'No major change to Thai health scheme'

[webfact]

'No major change to health scheme'
The Nation

Meeting to discuss co-payment, but minister says universal scheme won’t be scrapped

BANGKOK: -- THE Public Health Ministry has denied that it is planning to scrap or drastically change the universal healthcare scheme.

"The scheme will definitely remain in place. People won't be affected. It's just that we've been discussing how to make it sustainable," Public Health Minister Piyasakol Sakolsatayadorn said last week.

The minister was trying to play down mounting public concern that serious discussion over the scheme may lead to its demise.

Currently, about 48 million Thais enjoy access to most kinds of medical treatment at no cost under the scheme.

While the scheme has garnered international praise, economists and health experts are worried about the huge financial burden it imposes on state coffers.

Recently, word has spread that authorities are considering the option of introducing co-payments, which will require patients to pay a fee for some of the services they receive. Criticism has been growing since this has emerged.

Piyasakol said his ministry would meet tomorrow with a committee tasked with mobilising resources for the sustainability of the country's national health security scheme.

Dr Ammar Siamwalla, an expert in health insurance at the Thailand Research Development Institute, serves as an adviser to the committee. Dr Suwit Wibulpolprastert, a former specialist at the Public Health Ministry, is its chairman.

"We will listen to the recommendation from the committee that has already studied the issues," Piyasakol said.

'Japan forced to scrap its scheme'

Dr Yong Poovorawan of Chulalongkorn University said on Facebook that no one should ignore the problems associated with the universal healthcare scheme, which started as a Bt30-per-medical-visit programme more than a decade ago. Japan had implemented such a scheme and was compelled to ditch it in the end, he said.

Britain was still going ahead with its version but with far fewer |participating providers, he said.

After the Bt30 scheme was launched, Yong said Thailand could not introduce new free vaccinations for children.

So, he believed it had weakened the country's ability to prevent disease.

Yong urged people or non-|government organisations that oppose a co-payment for health services to look at the situation realistically.

"Co-payment will reduce the risk of the healthcare system |collapsing. It will also raise the standards of the medical services provided," he said.

Source: http://www.nationmultimedia.com/national/No-major-change-to-health-scheme-30275788.html


-- The Nation 2015-12-28

[shirtless]

You know what ever happens your leaders will get the best care

[phitsanulokjohn]

Shame the same free treatment of Thai citizens living in the Uk,isn't reciprocated to Uk citizens living here.

[aussieinthailand]

Now I've said it before and I'll say it again, If they got serious about fixing the health system there are a lot of ways to do it, starting with the mass corruption that is like all other things in LOS, find a way to make extra money and exploit it as much as possible regardless of it's impact on people or the country as a whole.

Corruption example 1. Wife told you need an injection, ok, we need to admit you overnight for your injection, = cost of injection + overnight in hospital???

Wife said NO and went too privet hospital, 200 baht for injection and out in 15 mins.

Corruption example 2. Wife needed Hemo Dialysis cable removed and a stich, ok, you need to be admitted overnight, cost of procedure + overnight in

hospital???

Wife goes back too privet hospital has procedure done 400 baht and out in 20 mins.

Corruption example 3. Wife goes too hospital every three months for med's and sundries, All day exercise in hospital inefficiency, cost med's 30 baht, + 1200 baht for 50% sundries and told go too local hospital to pick up the remaining 50% sundries, at local hospital armed with doctors prescription, 1/2 day exercise at hospital, as they don't accept doctors prescription and see doctor again, consult doctor for exactly the same (sundries 50% ) as doctor reads other script and writs new script... cost of consult doctor, 30 baht, 50% sundries free.

The picture is the care is not for the patient but the interest is in generating opportunity's to make money from the state which pays the 30 bath scheme.

Fix the corruption and half the battle is won...

[oneday]

"...THE Public Health Ministry has denied that it is planning to scrap or drastically change the universal healthcare scheme..."

The more they deny it, the easier it is to believe something bad for the poor people is in the works.

[connda]

Private insurance companies can't dominate health care like in the US. Don't think for a minute that 30 baht universal healthcare will be allowed to stand long-term. Expect 'end universal healthcare trolls' to appear out of the wood work.

[connda]

Now I've said it before and I'll say it again, If they got serious about fixing the health system there are a lot of ways to do it, starting with the mass corruption that is like all other things in LOS, find a way to make extra money and exploit it as much as possible regardless of it's impact on people or the country as a whole.

Corruption example 1. Wife told you need an injection, ok, we need to admit you overnight for your injection, = cost of injection + overnight in hospital???

Wife said NO and went too privet hospital, 200 baht for injection and out in 15 mins.

