seen as too expensive to handle and the subsequent availability of a bed!

[OzMick]

B30 health scheme has always (wrongly) been associated with Thaksin. Free health care was brought in by the Democrats.

The important issue is not the money raised and time wasted, but the glorification of the Great Leader Afar.

[Colabamumbai]

As a foreigner living with a Thai woman in her house, not married, how do I take advantage of the 30B healthcare?

[jcw]

Once you have a 30b collection in place, it is easy to up it to 100b.

[Moruya]

As a foreigner living with a Thai woman in her house, not married, how do I take advantage of the 30B healthcare?

gender reassignment

[Xonax]

Raise the fee to 100 BHT. Enough to administer the payment and will keep the people, who are not really sick away. Unfortunately some people see the doctor only because it is free (or at least extremely cheap).

Edited August 22, 2012 by Xonax

[h90]

An absolutely foolish idea from Pheua Thai-reintroduce the 30 baht fee after the Democrats made it free,reasoning collecting 30 baht was not worth the admin cost.

So how to sell to the public? Promise better services (for only 30 baht!). It's not going to happen and will simply cause resentment amongst the patients.

It must be Thaksins way, only...

[h90]

Raise the fee to 100 BHT. Enough to administer the payment and will keep the people, who are not really sick away. Unfortunately some people see the doctor only because it is free (or at least extremely cheap).

Actually you could also administer 30 Baht with profit. It needs just 1 person per hospital who can do hundreds per day if you cut out every unnecessary bureaucracy.

But cut out unnecessary bureaucracy will simply never happen.....

[belg]

off course, long term farangs and others putting down much money into the local economy, as always, are excluded

many people in the north do not pay 1 cent taxes but they get all the rights

[RisqEM]

PTP seems to be instituting a lot of new fees and taxes lately. Probably to pay for their absurd populist policies??? I mean, can't help the people with government money (that's for fat-cat pockets!)

[SICHONSTEVE]

Yes, I thought that one of the reasons for scrapping the 30 baht scheme, as stated in the article, was that it cost more than the incoming just to administer it...so no point.

They are upsetting their own voters through a lack of consideration and common sense...

'They are upsetting their own voters through a lack of consideration and common sense...'

Great!!! - what with the other stupid schemes and populist policies that have back-fired, it may shorten the life of this 'pathetic rabble' of a so-called government!!!.

[TommoPhysicist]

"The fee collection will raise the public's expectations of what they will get from the services and increase work procedures and expenses because hospital staff will have to prepare the payment documents," Arak said.

If this statement makes any sense at all, it eludes me. The public will expect more.....because the staff will all be busy preparing useless paper work.....HUH?

If the service is free and then costs a buck the expectation is that it will be better than it was.

The effort involved in having bits of paper signed by doctors and nurses sent to accounts and used to create a bill, receive a buck, provide a receipt etc. is not worth it.

If you had even been in a government hospital you would realize that everyone gets an itemized receipt, even if the charge is ZERO. Issuing a receipt with 30bht as a charge will cost nothing extra to process.

[MunterHunter]

off course, long term farangs and others putting down much money into the local economy, as always, are excluded

many people in the north do not pay 1 cent taxes but they get all the rights

Actually i pay all my taxes and i get a card that entitles me to the 30b healthcare,

The service is only available at the government hospitals, which most Farangs wont goto anyway, so your 'we are excluded' comment might be more your opinion than a reality.

A few years back, during the first incarnation of the 30b healthcare i was seeing a heart specialist about some issues i was having at his private clinic, once per week he had to work in a government hospital and asked me to go along to the hospital that day to have an echocardiograph and some other tests. This was in one of the big government hospitals, all the signs were in thai nobody spoke english there... was a nightmare to navigate around and get to where i needed to be and had to wait around for most of the day, When it came to bill time i showed my social security card i got from my employer (pink paper cardi think it was) and guess what... my bill turned up and it was 30b

[h90]

off course, long term farangs and others putting down much money into the local economy, as always, are excluded

many people in the north do not pay 1 cent taxes but they get all the rights

well hardly any farang would want the service you get for this 30 Baht.

I would rather take an veterinarian.....

[h90]

off course, long term farangs and others putting down much money into the local economy, as always, are excluded

many people in the north do not pay 1 cent taxes but they get all the rights

Actually i pay all my taxes and i get a card that entitles me to the 30b healthcare,

The service is only available at the government hospitals, which most Farangs wont goto anyway, so your 'we are excluded' comment might be more your opinion than a reality.

