Thailand's 30 Baht Health Care a Huge Success

[quidnunc]

From the Guardian: http://www.theguardian.com/society/2015/jan/06/-sp-universal-healthcare-the-affordable-dream-amartya-sen

Thailand’s experience in universal healthcare is exemplary, both in advancing health achievements across the board and in reducing inequalities between classes and regions. Prior to the introduction of UHC in 2001, there was reasonably good insurance coverage for about a quarter of the population. This privileged group included well-placed government servants, who qualified for a civil service medical benefit scheme, and employees in the privately owned organised sector, which had a mandatory social security scheme from 1990 onwards, and received some government subsidy. In the 1990s some further schemes of government subsidy did emerge, however they proved woefully inadequate. The bulk of the population had to continue to rely largely on out-of-pocket payments for medical care. However, in 2001 the government introduced a “30 baht universal coverage programme” that, for the first time, covered all the population, with a guarantee that a patient would not have to pay more than 30 baht (about 60p) per visit for medical care (there is exemption for all charges for the poorer sections – about a quarter – of the population).

The result of universal health coverage in Thailand has been a significant fall in mortality (particularly infant and child mortality, with infant mortality as low as 11 per 1,000) and a remarkable rise in life expectancy, which is now more than 74 years at birth – major achievements for a poor country. There has also been an astonishing removal of historic disparities in infant mortality between the poorer and richer regions of Thailand; so much so that Thailand’s low infant mortality rate is now shared by the poorer and richer parts of the country.

[zeichen]

Apparently you have never been in a government hospital. I don't think that getting up at 4 AM to get to the hospital by 5 to wait in line to see a doctor before 5pm is what I would call a success.

You also haven't read the reports about large scale resistant strains of bacteria because doctors are so overwhelmed with patients that they give antibiotics out without testing the strain.

A quote from a local doctor. "The reason I am giving you an antibiotic for a virus is that in a hot climate there are bacterias that go with the virus"

Sorry doc but it isn't a double date.

Though I am a supporter of this policy, I do believe that without education of patients and higher standards for practicioners, the tax payers are funding a lot of waste.

[quidnunc]

Apparently you have never been in a government hospital. I don't think that getting up at 4 AM to get to the hospital by 5 to wait in line to see a doctor before 5pm is what I would call a success.

You also haven't read the reports about large scale resistant strains of bacteria because doctors are so overwhelmed with patients that they give antibiotics out without testing the strain.

A quote from a local doctor. "The reason I am giving you an antibiotic for a virus is that in a hot climate there are bacterias that go with the virus"

Sorry doc but it isn't a double date.

Though I am a supporter of this policy, I do believe that without education of patients and higher standards for practicioners, the tax payers are funding a lot of waste.

The fact remains that from a public health standpoint, the program has been a huge success.

[sam3384]

So there is a balancing test of cheap cost v. inferior medical care.

I suppose it is a major inconvenience to have to wait in a long line for healthcare.

On the other hand if you only get sick once or twice a year how bad can it really be?

If I was a Thai citizen I would rather sit in a long line and pay 30 baht to get stitched up.

I think paying expensive monthly insurance premiums for a service you may or may not need is a tremendous waste of money.

I should also add that I exercise and eat a healthy diet. So I am essentially in charge of my own healthcare.

[quidnunc]

I should also add that I exercise and eat a healthy diet. So I am essentially in charge of my own healthcare.

While exercise and a healthful diet can lower the risk of heart disease, cancer, etc. they don't even come close to eliminating it. And diet and exercise what don't you much good in the event of an accident. Whether you call it chance, or God, or Karma, or whatever, those are the factors that are truly in charge of your health care.

