Thai editorial: Keep politics out of the healthcare debate

[webfact]

EDITORIAL
Keep politics out of the healthcare debate
The Nation

Outrage caused by a rumour of its demise illustrates the popularity of Bt30 healthcare, too important now to let go

BANGKOK: -- It turned out to be only a "rumour" that the universal healthcare scheme was to be scrapped, but the outcry it caused served to underline the programme's importance. Users of the social media raised a roar of dismay and the alarm spread among the general populace before Prime Minister Prayut Chan-o-cha stepped forward on Monday with reassurance that there was no intention to end the "Bt30 healthcare plan", as it was originally known.

There has been from the start a group of doctors who have warned that public reliance on government-subsidised healthcare will continue to increase, steadily draining state funds. They have proposed in its place a "co-payment" scheme by which citizens who can afford to pay more do so, lifting much of the weight from the government's shoulders so that lower-income people can receive healthcare for free.

Even such compromises fail to assuage critics of what began as a classic "populist" election campaign pledge. They point out that the country is suffering financially in spending Bt120 billion a year subsidising healthcare for almost 50 million people.

Advocates of universal healthcare counter that the government spends just 4 per cent of Gross Domestic Product on healthcare, a moderate proportion that poses no economic threat in the short term or the long term. Japan adopted universal healthcare 50 years ago, when its GDP was significantly smaller than Thailand's is today. Rights activists add that Thai people are entitled to the state's care as a fundamental right of citizenship.

For Thais who struggle to make ends meet, the programme has been a boon since its implementation in 2002. They no longer have to worry about money when they are injured or fall ill. Gone are the days when personal dignity had to be sacrificed because they required free medical treatment, when they would be tarred with the epithet "anatha" - destitute patients.

Like any other socially beneficial government programme that is simple and straightforward in its conception, the Bt30-per-medical-visit scheme has demanded efficient teamwork to keep it sustainable. The task will only become more difficult as society continues to age because of the low birth rate. The cost of running the plan will never stop rising. The government would do well to regard whatever arguments arise now as blessings in disguise - criticism that can be mined for constructive help in refining the scheme and finding ways to keep it going.

As long as universal healthcare remains in place, safe for now from its detractors, the government should be studying its strengths and weaknesses. It could well combine universal healthcare with the Civil Medical Benefit Scheme, as has been proposed, or seek sources of additional funding outside the state budget to maintain the programme as it stands.

Currently about five million people are registered with the CMBS, each spending Bt12,000 per annum, far in excess of the average Bt2,700 spent by those relying on universal healthcare.

Further debate - and even the occasional alarmist rumour - ought to do us some good. Debate, however, can only be tolerated if it is free of a political edge. Since it was former premier Thaksin Shinawatra who introduced universal healthcare, the argument over its continuation easily leads into political cul-de-sacs. All that is at stake now is the continued well-being of the public.

Political agendas must be put aside.

Source: http://www.nationmultimedia.com/opinion/Keep-politics-out-of-the-healthcare-debate-30263968.html


-- The Nation 2015-07-08

[deckape]

Do they really think politics can be absent of a debate on subsidized health care?

I feel dumber for having read some of this s--t.

[Eric Loh]

Prayuth has really done Thaksin a favour by raising this subject. Now more people realized the good programs that Thaksin introduced besides the Village Fund (continued) and OTOP (continued). Prayuth did poke fun and try to run down OTOP recently which really is not working and annoying many poor people involved. This guy is idiosyncratic and really not politically savvy.

[mmh8]

OR ELSE you will be sent for attitude adjustment training

[billd766]

Prayuth has really done Thaksin a favour by raising this subject. Now more people realized the good programs that Thaksin introduced besides the Village Fund (continued) and OTOP (continued). Prayuth did poke fun and try to run down OTOP recently which really is not working and annoying many poor people involved. This guy is idiosyncratic and really not politically savvy.

Actually it was originally a Democratic party plan that wasn't brought in due to the cost and that little old 1997 financial crash which the Democrats inherited (and got blamed for).

It was and still is a good idea but it does have several problems.

1 It has always been underfunded right from the very beginning and neither the TRT/PPP/PTP nor the Democrats nor the military government of 2006/07 ever pumped enough money into it.

2 The 30 baht fee cost more to administer and the Democrats under Abhisit scrapped it and made the UHC free. The PTP under Yingluck re-introduced it and the lataest government is carrying on with the charge.

