Hospitals defiant on medical plan
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Major private ones say policy on free emergency services still not clear
With more than 10 leading private hospitals still holding out over murky guidelines, the government's policy to allow citizens free access to emergency medical services from any provider is not going to happen by April 1.
“The government wants us to join its plan but it does not know about the real costs of emergency medical treatment,” Dr Pongsak Viddayakorn, director and executive adviser to Bangkok Dusit Medical Services, a major private hospital chain, said yesterday.
The hospitals are not happy with the reimbursement rates the government plans to offer.
Many of them have not confirmed their participation in the plan even though the government wants to kickstart it on Sunday so that patients will just need to show their national identification card to receive free treatment at the nearest hospital.
The chain operates the famous Bangkok Hospitals in various provinces.
Dr Kittisak Jirasottikuk, director of privately run Suphanimitrsena Hospital in Ayutthaya, believes premium private hospitals would have problems with the new plan relating to emergency medical services.
“Those already belonging to the universal healthcare and social security schemes won’t have any problem,” he said.
Indeed, Pongsak said that although his chain was going to join the plan, it would withdraw as soon as it realised that participation caused financial problems.
“Keeping private hospitals’ healthcare service fees at a low level especially for emergency treatment will risk patients’ lives,” he said.
“We strictly will not compromise the quality of services. It will hurt our standards. This is not about corporate social responsibility. It’s about the standard of care to save a patient’s life.”
Dr Khamphon Palassin, president of Chularat Hospital, said the government’s plan to provide unlimited emergency medical treatment under three healthcare schemes would affect private hospitals and the reimbursement rates were not enough to cover the service expenses, as they did not reflect the true cost.
The Social Security Office says it is ready to put Bt240 million into the plan, the Civil Servant Medical Benefit Scheme Bt400 million and the National Health Security Office (NHSO) Bt5 billion.
Today Prime Minister Yingluck Shinawatra will preside over the launch of the plan as the three agencies sign a memorandum of understanding at Government House.
Authorities have said they would pay attending hospitals at least Bt10,500 per condition. The reimbursement would rise according to how critical the condition is. For example, the rate could go well over Bt100,000 for a heart operation.
Dr Athaporn Limpanyalerd, director of the NHSO’s Claim Administration Bureau, said if the cost of treatment went beyond the approved rate, the hospitals would have to shoulder the difference.
“The approved rate can’t cover the actual cost of a heart operation,” Pongsak said.
Patients needing heart surgery at prestigious private hospitals usually pay about Bt395,000.
The rates should be based on the real cost of providing medical services, but those patients who can afford it should pay some portion for the best treatment possible, he said.
Dr Chalerm Hanpanich, president of the Private Hospital Association, complained that the government’s guidelines for the plan were still not clear enough.
“There are no clear reimbursement rates and payment periods. There is also no clear plan about the length of medical treatment for patients with emergency conditions,” he said.
Private hospitals want the government to give them sufficient guidelines so that they can manage their expenses.
“We need an effective system,” Chalerm said.
The government was always late in paying private hospitals in the past, he added.
Dr Winai Sawasdivorn, secretarygeneral of the NHSO, said the NHSO, which will act as the clearinghouse, has guaranteed private hospitals that they will get reimbursed within 15 days of sending their expense reports to the NHSO.
“Don’t worry about the reimbursement. We will not be late,” he said.
The upscale private hospitals will absolutely join the scheme, he said without revealing how many.
Last year, the NHSO spent Bt74 million to provide emergency treatment for 3,000 members of its universal healthcare scheme.