Edited January 7, 2015 by quidnunc

[LuckyLew]

IMO you get what you pay for with the 30 naht coverage

My GF mother went to one of these hospitals offering the 30 baht plan

She had taken a fall at work and need to see a doctor

The gave her an injection for the pain in her knee

The needle was a used needle, not cleaned and not strilized

Ever since then she has walked with a limp, cannot walk for more than 30 minutes

sure only cost her 30 baht, but has not been able to return to work since ..

Might work for some ... but definately not all

[zeichen]

"The fact remains that from a public health standpoint, the program has been a huge success."

Sorry but there are more than one form of facts. There are other long term studies and reports that show that there are side effects to this system.

And from a public health standpoint it is too soon to tell what the long term affects of mistreatment are. Patients going to the doctor for every sniffle, cold and fever have created gridlock and a drive through mentality for most government hospitals.

But yes, I do think that it is better than having nothing. But there still needs to be a serious overhaul.

[quidnunc]

"The fact remains that from a public health standpoint, the program has been a huge success."

Sorry but there are more than one form of facts. There are other long term studies and reports that show that there are side effects to this system.

And from a public health standpoint it is too soon to tell what the long term affects of mistreatment are. Patients going to the doctor for every sniffle, cold and fever have created gridlock and a drive through mentality for most government hospitals.

But yes, I do think that it is better than having nothing. But there still needs to be a serious overhaul.

They would have to be pretty huge side effects to seriously lessen the benefits of this system. Anyway, where can I find these long term studies and reports? I did a cursory search on the internet and found nothing that would back up your assertion.

[quidnunc]

IMO you get what you pay for with the 30 naht coverage

My GF mother went to one of these hospitals offering the 30 baht plan

She had taken a fall at work and need to see a doctor

The gave her an injection for the pain in her knee

The needle was a used needle, not cleaned and not strilized

Ever since then she has walked with a limp, cannot walk for more than 30 minutes

sure only cost her 30 baht, but has not been able to return to work since ..

Might work for some ... but definately not all

So, are you contending that your GF's mother got bad treatment because of the 30 baht program. Are you contending that before the 30 baht program things like this didn't happen?

[casualbiker]

I have been to a few different government hospitals and the service has been very good. To be fair I am from the Uk, so waiting is fairly normal!

Also the article is a bit out of date as there is no charge now.

Edited January 7, 2015 by casualbiker

[bkkgooner]

I should also add that I exercise and eat a healthy diet. So I am essentially in charge of my own healthcare.

I have a funny feeling that a car smashing into you might not care much about your diet or exercise but seriously don't be too naive about illness I have discovered myself that it can strike very suddenly and affect your life in a very serious manner.

My mother in law went to the clinic yesterday because she had diarrhea, she came home with 4 packs of pills

The 30 baht program has the potential to be amazing if they re-educated doctors on the use of antibiotics and general overuse of medication and they severely discouraged people from visiting the hospital or local clinic for every small medical problem.

[Anthony5]

Apparently you have never been in a government hospital. I don't think that getting up at 4 AM to get to the hospital by 5 to wait in line to see a doctor before 5pm is what I would call a success.

You also haven't read the reports about large scale resistant strains of bacteria because doctors are so overwhelmed with patients that they give antibiotics out without testing the strain.

A quote from a local doctor. "The reason I am giving you an antibiotic for a virus is that in a hot climate there are bacterias that go with the virus"

Sorry doc but it isn't a double date.

Though I am a supporter of this policy, I do believe that without education of patients and higher standards for practicioners, the tax payers are funding a lot of waste.

My son went the other day to the local government hospital for two teeth that had a hole. This wasn't under the 30 Baht scheme but still under the health care system.

He was told that it was only possible on Tuesday and Thursday and he had to be there before 6am.

So on Tuesday he went back before 6am, waited about 4 hours to see the doctor, then he was told they had to put him on the queue ..............which was 5 months .

He will go see a normal dentist in the next few days.

[casualbiker]

Apparently you have never been in a government hospital. I don't think that getting up at 4 AM to get to the hospital by 5 to wait in line to see a doctor before 5pm is what I would call a success.