A few years back, during the first incarnation of the 30b healthcare i was seeing a heart specialist about some issues i was having at his private clinic, once per week he had to work in a government hospital and asked me to go along to the hospital that day to have an echocardiograph and some other tests. This was in one of the big government hospitals, all the signs were in thai nobody spoke english there... was a nightmare to navigate around and get to where i needed to be and had to wait around for most of the day, When it came to bill time i showed my social security card i got from my employer (pink paper cardi think it was) and guess what... my bill turned up and it was 30b

Actually shocking is that no one speaks English....how can a Dr pass University without speaking English. As well nurses. I scientific literature is in English. Not Thai.

(And I am not a native English speaker, so the literature is also not in my language).

(I got once the third shot of a vaccine rejected as they weren't sure if the European sold vaccine is good enough quality for Thailand.....so I had to gave it myself).

[MunterHunter]

Actually shocking is that no one speaks English....how can a Dr pass University without speaking English. As well nurses. I scientific literature is in English. Not Thai.

(And I am not a native English speaker, so the literature is also not in my language).

(I got once the third shot of a vaccine rejected as they weren't sure if the European sold vaccine is good enough quality for Thailand.....so I had to gave it myself).

My Doctor spoke English, but none of the staff or nurses did (or wanted to with me, at least)

[Moruya]

"The fee collection will raise the public's expectations of what they will get from the services and increase work procedures and expenses because hospital staff will have to prepare the payment documents," Arak said.

If this statement makes any sense at all, it eludes me. The public will expect more.....because the staff will all be busy preparing useless paper work.....HUH?

If the service is free and then costs a buck the expectation is that it will be better than it was.

The effort involved in having bits of paper signed by doctors and nurses sent to accounts and used to create a bill, receive a buck, provide a receipt etc. is not worth it.

If you had even been in a government hospital you would realize that everyone gets an itemized receipt, even if the charge is ZERO. Issuing a receipt with 30bht as a charge will cost nothing extra to process.

So..... Khun Arak, the protesting quack, has his facts out of whack?

[rubl]

"The fee collection will raise the public's expectations of what they will get from the services and increase work procedures and expenses because hospital staff will have to prepare the payment documents," Arak said.

The director of a hospital in the South complained that the government tried to explain to the public that the co-payment would come with better services, such as making services available during lunch breaks.

"But that's something some hospitals won't be able to provide in practice," the hospital director said on condition of anonymity.

Public Health Ministry permanent secretary Paijit Warachit said most medical facilities under his supervision were equipped to increase the services for the implementation of Bt30-per-visit fee collection. He said only six hospitals at the tambon or district levels were unable to do because they were operating with just one doctor.

"But we are going to reallocate resources," he said.

doctor says 'people will expect better services', PermSec Paijit says most equipped to increase services'. Ergo it must be the doctor who's unwilling to provide better services, nothing to do with the good policies from this government. Soon we'll have another 'mission accomplished' party.

BTW how does an increase from 0 to 30 Baht reflect on inflation statistics?

[BusyBee123]

I can only assume there are huge variations on the quality of government hospitals given some of the replies. My girlfriend had her baby at thammasat university hospital after a long stay there and I thought it was a great hospital. The signs were all in thai but with a little persistance I found my way around quite easily in the end. The prices were on a tier system, you could stay on a general ward for 150 baht a day or private room with aircon tv fridge... 350baht a day against several thousand baht a day in a private hospital. The staff were brilliant big thanks to the Intensive care staff who always had a very competant english speaker every day i was in there and lloked forward to my visits probably to practise english, every day university students would pass and ask many general questions. It felt like it was one big family so I wouldn't hesitate recommending that particular hospital. They also had a black canyon restaurant if I wanted decentish coffee, several other restaurants, an onsite 7/11 and bakery shop plus a mini market on a few days of the week. I was bricking the price of the intensive care stay for the baby but my girlfriend just signed a form and paid 30 baht, i dread to think what that total stay would have been in a private hospital, hundreds of thousands i suspect. Total cost including c section, private room 10 days in icu 23000 baht.

I don't know how the private hospitals run as it was initially my intention to go to a private hospital but my gf refused saying it was too expensive and had no problems with thammasat.

[TommoPhysicist]

I was bricking the price of the intensive care stay for the baby but my girlfriend just signed a form and paid 30 baht, i dread to think what that total stay would have been in a private hospital, hundreds of thousands i suspect. Total cost including c section, private room 10 days in icu 23000 baht.

I don't know how the private hospitals run as it was initially my intention to go to a private hospital but my gf refused saying it was too expensive and had no problems with thammasat.

And yet, if she had used a government hospital, she would have probably delivered naturally, and the stay in hospital would have been 3 days (cost 2 or 3k for the private room). Unless there were medical complications with the birth you haven't told us about.

One of the main problems with elective C section (worldwide), is they can get the due date wrong, in which case a stay in ICU for baby and a big bill. Why was there any charge for baby in ICU, baby is entitled to free health care too?

Edited August 22, 2012 by TommoPhysicist