‘No change to health schemes’

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.