Corruption example 2. Wife needed Hemo Dialysis cable removed and a stich, ok, you need to be admitted overnight, cost of procedure + overnight in

hospital???

Wife goes back too privet hospital has procedure done 400 baht and out in 20 mins.

Corruption example 3. Wife goes too hospital every three months for med's and sundries, All day exercise in hospital inefficiency, cost med's 30 baht, + 1200 baht for 50% sundries and told go too local hospital to pick up the remaining 50% sundries, at local hospital armed with doctors prescription, 1/2 day exercise at hospital, as they don't accept doctors prescription and see doctor again, consult doctor for exactly the same (sundries 50% ) as doctor reads other script and writs new script... cost of consult doctor, 30 baht, 50% sundries free.

The picture is the care is not for the patient but the interest is in generating opportunity's to make money from the state which pays the 30 bath scheme.

Fix the corruption and half the battle is won...

Wife has stomach problems. We wait 9.5 hours to make an appointment. Wife is given appointment for upper GI scope a week later. At hospital for 4 hours the day of the procedure. Diagnosed with H. Pylori and given medication. Total cost to make appointment, procedure, and meds: 60 THB. Private hospital charges approximately 19K THB for same procedure and medication.

Well worth the wait. At private hospital she'd save perhaps 8 hours. Cost of time: 19K THB/8 = Pay 2.4K per hour saved. And that's why the average Thai goes to a government hospital.

If you personally don't like government hospitals, and you have the money to spend at a private hospital or private insurance, feel free to exercise your freedom of choice. There is plenty of freedom of choice in the present system. As evident, nobody is forcing your wife to use a government hospital as you attest. Currently, every Thai has the ability to make that same choice to balance cost, cost saving, and time into their personal choice of treatment. Don't fix what ain't broke.

Edited December 28, 2015 by connda

[daveAustin]

Britain was still going ahead with its 'version'? The NHS has been offering free healthcare since the 50s.

[webfact]

MOPH denies it will abolish universal healthcare, considers forming healthcare panel

BANGKOK, 28 December 2015 (NNT) - The Ministry of Public Health has confirmed that there are no plans to abolish universal healthcare, but there have been discussions on how to make the system more sustainable.

Public Health Minister Piyasakol Sakolsatayadorn spoke about the direction of public health reforms, dismissing rumors of plans to abolish universal healthcare. He advocated the system, which has received praise from the international community.

However, Dr. Piyasakol admitted that there have been discussions with all parties on how to create a more stable healthcare system with long-term sustainability.

To this end, the ministry is considering the establishment of a committee to direct policy on Thailand's healthcare system. The committee would be co-chaired by Ammar Siamwalla, a distinguished scholar with the Thailand Development Research Institute and Dr. Suwit Wibulpolprasert, former Senior Advisor at the Ministry of Public Health. The committee would be established after public health reforms have been finalized, a process that could take up to a year.


-- NNT 2015-12-28

[elgordo38]

"...THE Public Health Ministry has denied that it is planning to scrap or drastically change the universal healthcare scheme..."

The more they deny it, the easier it is to believe something bad for the poor people is in the works.

Yes your right. Trial balloons all over the place. Just like the sub deal. They assured everybody it was a no go and bang it was a done deal. The system is an easy read here. Yes means no and no means yes. Lull the masses into tranquility and then lower the boom. Its done over next the shock factor works here. Edited December 28, 2015 by elgordo38

[Srikcir]

'Japan forced to scrap its scheme'

Here is its present scheme (TY Wikipedia):

- Health insurance is, in general, mandatory for residents of Japan although no penalty

- All hospitals are not-for-profit

- Public health insurance pays 70% or more of medical and prescription drug costs with the remainder being covered by the patient (upper limits apply)

- The monthly insurance premium is paid per household and scaled to annual income

- Supplementary private health insurance is available only to cover the co-payments or non-covered costs

And Thais are concerned about a Bt30 co-payment?

[webfact]

‘No change to health schemes’
Pratch Rujivanarom
The Nation

BANGKOK: -- But minister says a panel will look at funding ideas

THE Public Health Minister has said there will be no change to the three major health schemes next year - but a ministry committee will be set up to consider suggestions on how to improve the schemes.

Yesterday, the committee studying sustainable long-term funding mechanisms for the health schemes presented the suggestions based on "SAFE" principles - sustainability, adequacy, fairness and efficiency - which stem from efforts to ensure their financial sustainability.

The schemes are: the Universal Health Coverage Scheme, the Social Security Scheme and the Civil Servant Medical Benefit Scheme.

