Fears over aged-care costs
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With people living longer and Thailand moving towards an ageing society, the country is facing a rising cost burden for treating chronic diseases, which will keep rising unless agencies reform the financing of national healthcare, a summit was told yester
The country’s healthcare expenses are 4.5 per cent of gross domestic product, or about Bt257 billion this year, said Kulit Sombatsiri, inspector-general of the Ministry of Finance.
The cost is forecast to reach Bt590 billion or 6.25 per cent of GDP by 2028, said Jiraphan Kalaprawit, of the Social Development Strategy and Planning Office.
It is expected that the number of senior citizens aged over 60 will increase by 20 per cent in the next 15 years.
Kulit said: “The National Healthcare Financing Development Office [NHFDO] has provided a mechanism whereby the three healthcare schemes would work together, which would benefit overall healthcare management – helping increase their bargaining power and even sharing a diagnosis-related group.
“The NHFDO is preparing to propose the mechanism’s model to the government for consideration.”
The scheme is funded jointly by the Social Security Office, covering 9.4 million people working in the private sector; the Comptroller-General’s Department covering 4.96 million workers in the government sector; and the National Health Security Office (NHSO) covering 48.1 million people.
Different proposals were presented yesterday at the Thailand Healthcare Summit under the concept of sustainable national healthcare financing. The meeting at the Pullman Bangkok King Power Hotel sought proposals from agencies and stakeholders on how to deal with financing problems and other challenges the country is facing.
Shared payment between people and the government in different forms was proposed, including medical saving, deductible medical expenses and having local administrative organisations partially pay for people’s medical expenses.
The NHSO, the organisation that finances regional and general hospitals nationwide, has not paid the hospitals adequately – causing most, some 585 hospitals, to suffer losses, said Dr Prachumphorn Booncharoen, president of the Federation of Thailand Regional and General Hospital.
“We have evidence that the NHSO accumulated Bt54 billion over the past nine years, although it denied having that amount. Why has it not paid the hospitals more?” she asked.
Prachumphorn said that as a result, the federation demanded that the NHSO change its role – stop allocating money to the hospitals and buying medical items and medicine, and allow provinces to manage and allocate the money to their own hospitals.
Representatives from many agencies agreed that the Public Health Ministry should initiate a national campaign to promote disease prevention rather than curing them. More budget should be allocated to the Department of Health to run a health-promotion and disease-prevention campaign seriously. Doing so would help reduce treatment expenses.
Jiraphan said: “About 50 per cent of the elderly suffer from preventable diseases, including high blood pressure, diabetes and heart disease.”
Ramathibodi Hospital director Dr Than Supatarapun said physicians treating patients should be allowed to participate in budget management. As a result, they would understand their hospital’s financial situation and help manage limited budgets and resources.
