Officials unsure about reviving Bt30 scheme

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YINGLUCK GOVERNMENT

Officials unsure about reviving Bt30 scheme
By Phongphon Sarnsamak
Duangkamon Sajirawattanakul
The Nation 2011-07-11

The newly-elected government's public health policy to bring back the Bt30 copayment has left health officials and economists sceptical about whether it will work.

"It is just a return of a populist policy after it was totally eliminated by the military-appointed government in 2007," said Viroj na Ranong, a senior official at the Thailand Development Research Institute (TDRI), who conducted a study on the impact of the Bt30 health care scheme after its introduction in 2001.

"The new government should focus more on improving the quality of medical services rather than thinking about collecting Bt30 for medical care," he said.

The Bt30 health care scheme was implemented by the dissolved Thai Rak Thai party led by ex-premier Thaksin Shinawatra to provide universal health care coverage for all people not eligible for medical services under the Social Security Scheme and the Civil Servant Medical Benefit Scheme.

The breakthrough policy allowed nearly 48 million, especially in remote areas, access to medical services and to remove financial burdens.

However, the government has to allocate over Bt100 billion as the total annual budget for the National Health Security Office to run the universal health care scheme. Even though the government charged Bt30 for medical services, it could collect only Bt 1 billion, which was not enough to improve their quality.

The scheme was later abolished by the military junta-appointed government which made the universal health care scheme free.

During the general election campaign, the Pheu Thai Party announced it would bring the Bt30 copayment back, saying it would ensure good quality health care services.

"This money will be collected to buy medical devices and other products to treat patients," deputy leader Vichan Meenchaiyanant said.

Instead of collecting Bt30 for medical service charges, Viroj said the government should increase the amount of per head budget to provide medical services of a high quality.

Former Public Health Minister Dr Mongkol Na Songkla, who was appointed by the military junta, said bringing the Bt30 scheme back would not reduce the large number of patients at hospital.

If the new government wanted to go ahead with its plan, it should collect only money for outpatient services and provide free treatment for inpatient services.

"Some people could not afford to pay money for medical treatment for inpatient services," he said.

However, he asked the new government to focus on health promotion and prevention to improve the quality of people's health.

"This approach would reduce the financial burden," he said.

Meanwhile, Thailand Medical Council's deputy secretary-general Dr Itthaporn Kanachareon said the Bt30 co-payment health care scheme would help hospitals to screen patients who really needed treatment and to reduce t patient numbers.

In order to help people receive quality health care services, the government should divide people into two groups according to their tax payments. This would create a balance for the health care system.

Itthaporn said the amount of money collected from the Bt30 scheme would be only a small portion but it would be enough to improve the quality of drugs and develop medical services such as kidney dialysis centres. Moreover, the government could allocate this budget to help hospitals now facing financial crisis.

[isanbirder]

I think it was a mistake to give free treatment rather than the 30 baht 'copayment'.  The latter is not very much, but it would have deterred a lot of people from making frivolous hospital visits.  Anyway, for small sicknesses or accidents, most villages in this area are serviced by a free local clinic staffed by a trained nurse;  in our village, everyone knows the nurse, and admittedly the clinic is a gossip centre every morning, but if there is a need, it's quickly catered for.

[mario299]

I agree, in our area the villages all have their clinics and this takes care of the simple ailments. The hospitals should be for the people that need it, and if they need to charge a little co-payment for it, that has to help defray the costs.

I had the need for the gov't hospital twice over the last couple of years, and the treatment, service and quality were very good. If a little money could assist them to make it even better for the poor villagers, better for all.

[TELLBOY]

yes we have a small clinick which treats minoer things and gives kids there injections etc and this must relieve the main hospital of over crouding i went there on a few ocations and was treated for free so great. when i take my lady to hospital or someone else i just sit in ther car and i see there would be more room if the thais did not treat it as a day out for all the family 1 person sick but 12 in the pickup all enter the hospital and all want seats.

[mario299]

yes we have a small clinick which treats minoer things and gives kids there injections etc and this must relieve the main hospital of over crouding i went there on a few ocations and was treated for free so great. when i take my lady to hospital or someone else i just sit in ther car and i see there would be more room if the thais did not treat it as a day out for all the family 1 person sick but 12 in the pickup all enter the hospital and all want seats.

Just the same as shopping at Tesco or Big C, it's an EVENT for the whole family!