Public Health Minister Piyasakol Sakolsatayadorn said the ministry accepted the suggestions of the committee and he will set up another committee to consider their recommendations in detail to prepare for real implementation.

Given many people were concerned about changes to public health systems, Piyasakol assured that there would be no alteration to the three schemes next year.

Nimit Tienudom, a committee member, said it was a good sign that the minister accepted the suggestions.

However, he said that as there would be a new committee to consider the suggestions, it should not leave any advice out because every suggestion is linked to others.

"It is very important that the improvement of the health security schemes must not decrease the existing benefits and it will not increase the burden on every beneficiaries," Nimit stressed.

He said it was up to the government to decide how to fund the system sufficiently and sustainably, but he suggested that by using VAT, it could help subsidise the system without raising money from co-payment.

"Everyone pays VAT on their daily life according to their ability to make purchases and this tax also brings in a lot of revenue. By increasing VAT or earmarking some of the VAT funds to subsidise health security, it can solve the financial problems of the health security schemes. And it is very fair to everyone," he said.

"I think health scheme reform can be done by this government."

Problems in funding the health schemes were highlighted in the committee's report. According to World Development Indicators 2015, government investment in healthcare increased from 10.4 per cent of all general government expenditure in 2001 to 17 per cent in 2013.

Moreover, it also stated that Thai people's general healthcare expenses rose from 3.4 per cent of gross domestic product in 2001 to 4.6 per cent in 2013. This increase was not high but the pace was more than economic growth over this period.

Dr Suwit Wibulpolprasert, head of the committee, said that in order to ensure the health security schemes are sustainable, funds can be raised through three ways.

The first choice would be co-payment into the schemes before benefits are used. This can be done by increasing contributions based on incomes with some difference between the schemes.

The second choice would be subsidising the schemes trough taxes, such as using revenue from VAT, and the last choice would be co-paying for treatments, he said.

Suwit added that care would have to be taken if the last choice is opted for because it might affect the poor and people with chronic diseases.

"The co-payment mechanism is not aimed at generating more income for the health security schemes, but to offer fair and just access to healthcare to everyone," Suwit said.

Meanwhile, Piyasakol said he would consider all suggestions and that a new committee, comprised of state and private sector representatives, and economists, would be handed the task.

"The committee should be ready after New Year and in 2016 there will be no changes in the UHC scheme until we can come up with something concrete by 2017," Piyasakol said.

Source: http://www.nationmultimedia.com/national/No-change-to-health-schemes-30275874.html

-- The Nation 2015-12-30

[Ricardo]

One would hope that funding for the scheme can eventually be improved, perhaps by an extra 'sin-tax', with the proceeds going to the hospital-system ?

Although this weakness was never really addressed properly by the several previous governments.

Meanwhile, at least they're not considering re-introducing the B30-charge, as some politicians might like to do.

[natway09]

Discussing how to make it feasible ????

One way to help would have been not to have given up to 15,000Bht back to the wealthy in the tax refund shopping bonanza..

Only the very wealthy would spend 215,000 Bht on gifts for the festive season.

So here is the Government doing another "Robin Hood"

[Balance]

I would like to sustain an addition to the "sin" tax: 3% tax added to every bill from foreign fast food shops. This would not be regressive since poor people either do not have access to McDonalds or Burger King of KFC, etc., or they cannot afford to go. A potential added benefit would be to stem the rapid rise in childhood obesity, early on-set high blood pressure, and diabetes. These diseases and those related to them are by far the highest contributors to the overall cost of health care. These foods should be treated in the same way as cigarettes; tax them.

[Solomon]

Hmmm.

Public health budget = 4.23%

Military budget = 7.5%

[micmichd]

What about a deal with a country that has a social security system based on incomes, but cannot afford good medical care for everyone at home due to high service costs?

[rubl]

Britain was still going ahead with its 'version'? The NHS has been offering free healthcare since the 50s.

"Publicly funded health care accounts for 83 per cent of total health care expenditure and reached an estimated £127.5 billion in 2013 (represented in 2015 prices, adjusted for inflation). This is a relatively high proportion compared to many other OECD member countries."

http://www.nuffieldtrust.org.uk/data-and-charts/uk-spending-public-and-private-health-care

Thailand doesn't spend this type of money on it's Healthcare Scheme nor is it rich enough to fund it like the British government can.

That means that something has to give.

BTW Britain population about 65 million, Thailand about 67 million.

[rubl]

Hmmm.

Public health budget = 4.23%

Military budget = 7.5%

Absolutely and who needs a defence anyway?

From the 20sh/3-sh:

http://www.collectienederland1940-1945.nl/images/041124100350.jpg

[bbbbooboo]

Global experience is that none of these "free" health schemes stay that way