You also haven't read the reports about large scale resistant strains of bacteria because doctors are so overwhelmed with patients that they give antibiotics out without testing the strain.

A quote from a local doctor. "The reason I am giving you an antibiotic for a virus is that in a hot climate there are bacterias that go with the virus"

Sorry doc but it isn't a double date.

Though I am a supporter of this policy, I do believe that without education of patients and higher standards for practicioners, the tax payers are funding a lot of waste.

My son went the other day to the local government hospital for two teeth that had a hole. This wasn't under the 30 Baht scheme but still under the health care system.

He was told that it was only possible on Tuesday and Thursday and he had to be there before 6am.

So on Tuesday he went back before 6am, waited about 4 hours to see the doctor, then he was told they had to put him on the queue ..............which was 5 months .

He will go see a normal dentist in the next few days.

I'm kinda gobs smacked that you didn't take him to a "normal dentist " in the first place!

[Anthony5]

Apparently you have never been in a government hospital. I don't think that getting up at 4 AM to get to the hospital by 5 to wait in line to see a doctor before 5pm is what I would call a success.

You also haven't read the reports about large scale resistant strains of bacteria because doctors are so overwhelmed with patients that they give antibiotics out without testing the strain.

A quote from a local doctor. "The reason I am giving you an antibiotic for a virus is that in a hot climate there are bacterias that go with the virus"

Sorry doc but it isn't a double date.

Though I am a supporter of this policy, I do believe that without education of patients and higher standards for practicioners, the tax payers are funding a lot of waste.

My son went the other day to the local government hospital for two teeth that had a hole. This wasn't under the 30 Baht scheme but still under the health care system.

He was told that it was only possible on Tuesday and Thursday and he had to be there before 6am.

So on Tuesday he went back before 6am, waited about 4 hours to see the doctor, then he was told they had to put him on the queue ..............which was 5 months .

He will go see a normal dentist in the next few days.

I'm kinda gobs smacked that you didn't take him to a "normal dentist " in the first place!

Well, the normal dentist asks 5000 Baht, the hospital quoted between 300 and 400 Baht.

I assume the dentist at the hospital is normal.

[samii]

If you seek a dentists from public health care in my country and if your teeth are not dropping off, you probably will have to wait at least one month for an actual appointment

It is good that some of the so called populistic programs are getting noticed elsewhere. Six o'clock information package will probably anyway take the credit...btw because of the 6 pm broadcast, the popularity of Lao tv is in a strong rise especially in NE

[sam3384]

I should also add that I exercise and eat a healthy diet. So I am essentially in charge of my own healthcare.

I have a funny feeling that a car smashing into you might not care much about your diet or exercise but seriously don't be too naive about illness I have discovered myself that it can strike very suddenly and affect your life in a very serious manner.

My mother in law went to the clinic yesterday because she had diarrhea, she came home with 4 packs of pills

The 30 baht program has the potential to be amazing if they re-educated doctors on the use of antibiotics and general overuse of medication and they severely discouraged people from visiting the hospital or local clinic for every small medical problem.

I never implied that healthy living is a cure all for whatever might lie waiting in the future. But at least it helps to eliminate many illness associated with living a sedentary lifestyle and/or eating junk food.

[Robby nz]

Apparently you have never been in a government hospital. I don't think that getting up at 4 AM to get to the hospital by 5 to wait in line to see a doctor before 5pm is what I would call a success.

You also haven't read the reports about large scale resistant strains of bacteria because doctors are so overwhelmed with patients that they give antibiotics out without testing the strain.

A quote from a local doctor. "The reason I am giving you an antibiotic for a virus is that in a hot climate there are bacterias that go with the virus"

Sorry doc but it isn't a double date.

Though I am a supporter of this policy, I do believe that without education of patients and higher standards for practicioners, the tax payers are funding a lot of waste.

