Health insurance being pushed by NRC

MILLIONS OF Thais will lose their right to many kinds of free medical treatment under the universal healthcare scheme, if a proposal pushed by the National Reform Council (NRC) committee on public health is passed.
The proposal related to the setting up of the National Health Insurance Council will require a large number of people now covered by the universal health scheme to pay extra for medical services that are beyond the basic range.
“We believe all Thais should receive the same standard of basic and necessary medical services. But if their needs exceed that range, they should buy health insurance,” Pornpan Boonyarattapan said, in her capacity as chair of the NRC panel on public health.
She said those who can afford to pay should contribute to the cost of healthcare.
Pornpan was commenting on a bill that has caused a big stir in the health sector, as it seeks to set the same standard for all three major healthcare programmes and gears towards a merger of the three schemes.
Yesterday, Pornpan firmly insisted that her committee would not support merging of the three health schemes.
The biggest healthcare programme in the country is the universal healthcare scheme, which covers 49 million people. With a budget of well over Bt150 billion a year, it offers most medical treatments for free. Two other major health programmes are the social security scheme, which uses a budget of about Bt40 billion a year, and the medical benefit programme for civil servants and their family members, which uses a budget of about Bt60 billion a year.
Thailand Development Research Institute (TDRI), which has played a role in drafting the bill, revealed recently that the mortality rate is higher among people in the universal health scheme, compared to the two other schemes.
TDRI describes the setting up of the National Health Insurance Council as a mechanism to reduce gaps among health programmes. The bill seeks to allocate 0.5 per cent of the country’s healthcare budget to the council, which is expected to merge the three health schemes.
Pornpan made clear yesterday that she did not agree with the provision of completely free medical treatment. She said treatments that are beyond the basic would only be free for those who could not afford to pay. People who can afford it would have to buy health insurance, she said. This would mark the start of a co-payment system, if her committee’s proposal goes ahead.
“In fact, nearly 30 million people covered by the universal healthcare scheme can afford healthcare insurance,” Pornpan said. Thailand should not fund its healthcare programme solely through tax on income, she said.
Pol Major Romayong Surakit-bunharn, deputy secretary general of the Social Security Office, said the Social Security Board would discuss the bill at its meeting next month.
Managing director of the Government Pharmaceutical Organisation Nopporn Cheanklin said earlier that co-payment must be introduced – or Thailand’s health security system would collapse.
“Look at the rising cost,” he said, “And the cost will soar even further after Thailand fully becomes an ageing society.”
Nopporn said Thailand should learn from Australia, where a range of co-payment options is made available.
In a related development, Prof Dr Apiwat Mutirangura of Chulalongkorn University told a forum yesterday that the National Health Security Office – which runs the universal healthcare scheme – should tell society that not all treatments can be free. “With people believing that treatments are completely free, there have been a huge number of patients at hospitals. With huge workloads, it becomes more difficult for doctors to detect complicated diseases,” he said.