Solutions offered for inequality in Thailand's healthcare schemes

[webfact]

Solutions offered for inequality in state healthcare schemes
MESINEE MUANGPIN,
PRATCH RUJIVANAROM
THE NATION



COUNCIL SHOULD BE SET UP TO NEGOTIATE BETWEEN THE THREE NATIONAL SYSTEMS AND A RELATED LAW BE PASSED, PANEL PROPOSES

BANGKOK: -- A MEETING led by the Thailand Development Research Institute Foundation (TDRI) was told that the government should establish a National Council on Health Insurance (NCHI) and pass a new law on national healthcare management to tackle the chronic problem of inequality in the national healthcare system.

This proposal aims to resolve inequality between the Universal Coverage Scheme (UC), Social Security Scheme (SS) and Civil Servant Medical Benefit Scheme (CSMBS).

This proposal was offered by a sub-committee that had been set up by the government to study the problem.

The meeting was attended by related agencies and subscribers' representatives yesterday.

Dr Suwit Wibulpolprasert, who leads the subcommittee, said a central agency that can coordinate between the three national healthcare schemes was necessary as it could negotiate between social security agencies, healthcare providers and beneficiaries.

"The NCHI would be under the Prime Minister's Office with the main objective of managing the operation among three social security schemes and cutting down on inequality among subscribers," Suwit said.

NCHI would be comprised of 18 representatives of the stakeholders to ensure participation from all parties.

"The new law on national healthcare management will also regulate the agency's work," he added.

Worawan Chandoevwit, a TDRI specialist on social security, blamed the inequality among these three schemes on different management and operation procedures as they come under the jurisdiction of different agencies.

"Statistics of the per-head cost of medical care for beneficiaries under different schemes from 2008 to 2013 revealed that the per-head cost under CSMBS was six times higher than the other two schemes," Worawan said. "The beneficiaries of CSMBS received up to Bt12,589 per head in 2013, compared to Bt 2,509 per head of SS beneficiaries and Bt2,245 per head for UC beneficiaries, which means those under CSMBS have access to better medical care."

Representatives of social security agencies, healthcare providers and beneficiaries reacted to the proposal by voicing concern about their representation at the NCHI. Many believe the council would have too few representatives and that they could not represent their respective group properly.

Many also asked for clarification about the new law, pointing out that punishment for violators still had to be debated. They also asked about the budget for the new agency.

All comments from yesterday's meeting will be presented to the panel charged with coordinating between the three schemes on Wednesday before passing it on to the Cabinet for consideration, Suwit said.

Source: http://www.nationmultimedia.com/national/Solutions-offered-for-inequality-in-state-healthca-30261650.html


-- The Nation 2015-06-05

[Balance]

The article did not address the reasons for the disparity. Are civil servants that much sicker that the other group? Are they older? Are there differences in the medical providers between the three groups? It would seem logical that the civil servants would go to the doctor more, so there would be potentially large differences in utilization of services, and if any service is paid for and subscribers can access services at any level of medical specialty, then it is likely that there is over utilization. The U.S. system recognizes this and "gate keeper" HMO's are less expensive that full access systems and each person or family can choose what system they want, but they have to pay the difference themselves.

[elgordo38]

Many also asked for clarification about the new law, pointing out that punishment for violators still had to be debated. Make the punishment and fines high enough so the system works. Not the usual slap on the wrist stuff. The "still had to be debated" part scares me as this in a lot of cases means it will gather dust somewhere never to see the light of day.

[Colabamumbai]

I paid 6,610 Baht for a blood test at Khon Kaen University Srinakarind Hospital yesterday and 650 Baht for a liver scan.

Where in the world does a blood test cost more than $200.? Only in Thailand?

[dageurreotype]

How is this going to work in places like Phuket where just one group owns all the hospitals here save for the government Vachira aka 'the slaughterhouse' as the Thais call it, and the small shabby far flung albeit cheaper than 'the monopoly' that is The Mission. You think they can ask Bangkok Phuket Group to lower their insane prices???

Nowhere is the disparity between the rich and the poor so glaring, in any country anywhere in the world, than their attitude towards healthcare. And this country hands down trumps them all.

[rubl]

I guess the wonderful 30 Baht scheme isn't really that wonderful. Better be a government worker.