The fact remains that from a public health standpoint, the program has been a huge success.

Are you aware that during the time of the Democrat Govt of Abhisit they did away with the 30 baht because it was costing more to collect than it was bringing in therefor making the scheme free.

The Yingluck Govt reintroduced the 30 baht.

Why they would do that you will have to try to work out for yourself.

[casualbiker]

Apparently you have never been in a government hospital. I don't think that getting up at 4 AM to get to the hospital by 5 to wait in line to see a doctor before 5pm is what I would call a success.

You also haven't read the reports about large scale resistant strains of bacteria because doctors are so overwhelmed with patients that they give antibiotics out without testing the strain.

A quote from a local doctor. "The reason I am giving you an antibiotic for a virus is that in a hot climate there are bacterias that go with the virus"

Sorry doc but it isn't a double date.

Though I am a supporter of this policy, I do believe that without education of patients and higher standards for practicioners, the tax payers are funding a lot of waste.

My son went the other day to the local government hospital for two teeth that had a hole. This wasn't under the 30 Baht scheme but still under the health care system.

He was told that it was only possible on Tuesday and Thursday and he had to be there before 6am.

So on Tuesday he went back before 6am, waited about 4 hours to see the doctor, then he was told they had to put him on the queue ..............which was 5 months .

He will go see a normal dentist in the next few days.

I'm kinda gobs smacked that you didn't take him to a "normal dentist " in the first place!

Well, the normal dentist asks 5000 Baht, the hospital quoted between 300 and 400 Baht.

I assume the dentist at the hospital is normal.

5,000 baht for a filling ... Jesus. That's expensive ..

[Sheryl]

Look, this is a glass half empty or glass half full kind of thing.

The system is certainly not without flaws and problems, but it is also certainly a vast improvement over the past situation.

[Anthony5]

Well, the normal dentist asks 5000 Baht, the hospital quoted between 300 and 400 Baht.

I assume the dentist at the hospital is normal.

5,000 baht for a filling ... Jesus. That's expensive ..

It are actually 2 fillings and repair those teeth as they are broken at the bottom.

But I also thought it was expensive, specifically since it is a dentist practice on the east side of Pattaya, not such a tourist trap.

[CaptHaddock]

MIT researchers found that in the first year alone of the 30 baht scheme infant mortality in Thailand was reduced by 13%. In public health terms, that is huge.

http://newsoffice.mit.edu/2014/how-health-care-plan-quickly-lowered-infant-mortality-0430

Chris Baker cites an additional statistic that the 30 baht scheme reduced poverty in Thailand by 30%. That's another vast improvement. Health care costs can crush households. In the US health care costs are the leading cause of bankruptcy.

The Western middle-class posters who complain about waiting on line and the other inconveniences of public health care show an embarassing inablity to conceive of what poverty is like. What is waiting on line compared to a child's dying?

The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays.

[casualbiker]

MIT researchers found that in the first year alone of the 30 baht scheme infant mortality in Thailand was reduced by 13%. In public health terms, that is huge.

http://newsoffice.mit.edu/2014/how-health-care-plan-quickly-lowered-infant-mortality-0430

Chris Baker cites an additional statistic that the 30 baht scheme reduced poverty in Thailand by 30%. That's another vast improvement. Health care costs can crush households. In the US health care costs are the leading cause of bankruptcy.

The Western middle-class posters who complain about waiting on line and the other inconveniences of public health care show an embarassing inablity to conceive of what poverty is like. What is waiting on line compared to a child's dying?

The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays.

" The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays."

It is a good scheme and it wasn't Thaksin's idea he just brushed it off and called it his. It was originally thought up just before the crash but had to be shelved .... move onto 2001 the world is in boom time, Thailand can finally afford it. As for your comments above.

The Democrats made it free of charge, citing that it actually cost more to take the 30b. Yingluck's government put the 30b back on (but only if you WANT to pay it) crass idea really, changing something so you can call it your own!