I believe that it should be kept going but like the national Health System in the UK it consumes more financial resources every year and will always do so. The hard part is going to be how to fund it. Cut somebodys budget or increase taxes?

The village fund wasn't a bad idea either unless you were/are in the Pu Yai Ban bad books in which case forget it. It also needs much more accountability and transparency.

OTOP in rural Thailand is dying on its own and does not need Prayuth to help it. There is an OTOP shop in my small village and I have not seen it open in months. Some shops are just about surviving but most aren't.

Eric, when was the last time YOU went into an OTOP shop and what did you buy?

[Bluespunk]

"Debate, however, can only be tolerated if it is free of a political edge."

Nonsense.

[Bluespunk]

"Political agendas must be put aside."

And how can this be done when discussing subsidised/free healthcare?

[elgordo38]

Do they really think politics can be absent of a debate on subsidized health care?

I feel dumber for having read some of this s--t.

The government is floating trial balloons to see if they can axe the program. I think they got quite a backlash from the people but when they want to do away with a program they keep chipping away at it till like a block of ice it is all gone.

[Eric Loh]

Prayuth has really done Thaksin a favour by raising this subject. Now more people realized the good programs that Thaksin introduced besides the Village Fund (continued) and OTOP (continued). Prayuth did poke fun and try to run down OTOP recently which really is not working and annoying many poor people involved. This guy is idiosyncratic and really not politically savvy.

Actually it was originally a Democratic party plan that wasn't brought in due to the cost and that little old 1997 financial crash which the Democrats inherited (and got blamed for).

It was and still is a good idea but it does have several problems.

1 It has always been underfunded right from the very beginning and neither the TRT/PPP/PTP nor the Democrats nor the military government of 2006/07 ever pumped enough money into it.

2 The 30 baht fee cost more to administer and the Democrats under Abhisit scrapped it and made the UHC free. The PTP under Yingluck re-introduced it and the lataest government is carrying on with the charge.

I believe that it should be kept going but like the national Health System in the UK it consumes more financial resources every year and will always do so. The hard part is going to be how to fund it. Cut somebodys budget or increase taxes?

The village fund wasn't a bad idea either unless you were/are in the Pu Yai Ban bad books in which case forget it. It also needs much more accountability and transparency.

OTOP in rural Thailand is dying on its own and does not need Prayuth to help it. There is an OTOP shop in my small village and I have not seen it open in months. Some shops are just about surviving but most aren't.

Eric, when was the last time YOU went into an OTOP shop and what did you buy?

Funding the healthcare was never a problem during Thaksin time. It is all about capable leadership and government. Poor government like current will always find something to blame when they cant do a good job. You can't ignore how Thaksin grew the GDP from 4 to 7 T and the national budget were always in surplus, even if you don't like the guy. Even the debt to GDP decreased and we have enough to pay off the IMF loan early. Regarding OTOP, it started to go down hill after the '06 coup government did a re-branding. Given a chance, the military Govnment will killed the project.

Last time I shop at an OTOP, easy, last weekend on way to and back Hua Hin. Bought lots of dry food for my family and friends. I find their food items very reasonable in prices. When you last shop?

[Srikcir]

"Thai people are entitled to the state's care as a fundamental right of citizenship."

When the Junta has stripped the Thai citizenship of their rights and liberties, they will respond quickly and negatively to more loss of their control over their national destiny. If the Junta wants to address the issue it should do so in a public forum and allow open and free discussion.

But we're dealing with a Junta that has yet even to commit to putting its draft constitutiotn to a referendum. What we will likely see soon is a Dusit poll showing 85% of those polled agree with the co-payment idea.

[h90]

Prayuth has really done Thaksin a favour by raising this subject. Now more people realized the good programs that Thaksin introduced besides the Village Fund (continued) and OTOP (continued). Prayuth did poke fun and try to run down OTOP recently which really is not working and annoying many poor people involved. This guy is idiosyncratic and really not politically savvy.

It was the program of the Democrats, but they had to postpone it because 1997 Thaksin and his buddies caused the crash of the Thai Baht and on the next elections they lost and Thaksin just followed the Democrats program.

The 30 Baht scheme never run well because Thaksin didn't fund it correct + it is over bureaucratic (collecting 30 Baht costs more than 30 Baht)

[wabothai]

amazing editorial