[quidnunc]

"The fact remains that from a public health standpoint, the program has been a huge success."

Sorry but there are more than one form of facts. There are other long term studies and reports that show that there are side effects to this system.

Still waiting to see some evidence that those studies actually exist. I can't find any evidence of them.

[quidnunc]

MIT researchers found that in the first year alone of the 30 baht scheme infant mortality in Thailand was reduced by 13%. In public health terms, that is huge.

http://newsoffice.mit.edu/2014/how-health-care-plan-quickly-lowered-infant-mortality-0430

Chris Baker cites an additional statistic that the 30 baht scheme reduced poverty in Thailand by 30%. That's another vast improvement. Health care costs can crush households. In the US health care costs are the leading cause of bankruptcy.

The Western middle-class posters who complain about waiting on line and the other inconveniences of public health care show an embarassing inablity to conceive of what poverty is like. What is waiting on line compared to a child's dying?

The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays.

" The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays."

It is a good scheme and it wasn't Thaksin's idea he just brushed it off and called it his. It was originally thought up just before the crash but had to be shelved .... move onto 2001 the world is in boom time, Thailand can finally afford it. As for your comments above.

The Democrats made it free of charge, citing that it actually cost more to take the 30b. Yingluck's government put the 30b back on (but only if you WANT to pay it) crass idea really, changing something so you can call it your own!

My recollection is that the Democrat party opposed the plan when Thaksin brought it up for a vote. Am I incorrect?

[casualbiker]

MIT researchers found that in the first year alone of the 30 baht scheme infant mortality in Thailand was reduced by 13%. In public health terms, that is huge.

http://newsoffice.mit.edu/2014/how-health-care-plan-quickly-lowered-infant-mortality-0430

Chris Baker cites an additional statistic that the 30 baht scheme reduced poverty in Thailand by 30%. That's another vast improvement. Health care costs can crush households. In the US health care costs are the leading cause of bankruptcy.

The Western middle-class posters who complain about waiting on line and the other inconveniences of public health care show an embarassing inablity to conceive of what poverty is like. What is waiting on line compared to a child's dying?

The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays.

" The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays."

It is a good scheme and it wasn't Thaksin's idea he just brushed it off and called it his. It was originally thought up just before the crash but had to be shelved .... move onto 2001 the world is in boom time, Thailand can finally afford it. As for your comments above.

The Democrats made it free of charge, citing that it actually cost more to take the 30b. Yingluck's government put the 30b back on (but only if you WANT to pay it) crass idea really, changing something so you can call it your own!

My recollection is that the Democrat party opposed the plan when Thaksin brought it up for a vote. Am I incorrect?

Dunno.. find a link!

[quidnunc]

MIT researchers found that in the first year alone of the 30 baht scheme infant mortality in Thailand was reduced by 13%. In public health terms, that is huge.

http://newsoffice.mit.edu/2014/how-health-care-plan-quickly-lowered-infant-mortality-0430

Chris Baker cites an additional statistic that the 30 baht scheme reduced poverty in Thailand by 30%. That's another vast improvement. Health care costs can crush households. In the US health care costs are the leading cause of bankruptcy.

The Western middle-class posters who complain about waiting on line and the other inconveniences of public health care show an embarassing inablity to conceive of what poverty is like. What is waiting on line compared to a child's dying?

The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays.

" The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays."

It is a good scheme and it wasn't Thaksin's idea he just brushed it off and called it his. It was originally thought up just before the crash but had to be shelved .... move onto 2001 the world is in boom time, Thailand can finally afford it. As for your comments above.

The Democrats made it free of charge, citing that it actually cost more to take the 30b. Yingluck's government put the 30b back on (but only if you WANT to pay it) crass idea really, changing something so you can call it your own!

My recollection is that the Democrat party opposed the plan when Thaksin brought it up for a vote. Am I incorrect?

Dunno.. find a link!

I'll keep on looking And since I'm looking for that, can you find a link supporting your contention that the program was originally the scheme of the Democrat party?

Edited January 8, 2015 by quidnunc

[casualbiker]

MIT researchers found that in the first year alone of the 30 baht scheme infant mortality in Thailand was reduced by 13%. In public health terms, that is huge.

http://newsoffice.mit.edu/2014/how-health-care-plan-quickly-lowered-infant-mortality-0430

Chris Baker cites an additional statistic that the 30 baht scheme reduced poverty in Thailand by 30%. That's another vast improvement. Health care costs can crush households. In the US health care costs are the leading cause of bankruptcy.

The Western middle-class posters who complain about waiting on line and the other inconveniences of public health care show an embarassing inablity to conceive of what poverty is like. What is waiting on line compared to a child's dying?

The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays.

" The 30 baht scheme is an achievement that every Thai should be proud of. That's not the case unfortunately and it looks like a matter of time until the resurgent ammat weakens the system by requiring copays."

It is a good scheme and it wasn't Thaksin's idea he just brushed it off and called it his. It was originally thought up just before the crash but had to be shelved .... move onto 2001 the world is in boom time, Thailand can finally afford it. As for your comments above.

The Democrats made it free of charge, citing that it actually cost more to take the 30b. Yingluck's government put the 30b back on (but only if you WANT to pay it) crass idea really, changing something so you can call it your own!

My recollection is that the Democrat party opposed the plan when Thaksin brought it up for a vote. Am I incorrect?

Dunno.. find a link!

I'll keep on looking And since I'm looking for that, can you find a link supporting your contention that the program was originally the scheme of the Democrat party?

Firstly I didn't say it was the Democrats. I said he dusted off an old scheme.

Full details here : http://www.ncbi.nlm.nih.gov/m/pubmed/11012405/

[quidnunc]

The reason I assumed that it was originally a Democrat proposal is this: why else would you bring it up? How is it relevant? Take these examples from U.S. Politics;

Financial stimulus during a deep recession despite deficits was the idea of John Maynard Keynes. , Obamacare was originally a proposal from conservative economists at the Heritage society But how is this relevant to the issue? There are hundreds, make that thousands of polcy proposals out there. But the person who deserves th credit or the blame is the one who makes it law. The rest is an interesting historical footnote but no more.

I can't find a link but I have asked a person who follows Thai politics closely and she said the democrats were opposed to the 30 baht plan. So yes, there was a program, it died, and the democrats were opposed to its revival. So who exactly should get credit for the program in its current incarnation?

[casualbiker]

The reason I assumed that it was originally a Democrat proposal is this: why else would you bring it up? How is it relevant? Take these examples from U.S. Politics;

Financial stimulus during a deep recession despite deficits was the idea of John Maynard Keynes. , Obamacare was originally a proposal from conservative economists at the Heritage society But how is this relevant to the issue? There are hundreds, make that thousands of polcy proposals out there. But the person who deserves th credit or the blame is the one who makes it law. The rest is an interesting historical footnote but no more.

I can't find a link but I have asked a person who follows Thai politics closely and she said the democrats were opposed to the 30 baht plan. So yes, there was a program, it died, and the democrats were opposed to its revival. So who exactly should get credit for the program in its current incarnation?

I mentioned it so that people were informed that it wasn't a wonder idea from Thaksin. I actually believe that the health care scheme is a valuable addition for Thailand.

Although many health care experts are saying it's always been underfunded, but I think that's the nature of general schemes like this.

Seeing as how neither of us can find ANY reference to the Democrats opposing the scheme we will have to believe "a person that follows Thai politics " that they did oppose it.

[quidnunc]

Anyway, thanks for posting that link. It was interesting to see that Thailand was on the verge of having widespread, if not universal, healthcare before 1997. I didn't know that.